Influenza in Poland in 2013 and 2013/2014 epidemic season

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Kondratiuk, Katarzyna; Czarkowski, Mirosław P; Hallmann-Szelińska, Ewelina; Staszewska, Ewa; Bednarska, Karolina; Cielebąk, Ewa; Brydak, Lidia B

2016-01-01

Analysis of epidemiological situation of influenza in Poland in 2013 and 2013/14 epidemic season in reference to previous years and seasons. Analysis was based on: 1) data collected within influenza routine surveillance system in Poland, including data published in annual bulletins “Infectious diseases and poisonings in Poland” as well as unpublished data gathered in the Department of Epidemiology of the NIPH-NIH; 2) data collected within influenza system - Sentinel, and beyond this system, concerning results of virological tests carried out in 2013/14 epidemic season in the Department of Influenza Research, National Influenza Center in the NIPHNIH and/or laboratories of provincial sanitary and epidemiological stations which are gathered in the National Influenza Center. Compared to 2012, the number of influenza and influenza-like cases increased more than twofold in 2013 in Poland. A total of 3 164 405 cases were reported. Incidence was 8 218.7 per 100,000 population (33 733.2 in 0-4 age group). As many as 0.45% of patients were referred to hospitals. According to the data of the Central Statistical Office, 115 deaths due to influenza were notified. Based on the data of the sanitary inspection (incomplete data), the percentage of population vaccinated against influenza was 2.4% (7.7% of persons aged more than 64 years). A total of 2 780 945 cases were registered in 2013/14 epidemic season. Its peak was reported in March 2014. Incidence was 7 224.0 per 100,000 population (35 172.8 in 0-4 age group). Compared to 2012/13 epidemic season, it was lower by 8.0%. Incidence rates ranged from 29 339.6 in pomorskie voivodeship to 1 306.5 in lubuskie voivodeship. Nearly a half of all cases (48.7%) were registered in children and adolescents up to 15 years. As many as 0.34% of patients were referred to hospitals (0.87% of persons aged more than 64 years). From the data of the Central Statistical Office transpires that 8 deaths due to influenza were reported in epidemic

Increases in absenteeism among health care workers in Hong Kong during influenza epidemics, 2004-2009.

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Ip, Dennis K M; Lau, Eric H Y; Tam, Yat Hung; So, Hau Chi; Cowling, Benjamin J; Kwok, Henry K H

2015-12-29

Acute respiratory infections (ARI) are a major cause of sickness absenteeism among health care workers (HCWs) and contribute significantly to overall productivity loss particularly during influenza epidemics. The purpose of this study is to quantify the increases in absenteeism during epidemics including the 2009 influenza A(H1N1)pdm09 pandemic. We analysed administrative data to determine patterns of sickness absence among HCWs in Hong Kong from January 2004 through December 2009, and used multivariable linear regression model to estimate the excess all-cause and ARI-related sickness absenteeism rates during influenza epidemics. We found that influenza epidemics prior to the 2009 pandemic and during the 2009 pandemic were associated with 8.4 % (95 % CI: 5.6-11.2 %) and 57.7 % (95 % CI: 54.6-60.9 %) increases in overall sickness absence, and 26.5 % (95 % CI: 21.4-31.5 %) and 90.9 % (95 % CI: 85.2-96.6 %) increases in ARI-related sickness absence among HCWs in Hong Kong, respectively. Comparing different staff types, increases in overall absenteeism were highest among medical staff, during seasonal influenza epidemic periods (51.3 %, 95 % CI: 38.9-63.7 %) and the pandemic mitigation period (142.1 %, 95 % CI: 128.0-156.1 %). Influenza epidemics were associated with a substantial increase in sickness absence and productivity loss among HCWs in Hong Kong, and there was a much higher rate of absenteeism during the 2009 pandemic. These findings could inform better a more proactive workforce redistribution plans to allow for sufficient surge capacity in annual epidemics, and for pandemic preparedness.

The role of subway travel in an influenza epidemic: a New York City simulation.

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Cooley, Philip; Brown, Shawn; Cajka, James; Chasteen, Bernadette; Ganapathi, Laxminarayana; Grefenstette, John; Hollingsworth, Craig R; Lee, Bruce Y; Levine, Burton; Wheaton, William D; Wagener, Diane K

2011-10-01

The interactions of people using public transportation in large metropolitan areas may help spread an influenza epidemic. An agent-based model computer simulation of New York City's (NYC's) five boroughs was developed that incorporated subway ridership into a Susceptible-Exposed-Infected-Recovered disease model framework. The model contains a total of 7,847,465 virtual people. Each person resides in one of the five boroughs of NYC and has a set of socio-demographic characteristics and daily behaviors that include age, sex, employment status, income, occupation, and household location and membership. The model simulates the interactions of subway riders with their workplaces, schools, households, and community activities. It was calibrated using historical data from the 1957-1958 influenza pandemics and from NYC travel surveys. The surveys were necessary to enable inclusion of subway riders into the model. The model results estimate that if influenza did occur in NYC with the characteristics of the 1957-1958 pandemic, 4% of transmissions would occur on the subway. This suggests that interventions targeted at subway riders would be relatively ineffective in containing the epidemic. A number of hypothetical examples demonstrate this feature. This information could prove useful to public health officials planning responses to epidemics.

Model-Based Comprehensive Analysis of School Closure Policies for Mitigating Influenza Epidemics and Pandemics.

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Fumanelli, Laura; Ajelli, Marco; Merler, Stefano; Ferguson, Neil M; Cauchemez, Simon

2016-01-01

School closure policies are among the non-pharmaceutical measures taken into consideration to mitigate influenza epidemics and pandemics spread. However, a systematic review of the effectiveness of alternative closure policies has yet to emerge. Here we perform a model-based analysis of four types of school closure, ranging from the nationwide closure of all schools at the same time to reactive gradual closure, starting from class-by-class, then grades and finally the whole school. We consider policies based on triggers that are feasible to monitor, such as school absenteeism and national ILI surveillance system. We found that, under specific constraints on the average number of weeks lost per student, reactive school-by-school, gradual, and county-wide closure give comparable outcomes in terms of optimal infection attack rate reduction, peak incidence reduction or peak delay. Optimal implementations generally require short closures of one week each; this duration is long enough to break the transmission chain without leading to unnecessarily long periods of class interruption. Moreover, we found that gradual and county closures may be slightly more easily applicable in practice as they are less sensitive to the value of the excess absenteeism threshold triggering the start of the intervention. These findings suggest that policy makers could consider school closure policies more diffusely as response strategy to influenza epidemics and pandemics, and the fact that some countries already have some experience of gradual or regional closures for seasonal influenza outbreaks demonstrates that logistic and feasibility challenges of school closure strategies can be to some extent overcome.

Non-stationary dynamics of climate variability in synchronous influenza epidemics in Japan

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Onozuka, Daisuke; Hagihara, Akihito

2015-09-01

Seasonal variation in the incidence of influenza is widely assumed. However, few studies have examined non-stationary relationships between global climate factors and influenza epidemics. We examined the monthly incidence of influenza in Fukuoka, Japan, from 2000 to 2012 using cross-wavelet coherency analysis to assess the patterns of associations between indices for the Indian Ocean Dipole (IOD) and El Niño Southern Oscillation (ENSO). The monthly incidence of influenza showed cycles of 1 year with the IOD and 2 years with ENSO indices (Multivariate, Niño 4, and Niño 3.4). These associations were non-stationary and appeared to have major influences on the synchrony of influenza epidemics. Our study provides quantitative evidence that non-stationary associations have major influences on synchrony between the monthly incidence of influenza and the dynamics of the IOD and ENSO. Our results call for the consideration of non-stationary patterns of association between influenza cases and climatic factors in early warning systems.

Surveillance and vaccine effectiveness of an influenza epidemic predominated by vaccine-mismatched influenza B/Yamagata-lineage viruses in Taiwan, 2011-12 season.

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Yi-Chun Lo

Full Text Available INTRODUCTION: The 2011-12 trivalent influenza vaccine contains a strain of influenza B/Victoria-lineage viruses. Despite free provision of influenza vaccine among target populations, an epidemic predominated by influenza B/Yamagata-lineage viruses occurred during the 2011-12 season in Taiwan. We characterized this vaccine-mismatched epidemic and estimated influenza vaccine effectiveness (VE. METHODS: Influenza activity was monitored through sentinel viral surveillance, emergency department (ED and outpatient influenza-like illness (ILI syndromic surveillance, and case-based surveillance of influenza with complications and deaths. VE against laboratory-confirmed influenza was evaluated through a case-control study on ILI patients enrolled into sentinel viral surveillance. Logistic regression was used to estimate VE adjusted for confounding factors. RESULTS: During July 2011-June 2012, influenza B accounted for 2,382 (72.5% of 3,285 influenza-positive respiratory specimens. Of 329 influenza B viral isolates with antigen characterization, 287 (87.2% were B/Yamagata-lineage viruses. Proportions of ED and outpatient visits being ILI-related increased from November 2011 to January 2012. Of 1,704 confirmed cases of influenza with complications, including 154 (9.0% deaths, influenza B accounted for 1,034 (60.7% of the confirmed cases and 103 (66.9% of the deaths. Reporting rates of confirmed influenza with complications and deaths were 73.5 and 6.6 per 1,000,000, respectively, highest among those aged ≥65 years, 50-64 years, 3-6 years, and 0-2 years. Adjusted VE was -31% (95% CI: -80, 4 against all influenza, 54% (95% CI: 3, 78 against influenza A, and -66% (95% CI: -132, -18 against influenza B. CONCLUSIONS: This influenza epidemic in Taiwan was predominated by B/Yamagata-lineage viruses unprotected by the 2011-12 trivalent vaccine. The morbidity and mortality of this vaccine-mismatched epidemic warrants careful consideration of introducing a

Recurrent dynamics in an epidemic model due to stimulated bifurcation crossovers

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Juanico, Drandreb Earl [Department of Mathematics, Ateneo de Manila University, Loyola Heights, Quezon City, Philippines 1108 (Philippines); National Institute of Physics, University of the Philippines, Diliman, Quezon City, Philippines 1101 (Philippines)

2015-05-15

Epidemics are known to persist in the form of recurrence cycles. Despite intervention efforts through vaccination and targeted social distancing, peaks of activity for infectious diseases like influenza reappear over time. Analysis of a stochastic model is here undertaken to explore a proposed cycle-generating mechanism – the bifurcation crossover. Time series from simulations of the model exhibit oscillations similar to the temporal signature of influenza activity. Power-spectral density indicates a resonant frequency, which corresponds to the annual seasonality of influenza in temperate zones. The study finds that intervention actions influence the extinguishability of epidemic activity. Asymptotic solution to a backward Kolmogorov equation corresponds to a mean extinction time that is a function of both intervention efficacy and population size. Intervention efficacy must be greater than a certain threshold to increase the chances of extinguishing the epidemic. Agreement of the model with several phenomenological features of epidemic cycles lends to it a tractability that may serve as early warning of imminent outbreaks.

Recurrent dynamics in an epidemic model due to stimulated bifurcation crossovers

International Nuclear Information System (INIS)

Juanico, Drandreb Earl

2015-01-01

Epidemics are known to persist in the form of recurrence cycles. Despite intervention efforts through vaccination and targeted social distancing, peaks of activity for infectious diseases like influenza reappear over time. Analysis of a stochastic model is here undertaken to explore a proposed cycle-generating mechanism – the bifurcation crossover. Time series from simulations of the model exhibit oscillations similar to the temporal signature of influenza activity. Power-spectral density indicates a resonant frequency, which corresponds to the annual seasonality of influenza in temperate zones. The study finds that intervention actions influence the extinguishability of epidemic activity. Asymptotic solution to a backward Kolmogorov equation corresponds to a mean extinction time that is a function of both intervention efficacy and population size. Intervention efficacy must be greater than a certain threshold to increase the chances of extinguishing the epidemic. Agreement of the model with several phenomenological features of epidemic cycles lends to it a tractability that may serve as early warning of imminent outbreaks

Nonlinear dynamics of avian influenza epidemic models.

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Liu, Sanhong; Ruan, Shigui; Zhang, Xinan

2017-01-01

Avian influenza is a zoonotic disease caused by the transmission of the avian influenza A virus, such as H5N1 and H7N9, from birds to humans. The avian influenza A H5N1 virus has caused more than 500 human infections worldwide with nearly a 60% death rate since it was first reported in Hong Kong in 1997. The four outbreaks of the avian influenza A H7N9 in China from March 2013 to June 2016 have resulted in 580 human cases including 202 deaths with a death rate of nearly 35%. In this paper, we construct two avian influenza bird-to-human transmission models with different growth laws of the avian population, one with logistic growth and the other with Allee effect, and analyze their dynamical behavior. We obtain a threshold value for the prevalence of avian influenza and investigate the local or global asymptotical stability of each equilibrium of these systems by using linear analysis technique or combining Liapunov function method and LaSalle's invariance principle, respectively. Moreover, we give necessary and sufficient conditions for the occurrence of periodic solutions in the avian influenza system with Allee effect of the avian population. Numerical simulations are also presented to illustrate the theoretical results. Copyright © 2016 Elsevier Inc. All rights reserved.

Accurate estimation of influenza epidemics using Google search data via ARGO.

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Yang, Shihao; Santillana, Mauricio; Kou, S C

2015-11-24

Accurate real-time tracking of influenza outbreaks helps public health officials make timely and meaningful decisions that could save lives. We propose an influenza tracking model, ARGO (AutoRegression with GOogle search data), that uses publicly available online search data. In addition to having a rigorous statistical foundation, ARGO outperforms all previously available Google-search-based tracking models, including the latest version of Google Flu Trends, even though it uses only low-quality search data as input from publicly available Google Trends and Google Correlate websites. ARGO not only incorporates the seasonality in influenza epidemics but also captures changes in people's online search behavior over time. ARGO is also flexible, self-correcting, robust, and scalable, making it a potentially powerful tool that can be used for real-time tracking of other social events at multiple temporal and spatial resolutions.

On avian influenza epidemic models with time delay.

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Liu, Sanhong; Ruan, Shigui; Zhang, Xinan

2015-12-01

After the outbreak of the first avian influenza A virus (H5N1) in Hong Kong in 1997, another avian influenza A virus (H7N9) crossed the species barrier in mainland China in 2013 and 2014 and caused more than 400 human cases with a death rate of nearly 40%. In this paper, we take account of the incubation periods of avian influenza A virus and construct a bird-to-human transmission model with different time delays in the avian and human populations combining the survival probability of the infective avian and human populations at the latent time. By analyzing the dynamical behavior of the model, we obtain a threshold value for the prevalence of avian influenza and investigate local and global asymptotical stability of equilibria of the system.

Phylogenetic and evolutionary history of influenza B viruses, which caused a large epidemic in 2011-2012, Taiwan.

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Ji-Rong Yang

Full Text Available The annual recurrence of the influenza epidemic is considered to be primarily associated with immune escape due to changes to the virus. In 2011-2012, the influenza B epidemic in Taiwan was unusually large, and influenza B was predominant for a long time. To investigate the genetic dynamics of influenza B viruses during the 2011-2012 epidemic, we analyzed the sequences of 4,386 influenza B viruses collected in Taiwan from 2004 to 2012. The data provided detailed insight into the flux patterns of multiple genotypes. We found that a re-emergent TW08-I virus, which was the major genotype and had co-circulated with the two others, TW08-II and TW08-III, from 2007 to 2009 in Taiwan, successively overtook TW08-II in March and then underwent a lineage switch in July 2011. This lineage switch was followed by the large epidemic in Taiwan. The whole-genome compositions and phylogenetic relationships of the representative viruses of various genotypes were compared to determine the viral evolutionary histories. We demonstrated that the large influenza B epidemic of 2011-2012 was caused by Yamagata lineage TW08-I viruses that were derived from TW04-II viruses in 2004-2005 through genetic drifts without detectable reassortments. The TW08-I viruses isolated in both 2011-2012 and 2007-2009 were antigenically similar, indicating that an influenza B virus have persisted for 5 years in antigenic stasis before causing a large epidemic. The results suggest that in addition to the emergence of new variants with mutations or reassortments, other factors, including the interference of multi-types or lineages of influenza viruses and the accumulation of susceptible hosts, can also affect the scale and time of an influenza B epidemic.

Novel measurement of spreading pattern of influenza epidemic by using weighted standard distance method: retrospective spatial statistical study of influenza, Japan, 1999-2009.

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Shobugawa, Yugo; Wiafe, Seth A; Saito, Reiko; Suzuki, Tsubasa; Inaida, Shinako; Taniguchi, Kiyosu; Suzuki, Hiroshi

2012-06-19

Annual influenza epidemics occur worldwide resulting in considerable morbidity and mortality. Spreading pattern of influenza is not well understood because it is often hampered by the quality of surveillance data that limits the reliability of analysis. In Japan, influenza is reported on a weekly basis from 5,000 hospitals and clinics nationwide under the scheme of the National Infectious Disease Surveillance. The collected data are available to the public as weekly reports which were summarized into number of patient visits per hospital or clinic in each of the 47 prefectures. From this surveillance data, we analyzed the spatial spreading patterns of influenza epidemics using weekly weighted standard distance (WSD) from the 1999/2000 through 2008/2009 influenza seasons in Japan. WSD is a single numerical value representing the spatial compactness of influenza outbreak, which is small in case of clustered distribution and large in case of dispersed distribution. We demonstrated that the weekly WSD value or the measure of spatial compactness of the distribution of reported influenza cases, decreased to its lowest value before each epidemic peak in nine out of ten seasons analyzed. The duration between the lowest WSD week and the peak week of influenza cases ranged from minus one week to twenty weeks. The duration showed significant negative association with the proportion of influenza A/H3N2 cases in early phase of each outbreak (correlation coefficient was -0.75, P = 0.012) and significant positive association with the proportion of influenza B cases in the early phase (correlation coefficient was 0.64, P = 0.045), but positively correlated with the proportion of influenza A/H1N1 strain cases (statistically not significant). It is assumed that the lowest WSD values just before influenza peaks are due to local outbreak which results in small standard distance values. As influenza cases disperse nationwide and an epidemic reaches its peak, WSD value changed to be a

Novel measurement of spreading pattern of influenza epidemic by using weighted standard distance method: retrospective spatial statistical study of influenza, Japan, 1999–2009

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Shobugawa Yugo

2012-06-01

Full Text Available Abstract Background Annual influenza epidemics occur worldwide resulting in considerable morbidity and mortality. Spreading pattern of influenza is not well understood because it is often hampered by the quality of surveillance data that limits the reliability of analysis. In Japan, influenza is reported on a weekly basis from 5,000 hospitals and clinics nationwide under the scheme of the National Infectious Disease Surveillance. The collected data are available to the public as weekly reports which were summarized into number of patient visits per hospital or clinic in each of the 47 prefectures. From this surveillance data, we analyzed the spatial spreading patterns of influenza epidemics using weekly weighted standard distance (WSD from the 1999/2000 through 2008/2009 influenza seasons in Japan. WSD is a single numerical value representing the spatial compactness of influenza outbreak, which is small in case of clustered distribution and large in case of dispersed distribution. Results We demonstrated that the weekly WSD value or the measure of spatial compactness of the distribution of reported influenza cases, decreased to its lowest value before each epidemic peak in nine out of ten seasons analyzed. The duration between the lowest WSD week and the peak week of influenza cases ranged from minus one week to twenty weeks. The duration showed significant negative association with the proportion of influenza A/H3N2 cases in early phase of each outbreak (correlation coefficient was −0.75, P = 0.012 and significant positive association with the proportion of influenza B cases in the early phase (correlation coefficient was 0.64, P = 0.045, but positively correlated with the proportion of influenza A/H1N1 strain cases (statistically not significant. It is assumed that the lowest WSD values just before influenza peaks are due to local outbreak which results in small standard distance values. As influenza cases disperse nationwide and an

Novel measurement of spreading pattern of influenza epidemic by using weighted standard distance method: retrospective spatial statistical study of influenza, Japan, 1999–2009

Science.gov (United States)

2012-01-01

Background Annual influenza epidemics occur worldwide resulting in considerable morbidity and mortality. Spreading pattern of influenza is not well understood because it is often hampered by the quality of surveillance data that limits the reliability of analysis. In Japan, influenza is reported on a weekly basis from 5,000 hospitals and clinics nationwide under the scheme of the National Infectious Disease Surveillance. The collected data are available to the public as weekly reports which were summarized into number of patient visits per hospital or clinic in each of the 47 prefectures. From this surveillance data, we analyzed the spatial spreading patterns of influenza epidemics using weekly weighted standard distance (WSD) from the 1999/2000 through 2008/2009 influenza seasons in Japan. WSD is a single numerical value representing the spatial compactness of influenza outbreak, which is small in case of clustered distribution and large in case of dispersed distribution. Results We demonstrated that the weekly WSD value or the measure of spatial compactness of the distribution of reported influenza cases, decreased to its lowest value before each epidemic peak in nine out of ten seasons analyzed. The duration between the lowest WSD week and the peak week of influenza cases ranged from minus one week to twenty weeks. The duration showed significant negative association with the proportion of influenza A/H3N2 cases in early phase of each outbreak (correlation coefficient was −0.75, P = 0.012) and significant positive association with the proportion of influenza B cases in the early phase (correlation coefficient was 0.64, P = 0.045), but positively correlated with the proportion of influenza A/H1N1 strain cases (statistically not significant). It is assumed that the lowest WSD values just before influenza peaks are due to local outbreak which results in small standard distance values. As influenza cases disperse nationwide and an epidemic reaches its peak

Parameter Scaling for Epidemic Size in a Spatial Epidemic Model with Mobile Individuals.

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Chiyori T Urabe

Full Text Available In recent years, serious infectious diseases tend to transcend national borders and widely spread in a global scale. The incidence and prevalence of epidemics are highly influenced not only by pathogen-dependent disease characteristics such as the force of infection, the latent period, and the infectious period, but also by human mobility and contact patterns. However, the effect of heterogeneous mobility of individuals on epidemic outcomes is not fully understood. Here, we aim to elucidate how spatial mobility of individuals contributes to the final epidemic size in a spatial susceptible-exposed-infectious-recovered (SEIR model with mobile individuals in a square lattice. After illustrating the interplay between the mobility parameters and the other parameters on the spatial epidemic spreading, we propose an index as a function of system parameters, which largely governs the final epidemic size. The main contribution of this study is to show that the proposed index is useful for estimating how parameter scaling affects the final epidemic size. To demonstrate the effectiveness of the proposed index, we show that there is a positive correlation between the proposed index computed with the real data of human airline travels and the actual number of positive incident cases of influenza B in the entire world, implying that the growing incidence of influenza B is attributed to increased human mobility.

Sickness absenteeism rate in Iranian schools during the 2009 epidemic of type a influenza.

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Pourabbasi, Ata; Shirvani, Mahbubeh Ebrahimnegad; Khashayar, Patricia

2012-02-01

Influenza pandemic was a global event in 2009 and intraschool transmission was its main spread method. The present study was designed to evaluate the absenteeism rate during the type A influenza epidemic. Four hundred and eight students from both a guidance school and high school in the Iranian capital were recruited in this retrospective study. The number of days of absenteeism, since the beginning of the school year until the end of the epidemic was recorded. Two hundred and thirteen students missed school during the disease epidemic because of related causes. In other words, 581 person day absences were reported during this period. The influenza pandemic has led to an increase in the absenteeism rate and may negatively affect the academic performance of the students. Teaching precautionary measures is an effective tool in reducing the number of days of sickness.

Modeling Influenza Transmission Using Environmental Parameters

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Soebiyanto, Radina P.; Kiang, Richard K.

2010-01-01

Influenza is an acute viral respiratory disease that has significant mortality, morbidity and economic burden worldwide. It infects approximately 5-15% of the world population, and causes 250,000 500,000 deaths each year. The role of environments on influenza is often drawn upon the latitude variability of influenza seasonality pattern. In regions with temperate climate, influenza epidemics exhibit clear seasonal pattern that peak during winter months, but it is not as evident in the tropics. Toward this end, we developed mathematical model and forecasting capabilities for influenza in regions characterized by warm climate Hong Kong (China) and Maricopa County (Arizona, USA). The best model for Hong Kong uses Land Surface Temperature (LST), precipitation and relative humidity as its covariates. Whereas for Maricopa County, we found that weekly influenza cases can be best modelled using mean air temperature as its covariates. Our forecasts can further guides public health organizations in targeting influenza prevention and control measures such as vaccination.

Different responses of influenza epidemic to weather factors among Shanghai, Hong Kong, and British Columbia.

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Wang, Xi-Ling; Yang, Lin; He, Dai-Hai; Chiu, Alice Py; Chan, Kwok-Hung; Chan, King-Pan; Zhou, Maigeng; Wong, Chit-Ming; Guo, Qing; Hu, Wenbiao

2017-06-01

Weather factors have long been considered as key sources for regional heterogeneity of influenza seasonal patterns. As influenza peaks coincide with both high and low temperature in subtropical cities, weather factors may nonlinearly or interactively affect influenza activity. This study aims to assess the nonlinear and interactive effects of weather factors with influenza activity and compare the responses of influenza epidemic to weather factors in two subtropical regions of southern China (Shanghai and Hong Kong) and one temperate province of Canada (British Columbia). Weekly data on influenza activity and weather factors (i.e., mean temperature and relative humidity (RH)) were obtained from pertinent government departments for the three regions. Absolute humidity (AH) was measured by vapor pressure (VP), which could be converted from temperature and RH. Generalized additive models were used to assess the exposure-response relationship between weather factors and influenza virus activity. Interactions of weather factors were further assessed by bivariate response models and stratification analyses. The exposure-response curves of temperature and VP, but not RH, were consistent among three regions/cities. Bivariate response model revealed a significant interactive effect between temperature (or VP) and RH (P weather factors in developing a universal model to explain seasonal outbreaks of influenza. However, further research is needed to assess the association between weather factors and influenza activity in a wider context of social and environmental conditions.

Global Dynamics of Avian Influenza Epidemic Models with Psychological Effect

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Sanhong Liu

2015-01-01

Full Text Available Cross-sectional surveys conducted in Thailand and China after the outbreaks of the avian influenza A H5N1 and H7N9 viruses show a high degree of awareness of human avian influenza in both urban and rural populations, a higher level of proper hygienic practice among urban residents, and in particular a dramatically reduced number of visits to live markets in urban population after the influenza A H7N9 outbreak in China in 2013. In this paper, taking into account the psychological effect toward avian influenza in the human population, a bird-to-human transmission model in which the avian population exhibits saturation effect is constructed. The dynamical behavior of the model is studied by using the basic reproduction number. The results demonstrate that the saturation effect within avian population and the psychological effect in human population cannot change the stability of equilibria but can affect the number of infected humans if the disease is prevalent. Numerical simulations are given to support the theoretical results and sensitivity analyses of the basic reproduction number in terms of model parameters that are performed to seek for effective control measures for avian influenza.

Global dynamics of avian influenza epidemic models with psychological effect.

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Liu, Sanhong; Pang, Liuyong; Ruan, Shigui; Zhang, Xinan

2015-01-01

Cross-sectional surveys conducted in Thailand and China after the outbreaks of the avian influenza A H5N1 and H7N9 viruses show a high degree of awareness of human avian influenza in both urban and rural populations, a higher level of proper hygienic practice among urban residents, and in particular a dramatically reduced number of visits to live markets in urban population after the influenza A H7N9 outbreak in China in 2013. In this paper, taking into account the psychological effect toward avian influenza in the human population, a bird-to-human transmission model in which the avian population exhibits saturation effect is constructed. The dynamical behavior of the model is studied by using the basic reproduction number. The results demonstrate that the saturation effect within avian population and the psychological effect in human population cannot change the stability of equilibria but can affect the number of infected humans if the disease is prevalent. Numerical simulations are given to support the theoretical results and sensitivity analyses of the basic reproduction number in terms of model parameters that are performed to seek for effective control measures for avian influenza.

Estimation of sickness absenteeism among Italian healthcare workers during seasonal influenza epidemics.

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Maria Michela Gianino

Full Text Available To analyze absenteeism among healthcare workers (HCWs at a large Italian hospital and to estimate the increase in absenteeism that occurred during seasonal flu periods.Retrospective observational study.The absenteeism data were divided into three "epidemic periods," starting at week 42 of one year and terminating at week 17 of the following year (2010-2011, 2011-2012, 2012-2013, and three "non-epidemic periods," defined as week 18 to week 41 and used as baseline data. The excess of the absenteeism occurring among HCWs during periods of epidemic influenza in comparison with baseline was estimated. All data, obtained from Hospital's databases, were collected for each of the following six job categories: medical doctors, technical executives (i.e., pharmacists, nurses and allied health professionals (i.e., radiographers, other executives (i.e., engineers, nonmedical support staff, and administrative staff. The HCWs were classified by: in and no-contact; vaccinated and unvaccinated.5,544, 5,369, and 5,291 workers in three years were studied. The average duration of absenteeism during the epidemic periods increased among all employees by +2.07 days/person (from 2.99 to 5.06, and the relative increase ranged from 64-94% among the different job categories. Workers not in contact with patients experienced a slightly greater increase in absenteeism (+2.28 days/person, from 2.73 to 5.01 than did employees in contact with patients (+2.04, from 3.04 to 5.08. The vaccination rate among HCWs was below 3%, however the higher excess of absenteeism rate among unvaccinated in comparison with vaccinated workers was observed during the epidemic periods (2.09 vs 1.45 days/person.The influenza-related absenteeism during epidemic periods was quantified as totaling more than 11,000 days/year at the Italian hospital studied. This result confirms the economic impact of sick leave on healthcare systems and stresses on the necessity of encouraging HCWs to be immunized

Estimation of sickness absenteeism among Italian healthcare workers during seasonal influenza epidemics.

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Gianino, Maria Michela; Politano, Gianfranco; Scarmozzino, Antonio; Charrier, Lorena; Testa, Marco; Giacomelli, Sebastian; Benso, Alfredo; Zotti, Carla Maria

2017-01-01

To analyze absenteeism among healthcare workers (HCWs) at a large Italian hospital and to estimate the increase in absenteeism that occurred during seasonal flu periods. Retrospective observational study. The absenteeism data were divided into three "epidemic periods," starting at week 42 of one year and terminating at week 17 of the following year (2010-2011, 2011-2012, 2012-2013), and three "non-epidemic periods," defined as week 18 to week 41 and used as baseline data. The excess of the absenteeism occurring among HCWs during periods of epidemic influenza in comparison with baseline was estimated. All data, obtained from Hospital's databases, were collected for each of the following six job categories: medical doctors, technical executives (i.e., pharmacists), nurses and allied health professionals (i.e., radiographers), other executives (i.e., engineers), nonmedical support staff, and administrative staff. The HCWs were classified by: in and no-contact; vaccinated and unvaccinated. 5,544, 5,369, and 5,291 workers in three years were studied. The average duration of absenteeism during the epidemic periods increased among all employees by +2.07 days/person (from 2.99 to 5.06), and the relative increase ranged from 64-94% among the different job categories. Workers not in contact with patients experienced a slightly greater increase in absenteeism (+2.28 days/person, from 2.73 to 5.01) than did employees in contact with patients (+2.04, from 3.04 to 5.08). The vaccination rate among HCWs was below 3%, however the higher excess of absenteeism rate among unvaccinated in comparison with vaccinated workers was observed during the epidemic periods (2.09 vs 1.45 days/person). The influenza-related absenteeism during epidemic periods was quantified as totaling more than 11,000 days/year at the Italian hospital studied. This result confirms the economic impact of sick leave on healthcare systems and stresses on the necessity of encouraging HCWs to be immunized against

Real-time forecasting of an epidemic using a discrete time stochastic model: a case study of pandemic influenza (H1N1-2009

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Nishiura Hiroshi

2011-02-01

Full Text Available Abstract Background Real-time forecasting of epidemics, especially those based on a likelihood-based approach, is understudied. This study aimed to develop a simple method that can be used for the real-time epidemic forecasting. Methods A discrete time stochastic model, accounting for demographic stochasticity and conditional measurement, was developed and applied as a case study to the weekly incidence of pandemic influenza (H1N1-2009 in Japan. By imposing a branching process approximation and by assuming the linear growth of cases within each reporting interval, the epidemic curve is predicted using only two parameters. The uncertainty bounds of the forecasts are computed using chains of conditional offspring distributions. Results The quality of the forecasts made before the epidemic peak appears largely to depend on obtaining valid parameter estimates. The forecasts of both weekly incidence and final epidemic size greatly improved at and after the epidemic peak with all the observed data points falling within the uncertainty bounds. Conclusions Real-time forecasting using the discrete time stochastic model with its simple computation of the uncertainty bounds was successful. Because of the simplistic model structure, the proposed model has the potential to additionally account for various types of heterogeneity, time-dependent transmission dynamics and epidemiological details. The impact of such complexities on forecasting should be explored when the data become available as part of the disease surveillance.

Gnarled-trunk evolutionary model of influenza A virus hemagglutinin.

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Kimihito Ito

Full Text Available Human influenza A viruses undergo antigenic changes with gradual accumulation of amino acid substitutions on the hemagglutinin (HA molecule. A strong antigenic mismatch between vaccine and epidemic strains often requires the replacement of influenza vaccines worldwide. To establish a practical model enabling us to predict the future direction of the influenza virus evolution, relative distances of amino acid sequences among past epidemic strains were analyzed by multidimensional scaling (MDS. We found that human influenza viruses have evolved along a gnarled evolutionary pathway with an approximately constant curvature in the MDS-constructed 3D space. The gnarled pathway indicated that evolution on the trunk favored multiple substitutions at the same amino acid positions on HA. The constant curvature was reasonably explained by assuming that the rate of amino acid substitutions varied from one position to another according to a gamma distribution. Furthermore, we utilized the estimated parameters of the gamma distribution to predict the amino acid substitutions on HA in subsequent years. Retrospective prediction tests for 12 years from 1997 to 2009 showed that 70% of actual amino acid substitutions were correctly predicted, and that 45% of predicted amino acid substitutions have been actually observed. Although it remains unsolved how to predict the exact timing of antigenic changes, the present results suggest that our model may have the potential to recognize emerging epidemic strains.

Sickness Absenteeism Rate in Iranian Schools during the 2009 Epidemic of Type a Influenza

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Pourabbasi, Ata; Shirvani, Mahbubeh Ebrahimnegad; Khashayar, Patricia

2012-01-01

Influenza pandemic was a global event in 2009 and intraschool transmission was its main spread method. The present study was designed to evaluate the absenteeism rate during the type A influenza epidemic. Four hundred and eight students from both a guidance school and high school in the Iranian capital were recruited in this retrospective study.…

Social deprivation and burden of influenza: Testing hypotheses and gaining insights from a simulation model for the spread of influenza

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Ayaz Hyder

2015-06-01

Full Text Available Factors associated with the burden of influenza among vulnerable populations have mainly been identified using statistical methodologies. Complex simulation models provide mechanistic explanations, in terms of spatial heterogeneity and contact rates, while controlling other factors and may be used to better understand statistical patterns and, ultimately, design optimal population-level interventions. We extended a sophisticated simulation model, which was applied to forecast epidemics and validated for predictive ability, to identify mechanisms for the empirical relationship between social deprivation and the burden of influenza. Our modeled scenarios and associated epidemic metrics systematically assessed whether neighborhood composition and/or spatial arrangement could qualitatively replicate this empirical relationship. We further used the model to determine consequences of local-scale heterogeneities on larger scale disease spread. Our findings indicated that both neighborhood composition and spatial arrangement were critical to qualitatively match the empirical relationship of interest. Also, when social deprivation was fully included in the model, we observed lower age-based attack rates and greater delay in epidemic peak week in the most socially deprived neighborhoods. Insights from simulation models complement current understandings from statistical-based association studies. Additional insights from our study are: (1 heterogeneous spatial arrangement of neighborhoods is a necessary condition for simulating observed disparities in the burden of influenza and (2 unmeasured factors may lead to a better quantitative match between simulated and observed rate ratio in the burden of influenza between the most and least socially deprived populations.

[The characteristics of epidemic influenza A and B virus strains circulating in Russia during the 2007-2008 season].

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Ivanova, V T; Trushakova, S V; Oskerko, T A; Shevchenko, E S; Kolobukhina, L V; Vartanian, R V; Beliakova, N V; Iatsyshina, S B; Feodoritova, E L; Zueva, N D; Burtseva, E I

2009-01-01

In 2007-2008 in Russia, the epidemic upsurge of influenza morbidity was caused by the active circulation of influenza A(H1N1, A(H3N2), and B viruses. The center for Ecology and Epidemiology of Influenza studied 334 epidemic strains. The results of a comparative study of the svirus specificity of commercial test systems (AmpliSens Influenza virus A/B and AmpliSens Influenza virus A/H5N1) for the polymerase chain reaction diagnosis and virological assays, including virus isolation, revealed their high correlation, which confirms that they may be expensively used to monitor the circulation of influenza viruses in the Russian Federation. All the strains were isolated in the MDCK cell culture. Influenza A(H1N1) viruses (n = 127) were antigenic variants of the reference strains A/Solomon Islands/3/06 and A/Brisbane/59107. Influenza A(H3N2) viruses (n = 49) were antigenic variants of the reference strains A/Wisconsin/67/05 and A/Brisbane/10/08. One hundred and fifty seven Influenza B strains were drift variants of the reference strains B/Florida/4/06 and B/Shanghai/361/02 of lineage B/Yamagata/16/88 and one strain, a variant of Malaysia/2506/04 related to lineage B/victoria/2/87. The isolates interacted actively with human 0(I) blood group erythrocytes and much more weakly with chicken ones. All study influenza A(H1N1) viruses (n = 74) preserved their sensitivity to rimantadine while 24 (77%) of the 31 study influenza A(H3N2) virus strains were resistant. A study of the time course of changes in the generation of antibodies in the donor sera obtained in Moscow and the Moscow Region in different periods of the epidemic process revealed an increase in antibodies to the reference influenza A and B virus strains circulating in this period.

THE ORGANIZATION OF HOSPITAL CARE DURING THE EPIDEMIC OF INFLUENZA AND SARS FOR THE 2016 SEASON IN VELIKY NOVGOROD

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M. V. Yuhno

2016-01-01

Full Text Available Analyzed organization of preventive measures and  patient  care  in  Velikiy Novgorod in  connection with  the  exceeding of the  epidemic threshold for influenza and  acute respiratory viral  infections in  2016.  The  epidemic rise  of influenza and  other  acute  respiratory viral  infections exceeded epidemiological and economic thresholds among  the cumulative population on the  territory  of the  Novgorod region started from the 3rd week 2016 (18.01.2016–24.01.2016 and continued for 4 weeks (until  mid February.  The peak  of the epidemic was passed on the 4th calendar week  of 2016, when  the weekly prevalence rate was 135,7 per 10 thousand population (8447,  the  epidemic  threshold was  exceeded in 2 times. In terms  of conversion to the  infectious diseases hospital, a multidisciplinary clinic № 2 «Central city clinical hospital» carried  out specialized medical assistance 301 the patient with  acute respiratory diseases and  influenza, 67 of which were confirmed influenza caused by the H1N1 virus, of which  28 patients would,  if hospitalized in serious  and critical condition and  needed to be held-Institute the  intensive care manual.

Modeling and Statistical Analysis of the Spatio-Temporal Patterns of Seasonal Influenza in Israel

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Katriel, Guy; Yaari, Rami; Roll, Uri; Stone, Lewi

2012-01-01

Background Seasonal influenza outbreaks are a serious burden for public health worldwide and cause morbidity to millions of people each year. In the temperate zone influenza is predominantly seasonal, with epidemics occurring every winter, but the severity of the outbreaks vary substantially between years. In this study we used a highly detailed database, which gave us both temporal and spatial information of influenza dynamics in Israel in the years 1998–2009. We use a discrete-time stochastic epidemic SIR model to find estimates and credible confidence intervals of key epidemiological parameters. Findings Despite the biological complexity of the disease we found that a simple SIR-type model can be fitted successfully to the seasonal influenza data. This was true at both the national levels and at the scale of single cities.The effective reproductive number Re varies between the different years both nationally and among Israeli cities. However, we did not find differences in Re between different Israeli cities within a year. R e was positively correlated to the strength of the spatial synchronization in Israel. For those years in which the disease was more “infectious”, then outbreaks in different cities tended to occur with smaller time lags. Our spatial analysis demonstrates that both the timing and the strength of the outbreak within a year are highly synchronized between the Israeli cities. We extend the spatial analysis to demonstrate the existence of high synchrony between Israeli and French influenza outbreaks. Conclusions The data analysis combined with mathematical modeling provided a better understanding of the spatio-temporal and synchronization dynamics of influenza in Israel and between Israel and France. Altogether, we show that despite major differences in demography and weather conditions intra-annual influenza epidemics are tightly synchronized in both their timing and magnitude, while they may vary greatly between years. The predominance of

Multi-scale modeling for the transmission of influenza and the evaluation of interventions toward it.

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Guo, Dongmin; Li, King C; Peters, Timothy R; Snively, Beverly M; Poehling, Katherine A; Zhou, Xiaobo

2015-03-11

Mathematical modeling of influenza epidemic is important for analyzing the main cause of the epidemic and finding effective interventions towards it. The epidemic is a dynamic process. In this process, daily infections are caused by people's contacts, and the frequency of contacts can be mainly influenced by their cognition to the disease. The cognition is in turn influenced by daily illness attack rate, climate, and other environment factors. Few existing methods considered the dynamic process in their models. Therefore, their prediction results can hardly be explained by the mechanisms of epidemic spreading. In this paper, we developed a heterogeneous graph modeling approach (HGM) to describe the dynamic process of influenza virus transmission by taking advantage of our unique clinical data. We built social network of studied region and embedded an Agent-Based Model (ABM) in the HGM to describe the dynamic change of an epidemic. Our simulations have a good agreement with clinical data. Parameter sensitivity analysis showed that temperature influences the dynamic of epidemic significantly and system behavior analysis showed social network degree is a critical factor determining the size of an epidemic. Finally, multiple scenarios for vaccination and school closure strategies were simulated and their performance was analyzed.

THE ANTIGENIC POTENCY OF EPIDEMIC INFLUENZA VIRUS FOLLOWING INACTIVATION BY ULTRAVIOLET RADIATION

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Salk, Jonas E.; Lavin, G. I.; Francis, Thomas

1940-01-01

A study of the antigenic potency of influenza virus inactivated by ultraviolet radiation has been made. Virus so inactivated is still capable of functioning as an immunizing agent when given to mice by the intraperitoneal route. In high concentrations inactivated virus appears to be nearly as effective as active virus but when quantitative comparisons of the immunity induced by different dilutions are made, it is seen that a hundredfold loss in immunizing capacity occurs during inactivation. Virus in suspensions prepared from the lungs of infected mice is inactivated more rapidly than virus in tissue culture medium. A standard for the comparison of vaccines of epidemic influenza virus is proposed. PMID:19871057

A universal long-term flu vaccine may not prevent severe epidemics

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Blower Sally

2010-04-01

Full Text Available Abstract Background Recently, the promise of a new universal long-term flu vaccine has become more tangible than ever before. Such a vaccine would protect against very many seasonal and pandemic flu strains for many years, making annual vaccination unnecessary. However, due to complacency behavior, it remains unclear whether the introduction of such vaccines would maintain high and stable levels of vaccination coverage year after year. Findings To predict the impact of universal long-term flu vaccines on influenza epidemics we developed a mathematical model that linked human cognition and memory with the transmission dynamics of influenza. Our modeling shows that universal vaccines that provide short-term protection are likely to result in small frequent epidemics, whereas universal vaccines that provide long-term protection are likely to result in severe infrequent epidemics. Conclusions Influenza vaccines that provide short-term protection maintain risk awareness regarding influenza in the population and result in stable vaccination coverage. Vaccines that provide long-term protection could lead to substantial drops in vaccination coverage and should therefore include an annual epidemic risk awareness programs in order to minimize the risk of severe epidemics.

A data-driven model for influenza transmission incorporating media effects.

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Mitchell, Lewis; Ross, Joshua V

2016-10-01

Numerous studies have attempted to model the effect of mass media on the transmission of diseases such as influenza; however, quantitative data on media engagement has until recently been difficult to obtain. With the recent explosion of 'big data' coming from online social media and the like, large volumes of data on a population's engagement with mass media during an epidemic are becoming available to researchers. In this study, we combine an online dataset comprising millions of shared messages relating to influenza with traditional surveillance data on flu activity to suggest a functional form for the relationship between the two. Using this data, we present a simple deterministic model for influenza dynamics incorporating media effects, and show that such a model helps explain the dynamics of historical influenza outbreaks. Furthermore, through model selection we show that the proposed media function fits historical data better than other media functions proposed in earlier studies.

Reconstruction of epidemic curves for pandemic influenza A (H1N1 2009 at city and sub-city levels

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Wong Ngai Sze

2010-11-01

Full Text Available Abstract To better describe the epidemiology of influenza at local level, the time course of pandemic influenza A (H1N1 2009 in the city of Hong Kong was reconstructed from notification data after decomposition procedure and time series analysis. GIS (geographic information system methodology was incorporated for assessing spatial variation. Between May and September 2009, a total of 24415 cases were successfully geocoded, out of 25473 (95.8% reports in the original dataset. The reconstructed epidemic curve was characterized by a small initial peak, a nadir followed by rapid rise to the ultimate plateau. The full course of the epidemic had lasted for about 6 months. Despite the small geographic area of only 1000 Km2, distinctive spatial variation was observed in the configuration of the curves across 6 geographic regions. With the relatively uniform physical and climatic environment within Hong Kong, the temporo-spatial variability of influenza spread could only be explained by the heterogeneous population structure and mobility patterns. Our study illustrated how an epidemic curve could be reconstructed using regularly collected surveillance data, which would be useful in informing intervention at local levels.

Recurrent epidemic cycles driven by intervention in a population of two susceptibility types

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Juanico, Drandreb Earl O

2014-01-01

Epidemics have been known to persist in the form of recurrence cycles. Despite intervention efforts through vaccination and targeted social distancing, infectious diseases like influenza continue to appear intermittently over time. I have undertaken an analysis of a stochastic epidemic model to explore the hypothesis that intervention efforts actually drive epidemic cycles. Time series from simulations of the model reveal oscillations exhibiting a similar temporal signature as influenza epidemics. The power-spectral density indicates a resonant frequency, which approximately corresponds to the apparent annual seasonality of influenza in temperate zones. Asymptotic solution to the backward Kolmogorov equation of the dynamics corresponds to an exponentially-decaying mean-exit time as a function of the intervention rate. Intervention must be implemented at a sufficiently high rate to extinguish the infection. The results demonstrate that intervention efforts can induce epidemic cycles, and that the temporal signature of cycles can provide early warning of imminent outbreaks

Transmission of Influenza B Viruses in the Guinea Pig

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Pica, Natalie; Chou, Yi-Ying; Bouvier, Nicole M.

2012-01-01

Epidemic influenza is typically caused by infection with viruses of the A and B types and can result in substantial morbidity and mortality during a given season. Here we demonstrate that influenza B viruses can replicate in the upper respiratory tract of the guinea pig and that viruses of the two main lineages can be transmitted with 100% efficiency between inoculated and naïve animals in both contact and noncontact models. Our results also indicate that, like in the case for influenza A virus, transmission of influenza B viruses is enhanced at colder temperatures, providing an explanation for the seasonality of influenza epidemics in temperate climates. We therefore present, for the first time, a small animal model with which to study the underlying mechanisms of influenza B virus transmission. PMID:22301149

On the Use of Human Mobility Proxies for Modeling Epidemics

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Tizzoni, Michele; Bajardi, Paolo; Decuyper, Adeline; Kon Kam King, Guillaume; Schneider, Christian M.; Blondel, Vincent; Smoreda, Zbigniew; González, Marta C.; Colizza, Vittoria

2014-01-01

Human mobility is a key component of large-scale spatial-transmission models of infectious diseases. Correctly modeling and quantifying human mobility is critical for improving epidemic control, but may be hindered by data incompleteness or unavailability. Here we explore the opportunity of using proxies for individual mobility to describe commuting flows and predict the diffusion of an influenza-like-illness epidemic. We consider three European countries and the corresponding commuting networks at different resolution scales, obtained from (i) official census surveys, (ii) proxy mobility data extracted from mobile phone call records, and (iii) the radiation model calibrated with census data. Metapopulation models defined on these countries and integrating the different mobility layers are compared in terms of epidemic observables. We show that commuting networks from mobile phone data capture the empirical commuting patterns well, accounting for more than 87% of the total fluxes. The distributions of commuting fluxes per link from mobile phones and census sources are similar and highly correlated, however a systematic overestimation of commuting traffic in the mobile phone data is observed. This leads to epidemics that spread faster than on census commuting networks, once the mobile phone commuting network is considered in the epidemic model, however preserving to a high degree the order of infection of newly affected locations. Proxies' calibration affects the arrival times' agreement across different models, and the observed topological and traffic discrepancies among mobility sources alter the resulting epidemic invasion patterns. Results also suggest that proxies perform differently in approximating commuting patterns for disease spread at different resolution scales, with the radiation model showing higher accuracy than mobile phone data when the seed is central in the network, the opposite being observed for peripheral locations. Proxies should therefore be

Bayesian nonparametric clustering in phylogenetics: modeling antigenic evolution in influenza.

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Cybis, Gabriela B; Sinsheimer, Janet S; Bedford, Trevor; Rambaut, Andrew; Lemey, Philippe; Suchard, Marc A

2018-01-30

Influenza is responsible for up to 500,000 deaths every year, and antigenic variability represents much of its epidemiological burden. To visualize antigenic differences across many viral strains, antigenic cartography methods use multidimensional scaling on binding assay data to map influenza antigenicity onto a low-dimensional space. Analysis of such assay data ideally leads to natural clustering of influenza strains of similar antigenicity that correlate with sequence evolution. To understand the dynamics of these antigenic groups, we present a framework that jointly models genetic and antigenic evolution by combining multidimensional scaling of binding assay data, Bayesian phylogenetic machinery and nonparametric clustering methods. We propose a phylogenetic Chinese restaurant process that extends the current process to incorporate the phylogenetic dependency structure between strains in the modeling of antigenic clusters. With this method, we are able to use the genetic information to better understand the evolution of antigenicity throughout epidemics, as shown in applications of this model to H1N1 influenza. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Phylogenetic analysis of influenza A viruses (H3N2 circulating in Zhytomyr region during 2013–2014 epidemic season

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Boyalska O. G.

2015-06-01

Full Text Available Aim. To perform phylogenetic analysis of the hemagglutinin (HA and neuraminidase (NA genes of influenza A(H3N2 viruses circulating in the Zhytomyr region during 2013–2014 epidemic season. To make comparison of the HA and NA genes sequences of the Zhytomyr region isolates with the HA and NA genes sequences of influenza viruses circulating in the world. Methods. Laboratory diagnosis was conducted by real-time polymerase chain reaction (RT-PCR. In this study the sequencing and phylogenetic analysis were carried out. Results. For the first time the genes of influenza A(H3N2 viruses isolated in the Zhytomyr region during 2013–2014 epidemic season, coding hemagglutinin and neuraminidase were compared with their orthologs. According to the results of this comparison the phylogenetic tree was constructed. Additionally, the amino acid substitutions of the influenza viruses circulating in Ukraine and worldwide were analyzed. Conclusions. The nucleotide sequences of the influenza A(H3N2 viruses genes HA and NA isolated in the Zhytomyr region were identified. Based on the nucleotide sequences of HA and NA we constructed the influenza virus phylogenetic tree demonstrating that the virus isolated in the Zhytomyr region was closely related to the Ukrainian isolate from Kharkov and in the world to the isolates from Germany, Romania, Italy.

Effect of modelling slum populations on influenza spread in Delhi

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Chen, Jiangzhuo; Chu, Shuyu; Chungbaek, Youngyun; Khan, Maleq; Kuhlman, Christopher; Marathe, Achla; Mortveit, Henning; Vullikanti, Anil; Xie, Dawen

2016-01-01

Objectives This research studies the impact of influenza epidemic in the slum and non-slum areas of Delhi, the National Capital Territory of India, by taking proper account of slum demographics and residents’ activities, using a highly resolved social contact network of the 13.8 million residents of Delhi. Methods An SEIR model is used to simulate the spread of influenza on two different synthetic social contact networks of Delhi, one where slums and non-slums are treated the same in terms of their demographics and daily sets of activities and the other, where slum and non-slum regions have different attributes. Results Differences between the epidemic outcomes on the two networks are large. Time-to-peak infection is overestimated by several weeks, and the cumulative infection rate and peak infection rate are underestimated by 10–50%, when slum attributes are ignored. Conclusions Slum populations have a significant effect on influenza transmission in urban areas. Improper specification of slums in large urban regions results in underestimation of infections in the entire population and hence will lead to misguided interventions by policy planners. PMID:27687898

Influenza newspaper reports and the influenza epidemic: an observational study in Fukuoka City, Japan

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Hagihara, Akihito; Onozuka, Daisuke; Miyazaki, Shougo; Abe, Takeru

2015-01-01

Objectives We examined whether the weekly number of newspaper articles reporting on influenza was related to the incidence of influenza in a large city. Design Prospective, non-randomised, observational study. Setting Registry data of influenza cases in Fukuoka City, Japan. Participants A total of 83 613 cases of influenza cases that occurred between October 1999 and March 2007 in Fukuoka City, Japan. Main outcome measure A linear model with autoregressive time series errors was fitted to time series data on the incidence of influenza and the accumulated number of influenza-related newspaper articles with different time lags in Fukuoka City, Japan. In order to obtain further evidence that the number of newspaper articles a week with specific time lags is related to the incidence of influenza, Granger causality was also tested. Results Of the 16 models including ‘number of newspaper articles’ with different time lags between 2 and 17 weeks (xt-2 to t-17), the β coefficients of ‘number of newspaper articles’ at time lags between t-5 and t-13 were significant. However, the β coefficients of ‘number of newspaper articles’ that are significant with respect to the Granger causality tests (pnewspaper articles at time lags between t-6 and t-10 (time shift of 10 weeks, β=−0.301, pnewspaper articles reporting on influenza in a week was related to the incidence of influenza 6–10 weeks after media coverage in a large city in Japan. PMID:26719323

The influence of school holiday timing on epidemic impact.

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Eames, K T D

2014-09-01

The impact of reactive school closure on an epidemic is uncertain, since it is not clear how an unplanned closure will affect social mixing patterns. The effect of school holidays on social mixing patterns is better understood. Here, we use mathematical models to explore the influence of the timing of school holidays on the final size and peak incidence of an influenza-like epidemic. A well-timed holiday can reduce the impact of an epidemic, in particular substantially reducing an epidemic's peak. Final size and peak incidence cannot both be minimized: a later holiday is optimal for minimizing the final size, while an earlier holiday minimizes peak incidence. Using social mixing data from the UK, we estimated that, had the 2009 influenza epidemic not been interrupted by the school summer holidays, the final size would have been about 20% larger and the peak about 170% higher.

Estimating Influenza Outbreaks Using Both Search Engine Query Data and Social Media Data in South Korea.

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Woo, Hyekyung; Cho, Youngtae; Shim, Eunyoung; Lee, Jong-Koo; Lee, Chang-Gun; Kim, Seong Hwan

2016-07-04

As suggested as early as in 2006, logs of queries submitted to search engines seeking information could be a source for detection of emerging influenza epidemics if changes in the volume of search queries are monitored (infodemiology). However, selecting queries that are most likely to be associated with influenza epidemics is a particular challenge when it comes to generating better predictions. In this study, we describe a methodological extension for detecting influenza outbreaks using search query data; we provide a new approach for query selection through the exploration of contextual information gleaned from social media data. Additionally, we evaluate whether it is possible to use these queries for monitoring and predicting influenza epidemics in South Korea. Our study was based on freely available weekly influenza incidence data and query data originating from the search engine on the Korean website Daum between April 3, 2011 and April 5, 2014. To select queries related to influenza epidemics, several approaches were applied: (1) exploring influenza-related words in social media data, (2) identifying the chief concerns related to influenza, and (3) using Web query recommendations. Optimal feature selection by least absolute shrinkage and selection operator (Lasso) and support vector machine for regression (SVR) were used to construct a model predicting influenza epidemics. In total, 146 queries related to influenza were generated through our initial query selection approach. A considerable proportion of optimal features for final models were derived from queries with reference to the social media data. The SVR model performed well: the prediction values were highly correlated with the recent observed influenza-like illness (r=.956; Psearch queries to enhance influenza surveillance in South Korea. In addition, an approach for query selection using social media data seems ideal for supporting influenza surveillance based on search query data.

Lessons from the Largest Epidemic of Avian Influenza Viruses in Taiwan, 2015.

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Chang, Ching-Fen; King, Chwan-Chuen; Wan, Cho-Hua; Chang, Yun-Cheng; Chan, Ta-Chien; David Lee, Chang-Chun; Chou, Po-Hao Borris; Li, Zheng-Rong Tiger; Li, Yao-Tsun; Tseng, Tzu-Jung; Lee, Pei-Fen; Chang, Chuan-Hsiung

2016-05-01

The largest epidemic of avian influenza (AI) in history attacked poultry and wild birds throughout Taiwan starting January 6, 2015. This study analyzed surveillance results, epidemiologic characteristics, and viral sequences by using government-released information, with the intention to provide recommendations to minimize future pandemic influenza. The H5 clade 2.3.4.4 highly pathogenic AI viruses (HPAIVs) had not been detected in Taiwan before 2015. During this epidemic, four types of etiologic agents were identified: the three novel subtypes H5N2, H5N8, and H5N3 clade 2.3.4.4 HPAIVs and one endemic chicken H5N2 subtype (Mexican-like lineage) of low pathogenic AI viruses. Cocirculation of mixed subtypes also occurred, with H5N2 clade 2.3.4.4 HPAIVs accompanied by the H5N8 and H5N3 subtypes or old H5N2 viruses in the same farm. More than 90% of domestic geese died from this AI epidemic; geese were affected the most at the early outbreaks. The epidemic peaked in mid-January for all three novel H5 subtypes. Spatial epidemiology found that most affected areas were located in southwestern coastal areas. In terrestrial poultry (mostly chickens), different geographic distributions of AI virus subtypes were detected, with hot spots of H5N2 clade 2.3.4.4 vs. past-endemic old H5N2 viruses in Changhwa (P = 0.03) and Yunlin (P = 0.007) counties, respectively, of central Taiwan. Phylogenetic and sequence analyses of all the early 10 Taiwan H5 clade 2.3.4.4 isolates covering the three subtypes showed that they were very different from the HA of the past local H5 viruses from domestic ducks (75%-80%) and chickens (70%-75%). However, they had the highest sequence identity percentages (99.53%-100%), with the HA of A/crane/Kagoshima/KU13/2014(H5N8) isolated on December 7, 2014, in Japan being higher than those of recent American and Korean H5 HPAIVs [A/Northern pintail/Washington/40964/2014 (H5N2) and A/gyrfalcon/Washington/41088-6/2014 (H5N8): 99.02%-99.54% and A/Baikal teal

[Summary of Guangdong provincial seminar on avian influenza and influenza].

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Yu, Shou-yi; Chen, Qing; Hu, Gui-fang

2005-12-01

On 8th November 2005, an academic seminar on avian influenza and influenza in Guangdong Province was held by Guangdong Society of Tropical Medicine and the Epidemiology Committee of the Guangdong Preventive Medicine Society in Southern Medical University, addressing the current problems in epidemics of avian influenza. The specialists attending the conference arrived at the common consideration that at present, the avian influenza virus H5N1 has not the capacity to trigger an pandemic in human population, but scattered cases had been reported to increase the suspicions of H5N1 virus transmission between humans. Due attention should be paid to the tendency of expansion of the host range and epidemic area, and the possibility of disastrous influenza pandemic among human populations persists, for which rational consideration is called for, and the role of specialists should be fully recognized who are endeavoring to examine the possible scale of influenza occurrence and devise strategy to deal with the epidemic in Guangdong province according to the practical situation in China. Increased funds and investment in scientific research on avian influenza is urged for influenza prediction and surveillance, rapid and early diagnostic assays, understanding of virus variation, mechanism of H5N1 virus adaptation to human hosts, effective medicines and vaccines for prevention and therapy of avian influenza. Laboratory bio-safety control should be enforced to prevent infections originated from laboratories. The specialists appeal that the media report the news objectively and issue the public warnings against avian influenza after consulting specialists, so as to avoid unnecessary social panic.

Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling.

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Lulla Opatowski

2018-02-01

Full Text Available Evidence is mounting that influenza virus interacts with other pathogens colonising or infecting the human respiratory tract. Taking into account interactions with other pathogens may be critical to determining the real influenza burden and the full impact of public health policies targeting influenza. This is particularly true for mathematical modelling studies, which have become critical in public health decision-making. Yet models usually focus on influenza virus acquisition and infection alone, thereby making broad oversimplifications of pathogen ecology. Herein, we report evidence of influenza virus interactions with bacteria and viruses and systematically review the modelling studies that have incorporated interactions. Despite the many studies examining possible associations between influenza and Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Neisseria meningitidis, respiratory syncytial virus (RSV, human rhinoviruses, human parainfluenza viruses, etc., very few mathematical models have integrated other pathogens alongside influenza. The notable exception is the pneumococcus-influenza interaction, for which several recent modelling studies demonstrate the power of dynamic modelling as an approach to test biological hypotheses on interaction mechanisms and estimate the strength of those interactions. We explore how different interference mechanisms may lead to unexpected incidence trends and possible misinterpretation, and we illustrate the impact of interactions on public health surveillance using simple transmission models. We demonstrate that the development of multipathogen models is essential to assessing the true public health burden of influenza and that it is needed to help improve planning and evaluation of control measures. Finally, we identify the public health, surveillance, modelling, and biological challenges and propose avenues of research for the coming years.

Influenza Vaccination in Community Dwelling Elderly Persons

NARCIS (Netherlands)

A.C.G. Voordouw (Bettie)

2005-01-01

textabstractAn influenza epidemic was first described in 1173, although there are reports of influenza as early as 412 BC. Recurrent epidemics and incidental pandemics caused by influenza virus are documented since the last 400 years. These were based upon clinical observation and epidemiology.

Influenza surveillance

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Karolina Bednarska

2016-04-01

Full Text Available Influenza surveillance was established in 1947. From this moment WHO (World Health Organization has been coordinating international cooperation, with a goal of monitoring influenza virus activity, effective diagnostic of the circulating viruses and informing society about epidemics or pandemics, as well as about emergence of new subtypes of influenza virus type A. Influenza surveillance is an important task, because it enables people to prepare themselves for battle with the virus that is constantly mutating, what leads to circulation of new and often more virulent strains of influenza in human population. As vaccination is the most effective method of fighting the virus, one of the major tasks of GISRS is developing an optimal antigenic composition of the vaccine for the current epidemic season. European Influenza Surveillance Network (EISN has also developed over the years. EISN is running integrated epidemiological and virological influenza surveillance, to provide appropriate data to public health experts in member countries, to enable them undertaking relevant activities based on the current information about influenza activity. In close cooperation with GISRS and EISN are National Influenza Centres - national institutions designated by the Ministry of Health in each country.

Spanish flu, Asian flu, Hong Kong flu, and seasonal influenza in Japan under social and demographic influence: review and analysis using the two-population model.

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Yoshikura, Hiroshi

2014-01-01

When cumulative numbers of patients (X) and deaths (Y) associated with an influenza epidemic are plotted using the log-log scale, the plots fall on an ascending straight line generally expressed as logY = k(logX - logN0). For the 2009 H1N1 influenza pandemic, the slope k was ～0.6 for Mexico and ～2 for other countries. The two-population model was proposed to explain this phenomenon (Yoshikura H. Jpn J Infect Dis. 2012;65:279-88; Yoshikura H. Jpn J Infect Dis. 2009;62:411-2; and Yoshikura H. Jpn J Infect Dis. 2009;62:482-4). The current article reviews and analyzes previous influenza epidemics in Japan to examine whether the two-population model is applicable to them. The slope k was found to be ～2 for the Spanish flu during 1918-1920 and the Asian flu during 1957-1958, and ～1 for the Hong Kong flu and seasonal influenza prior to 1960-1961; however, k was ～0.6 for seasonal influenza after 1960-1961. This transition of the slope k of seasonal influenza plots from ～1 to ～0.6 corresponded to the shift in influenza mortality toward the older age groups and a drastic reduction in infant mortality rates due to improvements in the standard of living during the 1950s and 1960s. All the above observations could be well explained by reconstitution of the influenza epidemic based on the two-population model.

Health Newscasts for Increasing Influenza Vaccination Coverage: An Inductive Reasoning Game Approach

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Breban, Romulus

2011-01-01

Both pandemic and seasonal influenza are receiving more attention from mass media than ever before. Topics such as epidemic severity and vaccination are changing the way in which we perceive the utility of disease prevention. Voluntary influenza vaccination has been recently modeled using inductive reasoning games. It has thus been found that severe epidemics may occur because individuals do not vaccinate and, instead, attempt to benefit from the immunity of their peers. Such epidemics could be prevented by voluntary vaccination if incentives were offered. However, a key assumption has been that individuals make vaccination decisions based on whether there was an epidemic each influenza season; no other epidemiological information is available to them. In this work, we relax this assumption and investigate the consequences of making more informed vaccination decisions while no incentives are offered. We obtain three major results. First, individuals will not cooperate enough to constantly prevent influenza epidemics through voluntary vaccination no matter how much they learned about influenza epidemiology. Second, broadcasting epidemiological information richer than whether an epidemic occurred may stabilize the vaccination coverage and suppress severe influenza epidemics. Third, the stable vaccination coverage follows the trend of the perceived benefit of vaccination. However, increasing the amount of epidemiological information released to the public may either increase or decrease the perceived benefit of vaccination. We discuss three scenarios where individuals know, in addition to whether there was an epidemic, (i) the incidence, (ii) the vaccination coverage and (iii) both the incidence and the vaccination coverage, every influenza season. We show that broadcasting both the incidence and the vaccination coverage could yield either better or worse vaccination coverage than broadcasting each piece of information on its own. PMID:22205944

Health newscasts for increasing influenza vaccination coverage: an inductive reasoning game approach.

Science.gov (United States)

Breban, Romulus

2011-01-01

Both pandemic and seasonal influenza are receiving more attention from mass media than ever before. Topics such as epidemic severity and vaccination are changing the way in which we perceive the utility of disease prevention. Voluntary influenza vaccination has been recently modeled using inductive reasoning games. It has thus been found that severe epidemics may occur because individuals do not vaccinate and, instead, attempt to benefit from the immunity of their peers. Such epidemics could be prevented by voluntary vaccination if incentives were offered. However, a key assumption has been that individuals make vaccination decisions based on whether there was an epidemic each influenza season; no other epidemiological information is available to them. In this work, we relax this assumption and investigate the consequences of making more informed vaccination decisions while no incentives are offered. We obtain three major results. First, individuals will not cooperate enough to constantly prevent influenza epidemics through voluntary vaccination no matter how much they learned about influenza epidemiology. Second, broadcasting epidemiological information richer than whether an epidemic occurred may stabilize the vaccination coverage and suppress severe influenza epidemics. Third, the stable vaccination coverage follows the trend of the perceived benefit of vaccination. However, increasing the amount of epidemiological information released to the public may either increase or decrease the perceived benefit of vaccination. We discuss three scenarios where individuals know, in addition to whether there was an epidemic, (i) the incidence, (ii) the vaccination coverage and (iii) both the incidence and the vaccination coverage, every influenza season. We show that broadcasting both the incidence and the vaccination coverage could yield either better or worse vaccination coverage than broadcasting each piece of information on its own.

Modelling the wind-borne spread of highly pathogenic avian influenza virus between farms.

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Amos Ssematimba

Full Text Available A quantitative understanding of the spread of contaminated farm dust between locations is a prerequisite for obtaining much-needed insight into one of the possible mechanisms of disease spread between farms. Here, we develop a model to calculate the quantity of contaminated farm-dust particles deposited at various locations downwind of a source farm and apply the model to assess the possible contribution of the wind-borne route to the transmission of Highly Pathogenic Avian Influenza virus (HPAI during the 2003 epidemic in the Netherlands. The model is obtained from a Gaussian Plume Model by incorporating the dust deposition process, pathogen decay, and a model for the infection process on exposed farms. Using poultry- and avian influenza-specific parameter values we calculate the distance-dependent probability of between-farm transmission by this route. A comparison between the transmission risk pattern predicted by the model and the pattern observed during the 2003 epidemic reveals that the wind-borne route alone is insufficient to explain the observations although it could contribute substantially to the spread over short distance ranges, for example, explaining 24% of the transmission over distances up to 25 km.

Influenza newspaper reports and the influenza epidemic: an observational study in Fukuoka City, Japan.

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Hagihara, Akihito; Onozuka, Daisuke; Miyazaki, Shougo; Abe, Takeru

2015-12-30

We examined whether the weekly number of newspaper articles reporting on influenza was related to the incidence of influenza in a large city. Prospective, non-randomised, observational study. Registry data of influenza cases in Fukuoka City, Japan. A total of 83,613 cases of influenza cases that occurred between October 1999 and March 2007 in Fukuoka City, Japan. A linear model with autoregressive time series errors was fitted to time series data on the incidence of influenza and the accumulated number of influenza-related newspaper articles with different time lags in Fukuoka City, Japan. In order to obtain further evidence that the number of newspaper articles a week with specific time lags is related to the incidence of influenza, Granger causality was also tested. Of the 16 models including 'number of newspaper articles' with different time lags between 2 and 17 weeks (xt-2 to t-17), the β coefficients of 'number of newspaper articles' at time lags between t-5 and t-13 were significant. However, the β coefficients of 'number of newspaper articles' that are significant with respect to the Granger causality tests (p<0.05) were the weekly number of newspaper articles at time lags between t-6 and t-10 (time shift of 10 weeks, β=-0.301, p<0.01; time shift of 9 weeks, β=-0.200, p<0.01; time shift of 8 weeks, β=-0.156, p<0.01; time shift of 7 weeks, β=-0.122, p<0.05; time shift of 6 weeks, β=-0.113, p<0.05). We found that the number of newspaper articles reporting on influenza in a week was related to the incidence of influenza 6-10 weeks after media coverage in a large city in Japan. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Update: Increase in Human Infections with Novel Asian Lineage Avian Influenza A(H7N9) Viruses During the Fifth Epidemic - China, October 1, 2016-August 7, 2017.

Science.gov (United States)

Kile, James C; Ren, Ruiqi; Liu, Liqi; Greene, Carolyn M; Roguski, Katherine; Iuliano, A Danielle; Jang, Yunho; Jones, Joyce; Thor, Sharmi; Song, Ying; Zhou, Suizan; Trock, Susan C; Dugan, Vivien; Wentworth, David E; Levine, Min Z; Uyeki, Timothy M; Katz, Jacqueline M; Jernigan, Daniel B; Olsen, Sonja J; Fry, Alicia M; Azziz-Baumgartner, Eduardo; Davis, C Todd

2017-09-08

Among all influenza viruses assessed using CDC's Influenza Risk Assessment Tool (IRAT), the Asian lineage avian influenza A(H7N9) virus (Asian H7N9), first reported in China in March 2013,* is ranked as the influenza virus with the highest potential pandemic risk (1). During October 1, 2016-August 7, 2017, the National Health and Family Planning Commission of China; CDC, Taiwan; the Hong Kong Centre for Health Protection; and the Macao CDC reported 759 human infections with Asian H7N9 viruses, including 281 deaths, to the World Health Organization (WHO), making this the largest of the five epidemics of Asian H7N9 infections that have occurred since 2013 (Figure 1). This report summarizes new viral and epidemiologic features identified during the fifth epidemic of Asian H7N9 in China and summarizes ongoing measures to enhance pandemic preparedness. Infections in humans and poultry were reported from most areas of China, including provinces bordering other countries, indicating extensive, ongoing geographic spread. The risk to the general public is very low and most human infections were, and continue to be, associated with poultry exposure, especially at live bird markets in mainland China. Throughout the first four epidemics of Asian H7N9 infections, only low pathogenic avian influenza (LPAI) viruses were detected among human, poultry, and environmental specimens and samples. During the fifth epidemic, mutations were detected among some Asian H7N9 viruses, identifying the emergence of high pathogenic avian influenza (HPAI) viruses as well as viruses with reduced susceptibility to influenza antiviral medications recommended for treatment. Furthermore, the fifth-epidemic viruses diverged genetically into two separate lineages (Pearl River Delta lineage and Yangtze River Delta lineage), with Yangtze River Delta lineage viruses emerging as antigenically different compared with those from earlier epidemics. Because of its pandemic potential, candidate vaccine viruses

Lessons from the epidemiological surveillance program, during the influenza A (H1N1 virus epidemic, in a reference university hospital of Southeastern Brazil

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Maria Luiza Moretti

2011-08-01

Full Text Available INTRODUCTION: The case definition of influenza-like illness (ILI is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature > 38ºC in period 1, and the definition of severe acute respiratory infection (ARS (coughing + temperature > 38ºC and dyspnoea in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50% than in children (21.6% ( p < 0.0001 and influenza infection was more prevalent in the ILI definition (53% than ARS (24.4% (p < 0.0001. Adults reported more chills and myalgia than children (p = 0.0001. Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. CONCLUSIONS: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.

Influenza vaccine coverage, influenza-associated morbidity and all-cause mortality in Catalonia (Spain).

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Muñoz, M Pilar; Soldevila, Núria; Martínez, Anna; Carmona, Glòria; Batalla, Joan; Acosta, Lesly M; Domínguez, Angela

2011-07-12

The objective of this work was to study the behaviour of influenza with respect to morbidity and all-cause mortality in Catalonia, and their association with influenza vaccination coverage. The study was carried out over 13 influenza seasons, from epidemiological week 40 of 1994 to week 20 of 2007, and included confirmed cases of influenza and all-cause mortality. Two generalized linear models were fitted: influenza-associated morbidity was modelled by Poisson regression and all-cause mortality by negative binomial regression. The seasonal component was modelled with the periodic function formed by the sum of the sinus and cosines. Expected influenza mortality during periods of influenza virus circulation was estimated by Poisson regression and its confidence intervals using the Bootstrap approach. Vaccination coverage was associated with a reduction in influenza-associated morbidity (pcase of influenza-associated morbidity, an increase of 5% in vaccination coverage represented a reduction of 3% in the incidence rate of influenza. There was a positive association between influenza-associated morbidity and all-cause mortality. Excess mortality attributable to influenza epidemics was estimated as 34.4 (95% CI: 28.4-40.8) weekly deaths. In conclusion, all-cause mortality is a good indicator of influenza surveillance and vaccination coverage is associated with a reduction in influenza-associated morbidity but not with all-cause mortality. Copyright © 2011 Elsevier Ltd. All rights reserved.

Mathematical modeling of Avian Influenza epidemic with bird vaccination in constant population

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Kharis, M.; Amidi

2018-03-01

The development of the industrial world and human life is increasingly modern and less attention to environmental sustainability causes the virus causes the epidemic has a high tendency to mutate so that the virus that initially only attack animals, is also found to have the ability to attack humans. The epidemics that lasted some time were bird flu epidemics and swine flu epidemics. The flu epidemic led to several deaths and many people admitted to the hospital. Strain (derivatives) of H5N1 virus was identified as the cause of the bird flu epidemic while the H1N1 strain of the virus was identified as the cause of the swine flu epidemic. The symptoms are similar to seasonal flu caused by H3N2 strain of the virus. Outbreaks of bird flu and swine flu initially only attacked animals, but over time some people were found to be infected with the virus.

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics.

Science.gov (United States)

Conesa, David; López-Quílez, Antonio; Martínez-Beneito, Miguel Angel; Miralles, María Teresa; Verdejo, Francisco

2009-07-29

The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software. In this paper, we introduce FluDetWeb, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (R and WinBUGS), a web server environment for Java code (Tomcat) and a software module created by us (Rdp) responsible for managing internal tasks; the software package MySQL has been used to construct the database management system. The implementation is available on-line from: http://www.geeitema.org/meviepi/fludetweb/. The ease of use of FluDetWeb and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.

Information Spreading in Epidemics and in Communication Networks

DEFF Research Database (Denmark)

Uekermann, Florian Philipp

The PhD thesis revolves mainly around models of disease spreading and human behavior. We present models for different epidemic patterns of infectious diseases. This includes investigations of the trajectory of the 2014 Ebola outbreak in West-Africa, influenza evolution and the seasonal dynamics...

Human mobility and the spatial transmission of influenza in the United States

DEFF Research Database (Denmark)

Charu, Vivek; Zeger, Scott; Gog, Julia

2017-01-01

Seasonal influenza epidemics offer unique opportunities to study the invasion and re-invasion waves of a pathogen in a partially immune population. Detailed patterns of spread remain elusive, however, due to lack of granular disease data. Here we model high-volume city-level medical claims data...... and human mobility proxies to explore the drivers of influenza spread in the US during 2002–2010. Although the speed and pathways of spread varied across seasons, seven of eight epidemics likely originated in the Southern US. Each epidemic was associated with 1–5 early long-range transmission events, half...... of which sparked onward transmission. Gravity model estimates indicate a sharp decay in influenza transmission with the distance between infectious and susceptible cities, consistent with spread dominated by work commutes rather than air traffic. Two early-onset seasons associated with antigenic novelty...

[Estimation of the excess death associated with influenza pandemics and epidemics in Japan after world war II: relation with pandemics and the vaccination system].

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Ohmi, Kenichi; Marui, Eiji

2011-10-01

To estimate the excess death associated with influenza pandemics and epidemics in Japan after World War II, and to reexamine the relationship between the excess death and the vaccination system in Japan. Using the Japanese national vital statistics data for 1952-2009, we specified months with influenza epidemics, monthly mortality rates and the seasonal index for 1952-74 and for 1975-2009. Then we calculated excess deaths of each month from the observed number of deaths and the 95% range of expected deaths. Lastly we calculated age-adjusted excess death rates using the 1985 model population of Japan. The total number of excess deaths for 1952-2009 was 687,279 (95% range, 384,149-970,468), 12,058 (95% range, 6,739-17,026) per year. The total number of excess deaths in 6 pandemic years of 1957-58, 58-59, 1968-69, 69-70, 77-78 and 78-79, was 95,904, while that in 51 'non-pandemic' years was 591,376, 6.17 fold larger than pandemic years. The average number of excess deaths for pandemic years was 23,976, nearly equal to that for 'non-pandemic' years, 23,655. At the beginning of pandemics, 1957-58, 1968-69, 1969-70, the proportion of those aged pandemic' years. In the 1970s and 1980s, when the vaccination program for schoolchildren was mandatory in Japan on the basis of the "Fukumi thesis", age-adjusted average excess mortality rates were relatively low, with an average of 6.17 per hundred thousand. In the 1990s, when group vaccination was discontinued, age-adjusted excess mortality rose up to 9.42, only to drop again to 2.04 when influenza vaccination was made available to the elderly in the 2000s, suggesting that the vaccination of Japanese children prevented excess deaths from influenza pandemics and epidemics. Moreover, in the age group under 65, average excess mortality rates were low in the 1970s and 1980s rather than in the 2000s, which shows that the "Social Defensive" schoolchildren vaccination program in the 1970s and 1980s was more effective than the

High burden of non-influenza viruses in influenza-like illness in the early weeks of H1N1v epidemic in France.

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Nathalie Schnepf

Full Text Available BACKGROUND: Influenza-like illness (ILI may be caused by a variety of pathogens. Clinical observations are of little help to recognise myxovirus infection and implement appropriate prevention measures. The limited use of molecular tools underestimates the role of other common pathogens. OBJECTIVES: During the early weeks of the 2009-2010 flu pandemic, a clinical and virological survey was conducted in adult and paediatric patients with ILI referred to two French University hospitals in Paris and Tours. Aims were to investigate the different pathogens involved in ILI and describe the associated symptoms. METHODS: H1N1v pandemic influenza diagnosis was performed with real time RT-PCR assay. Other viral aetiologies were investigated by the molecular multiplex assay RespiFinder19®. Clinical data were collected prospectively by physicians using a standard questionnaire. RESULTS: From week 35 to 44, endonasal swabs were collected in 413 patients. Overall, 68 samples (16.5% were positive for H1N1v. In 13 of them, other respiratory pathogens were also detected. Among H1N1v negative samples, 213 (61.9% were positive for various respiratory agents, 190 in single infections and 23 in mixed infections. The most prevalent viruses in H1N1v negative single infections were rhinovirus (62.6%, followed by parainfluenza viruses (24.2% and adenovirus (5.3%. 70.6% of H1N1v cases were identified in patients under 40 years and none after 65 years. There was no difference between clinical symptoms observed in patients infected with H1N1v or with other pathogens. CONCLUSION: Our results highlight the high frequency of non-influenza viruses involved in ILI during the pre-epidemic period of a flu alert and the lack of specific clinical signs associated with influenza infections. Rapid diagnostic screening of a large panel of respiratory pathogens may be critical to define and survey the epidemic situation and to provide critical information for patient management.

Modeling Epidemic Network Failures

DEFF Research Database (Denmark)

Ruepp, Sarah Renée; Fagertun, Anna Manolova

2013-01-01

This paper presents the implementation of a failure propagation model for transport networks when multiple failures occur resulting in an epidemic. We model the Susceptible Infected Disabled (SID) epidemic model and validate it by comparing it to analytical solutions. Furthermore, we evaluate...... the SID model’s behavior and impact on the network performance, as well as the severity of the infection spreading. The simulations are carried out in OPNET Modeler. The model provides an important input to epidemic connection recovery mechanisms, and can due to its flexibility and versatility be used...... to evaluate multiple epidemic scenarios in various network types....

A lattice model for influenza spreading.

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Antonella Liccardo

Full Text Available We construct a stochastic SIR model for influenza spreading on a D-dimensional lattice, which represents the dynamic contact network of individuals. An age distributed population is placed on the lattice and moves on it. The displacement from a site to a nearest neighbor empty site, allows individuals to change the number and identities of their contacts. The dynamics on the lattice is governed by an attractive interaction between individuals belonging to the same age-class. The parameters, which regulate the pattern dynamics, are fixed fitting the data on the age-dependent daily contact numbers, furnished by the Polymod survey. A simple SIR transmission model with a nearest neighbors interaction and some very basic adaptive mobility restrictions complete the model. The model is validated against the age-distributed Italian epidemiological data for the influenza A(H1N1 during the [Formula: see text] season, with sensible predictions for the epidemiological parameters. For an appropriate topology of the lattice, we find that, whenever the accordance between the contact patterns of the model and the Polymod data is satisfactory, there is a good agreement between the numerical and the experimental epidemiological data. This result shows how rich is the information encoded in the average contact patterns of individuals, with respect to the analysis of the epidemic spreading of an infectious disease.

Secondary Bacterial Infections Associated with Influenza Pandemics

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Morris, Denise E.; Cleary, David W.; Clarke, Stuart C.

2017-01-01

Lower and upper respiratory infections are the fourth highest cause of global mortality (Lozano et al., 2012). Epidemic and pandemic outbreaks of respiratory infection are a major medical concern, often causing considerable disease and a high death toll, typically over a relatively short period of time. Influenza is a major cause of epidemic and pandemic infection. Bacterial co/secondary infection further increases morbidity and mortality of influenza infection, with Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus reported as the most common causes. With increased antibiotic resistance and vaccine evasion it is important to monitor the epidemiology of pathogens in circulation to inform clinical treatment and development, particularly in the setting of an influenza epidemic/pandemic. PMID:28690590

Secondary Bacterial Infections Associated with Influenza Pandemics

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Denise E. Morris

2017-06-01

Full Text Available Lower and upper respiratory infections are the fourth highest cause of global mortality (Lozano et al., 2012. Epidemic and pandemic outbreaks of respiratory infection are a major medical concern, often causing considerable disease and a high death toll, typically over a relatively short period of time. Influenza is a major cause of epidemic and pandemic infection. Bacterial co/secondary infection further increases morbidity and mortality of influenza infection, with Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus reported as the most common causes. With increased antibiotic resistance and vaccine evasion it is important to monitor the epidemiology of pathogens in circulation to inform clinical treatment and development, particularly in the setting of an influenza epidemic/pandemic.

FRED (a Framework for Reconstructing Epidemic Dynamics): an open-source software system for modeling infectious diseases and control strategies using census-based populations.

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Grefenstette, John J; Brown, Shawn T; Rosenfeld, Roni; DePasse, Jay; Stone, Nathan T B; Cooley, Phillip C; Wheaton, William D; Fyshe, Alona; Galloway, David D; Sriram, Anuroop; Guclu, Hasan; Abraham, Thomas; Burke, Donald S

2013-10-08

Mathematical and computational models provide valuable tools that help public health planners to evaluate competing health interventions, especially for novel circumstances that cannot be examined through observational or controlled studies, such as pandemic influenza. The spread of diseases like influenza depends on the mixing patterns within the population, and these mixing patterns depend in part on local factors including the spatial distribution and age structure of the population, the distribution of size and composition of households, employment status and commuting patterns of adults, and the size and age structure of schools. Finally, public health planners must take into account the health behavior patterns of the population, patterns that often vary according to socioeconomic factors such as race, household income, and education levels. FRED (a Framework for Reconstructing Epidemic Dynamics) is a freely available open-source agent-based modeling system based closely on models used in previously published studies of pandemic influenza. This version of FRED uses open-access census-based synthetic populations that capture the demographic and geographic heterogeneities of the population, including realistic household, school, and workplace social networks. FRED epidemic models are currently available for every state and county in the United States, and for selected international locations. State and county public health planners can use FRED to explore the effects of possible influenza epidemics in specific geographic regions of interest and to help evaluate the effect of interventions such as vaccination programs and school closure policies. FRED is available under a free open source license in order to contribute to the development of better modeling tools and to encourage open discussion of modeling tools being used to evaluate public health policies. We also welcome participation by other researchers in the further development of FRED.

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics

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Miralles María

2009-07-01

Full Text Available Abstract Background The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software. Results In this paper, we introduce FluDetWeb, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired. When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (ℝ and WinBUGS, a web server environment for Java code (Tomcat and a software module created by us (Rdp responsible for managing internal tasks; the software package MySQL has been used to construct the database management system. The implementation is available on-line from: http://www.geeitema.org/meviepi/fludetweb/. Conclusion The ease of use of FluDetWeb and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.

Modeling influenza-like illnesses through composite compartmental models

Science.gov (United States)

Levy, Nir; , Michael, Iv; Yom-Tov, Elad

2018-03-01

Epidemiological models for the spread of pathogens in a population are usually only able to describe a single pathogen. This makes their application unrealistic in cases where multiple pathogens with similar symptoms are spreading concurrently within the same population. Here we describe a method which makes possible the application of multiple single-strain models under minimal conditions. As such, our method provides a bridge between theoretical models of epidemiology and data-driven approaches for modeling of influenza and other similar viruses. Our model extends the Susceptible-Infected-Recovered model to higher dimensions, allowing the modeling of a population infected by multiple viruses. We further provide a method, based on an overcomplete dictionary of feasible realizations of SIR solutions, to blindly partition the time series representing the number of infected people in a population into individual components, each representing the effect of a single pathogen. We demonstrate the applicability of our proposed method on five years of seasonal influenza-like illness (ILI) rates, estimated from Twitter data. We demonstrate that our method describes, on average, 44% of the variance in the ILI time series. The individual infectious components derived from our model are matched to known viral profiles in the populations, which we demonstrate matches that of independently collected epidemiological data. We further show that the basic reproductive numbers (R 0) of the matched components are in range known for these pathogens. Our results suggest that the proposed method can be applied to other pathogens and geographies, providing a simple method for estimating the parameters of epidemics in a population.

Lattice model for influenza spreading with spontaneous behavioral changes.

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Fierro, Annalisa; Liccardo, Antonella

2013-01-01

Individual behavioral response to the spreading of an epidemic plays a crucial role in the progression of the epidemic itself. The risk perception induces individuals to adopt a protective behavior, as for instance reducing their social contacts, adopting more restrictive hygienic measures or undergoing prophylaxis procedures. In this paper, starting with a previously developed lattice-gas SIR model, we construct a coupled behavior-disease model for influenza spreading with spontaneous behavioral changes. The focus is on self-initiated behavioral changes that alter the susceptibility to the disease, without altering the contact patterns among individuals. Three different mechanisms of awareness spreading are analyzed: the local spreading due to the presence in the neighborhood of infective individuals; the global spreading due to the news published by the mass media and to educational campaigns implemented at institutional level; the local spreading occurring through the "thought contagion" among aware and unaware individuals. The peculiarity of the present approach is that the awareness spreading model is calibrated on available data on awareness and concern of the population about the risk of contagion. In particular, the model is validated against the A(H1N1) epidemic outbreak in Italy during the 2009/2010 season, by making use of the awareness data gathered by the behavioral risk factor surveillance system (PASSI). We find that, increasing the accordance between the simulated awareness spreading and the PASSI data on risk perception, the agreement between simulated and experimental epidemiological data improves as well. Furthermore, we show that, within our model, the primary mechanism to reproduce a realistic evolution of the awareness during an epidemic, is the one due to globally available information. This result highlights how crucial is the role of mass media and educational campaigns in influencing the epidemic spreading of infectious diseases.

Lattice model for influenza spreading with spontaneous behavioral changes.

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Annalisa Fierro

Full Text Available Individual behavioral response to the spreading of an epidemic plays a crucial role in the progression of the epidemic itself. The risk perception induces individuals to adopt a protective behavior, as for instance reducing their social contacts, adopting more restrictive hygienic measures or undergoing prophylaxis procedures. In this paper, starting with a previously developed lattice-gas SIR model, we construct a coupled behavior-disease model for influenza spreading with spontaneous behavioral changes. The focus is on self-initiated behavioral changes that alter the susceptibility to the disease, without altering the contact patterns among individuals. Three different mechanisms of awareness spreading are analyzed: the local spreading due to the presence in the neighborhood of infective individuals; the global spreading due to the news published by the mass media and to educational campaigns implemented at institutional level; the local spreading occurring through the "thought contagion" among aware and unaware individuals. The peculiarity of the present approach is that the awareness spreading model is calibrated on available data on awareness and concern of the population about the risk of contagion. In particular, the model is validated against the A(H1N1 epidemic outbreak in Italy during the 2009/2010 season, by making use of the awareness data gathered by the behavioral risk factor surveillance system (PASSI. We find that, increasing the accordance between the simulated awareness spreading and the PASSI data on risk perception, the agreement between simulated and experimental epidemiological data improves as well. Furthermore, we show that, within our model, the primary mechanism to reproduce a realistic evolution of the awareness during an epidemic, is the one due to globally available information. This result highlights how crucial is the role of mass media and educational campaigns in influencing the epidemic spreading of infectious

Multiple reassorted viruses as cause of highly pathogenic avian influenza A(H5N8) virus epidemic, the Netherlands, 2016

NARCIS (Netherlands)

Beerens, Nancy; Heutink, Rene; Bergervoet, Saskia A.; Harders, Frank; Bossers, Alex; Koch, Guus

2017-01-01

In 2016, an epidemic of highly pathogenic avian influenza A virus subtype H5N8 in the Netherlands caused mass deaths among wild birds, and several commercial poultry farms and captive bird holdings were affected. We performed complete genome sequencing to study the relationship between the wild bird

Transmission of highly pathogenic avian influenza H7 virus

NARCIS (Netherlands)

Bos, M.E.H.

2009-01-01

Knowledge of the transmission of highly pathogenic avian influenza (HPAI) virus still has gaps, complicating epidemic control. A model was developed to back-calculate the day HPAI virus was introduced into a flock, based on within-flock mortality data of the Dutch HPAI H7N7 epidemic (2003). The

Real-time characterization of partially observed epidemics using surrogate models.

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Safta, Cosmin; Ray, Jaideep; Lefantzi, Sophia; Crary, David (Applied Research Associates, Arlington, VA); Sargsyan, Khachik; Cheng, Karen (Applied Research Associates, Arlington, VA)

2011-09-01

We present a statistical method, predicated on the use of surrogate models, for the 'real-time' characterization of partially observed epidemics. Observations consist of counts of symptomatic patients, diagnosed with the disease, that may be available in the early epoch of an ongoing outbreak. Characterization, in this context, refers to estimation of epidemiological parameters that can be used to provide short-term forecasts of the ongoing epidemic, as well as to provide gross information on the dynamics of the etiologic agent in the affected population e.g., the time-dependent infection rate. The characterization problem is formulated as a Bayesian inverse problem, and epidemiological parameters are estimated as distributions using a Markov chain Monte Carlo (MCMC) method, thus quantifying the uncertainty in the estimates. In some cases, the inverse problem can be computationally expensive, primarily due to the epidemic simulator used inside the inversion algorithm. We present a method, based on replacing the epidemiological model with computationally inexpensive surrogates, that can reduce the computational time to minutes, without a significant loss of accuracy. The surrogates are created by projecting the output of an epidemiological model on a set of polynomial chaos bases; thereafter, computations involving the surrogate model reduce to evaluations of a polynomial. We find that the epidemic characterizations obtained with the surrogate models is very close to that obtained with the original model. We also find that the number of projections required to construct a surrogate model is O(10)-O(10{sup 2}) less than the number of samples required by the MCMC to construct a stationary posterior distribution; thus, depending upon the epidemiological models in question, it may be possible to omit the offline creation and caching of surrogate models, prior to their use in an inverse problem. The technique is demonstrated on synthetic data as well as

A case-control study of risk factors for equine influenza spread onto horse premises during the 2007 epidemic in Australia.

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Firestone, Simon M; Schemann, Kathrin A; Toribio, Jenny-Ann L M L; Ward, Michael P; Dhand, Navneet K

2011-06-01

The 2007 epidemic of equine influenza in Australia provided an opportunity to investigate the effectiveness of on-farm biosecurity measures in preventing the spread of a novel pathogen in a largely naive population. We conducted a case-control study of 200 horse premises from highly affected regions of the state of New South Wales (NSW), to investigate risk factors for the spread of equine influenza onto horse premises, specifically, non-compliance with biosecurity measures recommended to horse owners by the relevant animal health authority, the NSW Department of Primary Industries. The study was restricted to cases occurring during the first seven weeks of the epidemic, a period prior to vaccination and the relaxation of some movement restrictions. Case and control premises were selected from a laboratory testing dataset and interviews were conducted with horse owners and managers on premises between July and November 2009. The proximity of premises to the nearest infected premises was the factor most strongly associated with case status. Case premises were more likely than control premises to be within 5 km and beyond 10 km of an infected premises. Having a footbath in place on the premises before any horses were infected was associated with a nearly four-fold reduction in odds of infection (odds ratio=0.27; 95% confidence interval: 0.09, 0.83). This protective association may have reflected overall premises biosecurity standards related to the fomite transmission of equine influenza. Compliance with certain on-farm biosecurity practices seemingly prevented horses on premises in high risk areas being infected with equine influenza during the 2007 outbreak in Australia. In future outbreaks, in addition to broader disease control measures, on-farm biosecurity practices should be adopted by horse owners and managers to prevent equine influenza spread. Copyright © 2011 Elsevier B.V. All rights reserved.

Cyber Epidemic Models with Dependences

OpenAIRE

Xu, Maochao; Da, Gaofeng; Xu, Shouhuai

2016-01-01

Studying models of cyber epidemics over arbitrary complex networks can deepen our understanding of cyber security from a whole-system perspective. In this paper, we initiate the investigation of cyber epidemic models that accommodate the {\\em dependences} between the cyber attack events. Due to the notorious difficulty in dealing with such dependences, essentially all existing cyber epidemic models have assumed them away. Specifically, we introduce the idea of Copulas into cyber epidemic mode...

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

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Shi, Pengyi; Keskinocak, Pinar; Swann, Julie L; Lee, Bruce Y

2010-12-21

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

[History of pandemic influenza in Japan].

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Matsumoto, Keizo

2010-09-01

In Japan, influenza like epidemics were described many times since Heian era. However, Spanish flu as the modern medicine invaded Japan in 1918, thus almost infected 390,000 patients died with associated pneumonia. After the discovery of influenza virus in 1933, Japan experienced pandemic influenza--Asian flu(H2N2) in 1957. After about 10 years, Hong Kong flu (H3N2) came to Japan at 1968. However, we had many reliable antibiotics but had not any antiviral drug at the early time. After year 2000, we fortunately obtained reliable three antiviral drugs such as amantadine, oseltamivir and zanamivir. Moreover, very useful rapid test kits for influenza A and B viruses were developed and used in Japan. 2009 H1N1 influenza epidemic occured in Japan after the great epidemic in Mexico and North America but elderly patient was few. With together, host conditions regarding with high risk are changing. Lessons from past several pandemic influenza are those that many issues for changing high risk conditions, viral genetic changes, developing antiviral agents, developing new useful vaccins and determinating bacterial secondary pathogens are important.

Avian Influenza.

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Zeitlin, Gary Adam; Maslow, Melanie Jane

2005-05-01

The current epidemic of H5N1 highly pathogenic avian influenza in Southeast Asia raises serious concerns that genetic reassortment will result in the next influenza pandemic. There have been 164 confirmed cases of human infection with avian influenza since 1996. In 2004, there were 45 cases of human H5N1 in Vietnam and Thailand, with a mortality rate more than 70%. In addition to the potential public health hazard, the current zoonotic epidemic has caused severe economic losses. Efforts must be concentrated on early detection of bird outbreaks with aggressive culling, quarantining, and disinfection. To prepare for and prevent an increase in human cases, it is essential to improve detection methods and stockpile effective antivirals. Novel therapeutic modalities, including short-interfering RNAs and new vaccine strategies that use plasmid-based genetic systems, offer promise should a pandemic occur.

Evolution of Therapeutic Antibodies, Influenza Virus Biology, Influenza, and Influenza Immunotherapy

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Urai Chaisri

2018-01-01

Full Text Available This narrative review article summarizes past and current technologies for generating antibodies for passive immunization/immunotherapy. Contemporary DNA and protein technologies have facilitated the development of engineered therapeutic monoclonal antibodies in a variety of formats according to the required effector functions. Chimeric, humanized, and human monoclonal antibodies to antigenic/epitopic myriads with less immunogenicity than animal-derived antibodies in human recipients can be produced in vitro. Immunotherapy with ready-to-use antibodies has gained wide acceptance as a powerful treatment against both infectious and noninfectious diseases. Influenza, a highly contagious disease, precipitates annual epidemics and occasional pandemics, resulting in high health and economic burden worldwide. Currently available drugs are becoming less and less effective against this rapidly mutating virus. Alternative treatment strategies are needed, particularly for individuals at high risk for severe morbidity. In a setting where vaccines are not yet protective or available, human antibodies that are broadly effective against various influenza subtypes could be highly efficacious in lowering morbidity and mortality and controlling unprecedented epidemic/pandemic. Prototypes of human single-chain antibodies to several conserved proteins of influenza virus with no Fc portion (hence, no ADE effect in recipients are available. These antibodies have high potential as a novel, safe, and effective anti-influenza agent.

Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster

NARCIS (Netherlands)

Sprung, Charles L.; Cohen, Robert; Adini, Bruria; Christian, Michael D.; Camargo, Ruben; Ceraso, Daniel; Azoulay, Elie; Duguet, Alexandre; Guery, Benoit; Reinhart, Konrad; Barlavie, Yaron; Benin-Goren, Odeda; Klein, Motti; Leoniv, Yuval; Margalit, Gila; Rubinovitch, Bina; Sonnenblick, Moshe; Steinberg, Avraham; Weissman, Charles; Wolff, Donna; Kesecioglu, Jozef; de Jong, Menno; Moreno, Rui; An, Youzhong; Du, Bin; Joynt, Gavin M.; Colvin, John; Loo, Shi; Richards, Guy; Artigas, Antonio; Pugin, Jerome; Amundson, Dennis; Devereaux, Asha; Beigel, John; Danis, Marion; Farmer, Chris; Hick, John L.; Maki, Dennis; Masur, Henry; Rubinson, Lewis; Sandrock, Christian; Talmor, Daniel; Truong, Robert; Zimmerman, Janice; Brett, Steve; Montgomery, Hugh; Rhodes, Andrew; Sanderson, Frances; Taylor, Bruce; Monrgomery, Hugh

2010-01-01

In December 2007, the European Society of Intensive Care Medicine established a Task Force to develop standard operating procedures (SOPs) for operating intensive care units (ICU) during an influenza epidemic or mass disaster. To provide direction for health care professionals in the preparation and

Needle-free influenza vaccination

NARCIS (Netherlands)

Amorij, Jean-Pierre; Hinrichs, Wouter L.J.; Frijlink, Henderik W.; Wilschut, Jan C.; Huckriede, Anke

2010-01-01

Vaccination is the cornerstone of influenza control in epidemic and pandemic situations. Influenza vaccines are typically given by intramuscular injection. However, needle-free vaccinations could offer several distinct advantages over intramuscular injections: they are pain-free, easier to

Pan-Influenza A Protection by Prime-Boost Vaccination with Cold-Adapted Live-Attenuated Influenza Vaccine in a Mouse Model.

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Jang, Yo Han; Kim, Joo Young; Byun, Young Ho; Son, Ahyun; Lee, Jeong-Yoon; Lee, Yoon Jae; Chang, Jun; Seong, Baik Lin

2018-01-01

Influenza virus infections continually pose a major public health threat with seasonal epidemics and sporadic pandemics worldwide. While currently licensed influenza vaccines provide only strain-specific protection, antigenic drift and shift occasionally render the viruses resistant to the host immune responses, which highlight the need for a vaccine that provides broad protection against multiple subtypes. In this study, we suggest a vaccination strategy using cold-adapted, live attenuated influenza vaccines (CAIVs) to provide a broad, potent, and safe cross-protection covering antigenically distinct hemagglutinin (HA) groups 1 and 2 influenza viruses. Using a mouse model, we tested different prime-boost combinations of CAIVs for their ability to induce humoral and T-cell responses, and protective efficacy against H1 and H5 (HA group 1) as well as H3 and H7 (HA group 2) influenza viruses. Notably, even in the absence of antibody-mediated neutralizing activity or HA inhibitory activity in vitro , CAIVs provided a potent protection against heterologous and heterosubtypic lethal challenges in vivo . Heterologous combination of prime (H1)-boost (H5) vaccine strains showed the most potent cross-protection efficacy. In vivo depletion experiments demonstrated not only that T cells and natural killer cells contributed to the cross-protection, but also the involvement of antibody-dependent mechanisms for the cross-protection. Vaccination-induced antibodies did not enhance the infectivity of heterologous viruses, and prime vaccination did not interfere with neutralizing antibody generation by the boost vaccination, allaying vaccine safety concerns associated with heterogeneity between the vaccines and challenge strains. Our data show that CAIV-based strategy can serve as a simple but powerful option for developing a "truly" universal influenza vaccine providing pan-influenza A protection, which has not been achieved yet by other vaccine strategies. The promising results

Pan-Influenza A Protection by Prime–Boost Vaccination with Cold-Adapted Live-Attenuated Influenza Vaccine in a Mouse Model

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Jang, Yo Han; Kim, Joo Young; Byun, Young Ho; Son, Ahyun; Lee, Jeong-Yoon; Lee, Yoon Jae; Chang, Jun; Seong, Baik Lin

2018-01-01

Influenza virus infections continually pose a major public health threat with seasonal epidemics and sporadic pandemics worldwide. While currently licensed influenza vaccines provide only strain-specific protection, antigenic drift and shift occasionally render the viruses resistant to the host immune responses, which highlight the need for a vaccine that provides broad protection against multiple subtypes. In this study, we suggest a vaccination strategy using cold-adapted, live attenuated influenza vaccines (CAIVs) to provide a broad, potent, and safe cross-protection covering antigenically distinct hemagglutinin (HA) groups 1 and 2 influenza viruses. Using a mouse model, we tested different prime–boost combinations of CAIVs for their ability to induce humoral and T-cell responses, and protective efficacy against H1 and H5 (HA group 1) as well as H3 and H7 (HA group 2) influenza viruses. Notably, even in the absence of antibody-mediated neutralizing activity or HA inhibitory activity in vitro, CAIVs provided a potent protection against heterologous and heterosubtypic lethal challenges in vivo. Heterologous combination of prime (H1)–boost (H5) vaccine strains showed the most potent cross-protection efficacy. In vivo depletion experiments demonstrated not only that T cells and natural killer cells contributed to the cross-protection, but also the involvement of antibody-dependent mechanisms for the cross-protection. Vaccination-induced antibodies did not enhance the infectivity of heterologous viruses, and prime vaccination did not interfere with neutralizing antibody generation by the boost vaccination, allaying vaccine safety concerns associated with heterogeneity between the vaccines and challenge strains. Our data show that CAIV-based strategy can serve as a simple but powerful option for developing a “truly” universal influenza vaccine providing pan-influenza A protection, which has not been achieved yet by other vaccine strategies. The promising

Impact of A Waning Vaccine and Altered Behavior on the Spread of Influenza

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Kasia A. Pawelek

2017-06-01

Full Text Available Influenza remains one of the major infectious diseases that targets humankind. Understanding within-host dynamics of the virus and how it translates into the spread of the disease at a population level can help us obtain more accurate disease outbreak predictions. We created an ordinary differential equation model with parameter estimates based on the disease symptoms score data to determine various disease stages and parameters associated with infectiousness and disease progression. Having various stages with different intensities of symptoms enables us to incorporate spontaneous behavior change due to the onset/offset of disease symptoms. Additionally, we incorporate the effect of a waning vaccine on delaying the time and decreasing the size of an epidemic peak. Our results showed that the epidemic peak in the model was significantly lowered when public vaccination was performed up to two months past the onset of an epidemic. Also, behavior change in the earliest stages of the epidemic lowers and delays the epidemic peak. This study further provides information on the potential impact of pharmaceutical and non-pharmaceutical interventions during an influenza epidemic.

On the epidemiology of influenza

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Scragg Robert

2008-02-01

Full Text Available Abstract The epidemiology of influenza swarms with incongruities, incongruities exhaustively detailed by the late British epidemiologist, Edgar Hope-Simpson. He was the first to propose a parsimonious theory explaining why influenza is, as Gregg said, "seemingly unmindful of traditional infectious disease behavioral patterns." Recent discoveries indicate vitamin D upregulates the endogenous antibiotics of innate immunity and suggest that the incongruities explored by Hope-Simpson may be secondary to the epidemiology of vitamin D deficiency. We identify – and attempt to explain – nine influenza conundrums: (1 Why is influenza both seasonal and ubiquitous and where is the virus between epidemics? (2 Why are the epidemics so explosive? (3 Why do they end so abruptly? (4 What explains the frequent coincidental timing of epidemics in countries of similar latitude? (5 Why is the serial interval obscure? (6 Why is the secondary attack rate so low? (7 Why did epidemics in previous ages spread so rapidly, despite the lack of modern transport? (8 Why does experimental inoculation of seronegative humans fail to cause illness in all the volunteers? (9 Why has influenza mortality of the aged not declined as their vaccination rates increased? We review recent discoveries about vitamin D's effects on innate immunity, human studies attempting sick-to-well transmission, naturalistic reports of human transmission, studies of serial interval, secondary attack rates, and relevant animal studies. We hypothesize that two factors explain the nine conundrums: vitamin D's seasonal and population effects on innate immunity, and the presence of a subpopulation of "good infectors." If true, our revision of Edgar Hope-Simpson's theory has profound implications for the prevention of influenza.

Chimeric Hemagglutinin Constructs Induce Broad Protection against Influenza B Virus Challenge in the Mouse Model

OpenAIRE

Ermler, Megan E.; Kirkpatrick, Ericka; Sun, Weina; Hai, Rong; Amanat, Fatima; Chromikova, Veronika; Palese, Peter; Krammer, Florian

2017-01-01

Seasonal influenza virus epidemics represent a significant public health burden. Approximately 25% of all influenza virus infections are caused by type B viruses, and these infections can be severe, especially in children. Current influenza virus vaccines are an effective prophylaxis against infection but are impacted by rapid antigenic drift, which can lead to mismatches between vaccine strains and circulating strains. Here, we describe a broadly protective vaccine candidate based on chimeri...

Network information analysis reveals risk perception transmission in a behaviour-influenza dynamics system.

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Liao, C-M; You, S-H; Cheng, Y-H

2015-01-01

Influenza poses a significant public health burden worldwide. Understanding how and to what extent people would change their behaviour in response to influenza outbreaks is critical for formulating public health policies. We incorporated the information-theoretic framework into a behaviour-influenza (BI) transmission dynamics system in order to understand the effects of individual behavioural change on influenza epidemics. We showed that information transmission of risk perception played a crucial role in the spread of health-seeking behaviour throughout influenza epidemics. Here a network BI model provides a new approach for understanding the risk perception spread and human behavioural change during disease outbreaks. Our study allows simultaneous consideration of epidemiological, psychological, and social factors as predictors of individual perception rates in behaviour-disease transmission systems. We suggest that a monitoring system with precise information on risk perception should be constructed to effectively promote health behaviours in preparation for emerging disease outbreaks.

Antiviral Efficacy of Verdinexor In Vivo in Two Animal Models of Influenza A Virus Infection

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Perwitasari, Olivia; Johnson, Scott; Yan, Xiuzhen; Register, Emery; Crabtree, Jackelyn; Gabbard, Jon; Howerth, Elizabeth; Shacham, Sharon; Carlson, Robert; Tamir, Sharon; Tripp, Ralph A.

2016-01-01

Influenza A virus (IAV) causes seasonal epidemics of respiratory illness that can cause mild to severe illness and potentially death. Antiviral drugs are an important countermeasure against IAV; however, drug resistance has developed, thus new therapeutic approaches are being sought. Previously, we demonstrated the antiviral activity of a novel nuclear export inhibitor drug, verdinexor, to reduce influenza replication in vitro and pulmonary virus burden in mice. In this study, in vivo efficacy of verdinexor was further evaluated in two animal models or influenza virus infection, mice and ferrets. In mice, verdinexor was efficacious to limit virus shedding, reduce pulmonary pro-inflammatory cytokine expression, and moderate leukocyte infiltration into the bronchoalveolar space. Similarly, verdinexor-treated ferrets had reduced lung pathology, virus burden, and inflammatory cytokine expression in the nasal wash exudate. These findings support the anti-viral efficacy of verdinexor, and warrant its development as a novel antiviral therapeutic for influenza infection. PMID:27893810

Antiviral Efficacy of Verdinexor In Vivo in Two Animal Models of Influenza A Virus Infection.

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Olivia Perwitasari

Full Text Available Influenza A virus (IAV causes seasonal epidemics of respiratory illness that can cause mild to severe illness and potentially death. Antiviral drugs are an important countermeasure against IAV; however, drug resistance has developed, thus new therapeutic approaches are being sought. Previously, we demonstrated the antiviral activity of a novel nuclear export inhibitor drug, verdinexor, to reduce influenza replication in vitro and pulmonary virus burden in mice. In this study, in vivo efficacy of verdinexor was further evaluated in two animal models or influenza virus infection, mice and ferrets. In mice, verdinexor was efficacious to limit virus shedding, reduce pulmonary pro-inflammatory cytokine expression, and moderate leukocyte infiltration into the bronchoalveolar space. Similarly, verdinexor-treated ferrets had reduced lung pathology, virus burden, and inflammatory cytokine expression in the nasal wash exudate. These findings support the anti-viral efficacy of verdinexor, and warrant its development as a novel antiviral therapeutic for influenza infection.

Estimating the between-farm transmission rates for highly pathogenic avian influenza subtype H5N1 epidemics in Bangladesh between 2007 and 2013

NARCIS (Netherlands)

Ssematimba, A.; Okike, I.; Ahmed, G.M.; Yamage, M.; Boender, G.J.; Hagenaars, T.J.; Bett, B.

2018-01-01

Highly Pathogenic Avian Influenza (HPAI) is classified by the World Organization for Animal Health as one of the notifiable diseases. Its occurrence is associated with severe socio-economic impacts and is also zoonotic. Bangladesh HPAI epidemic data for the period between 2007 and 2013 were obtained

Modeling the effect of transient populations on epidemics in Washington DC.

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Parikh, Nidhi; Youssef, Mina; Swarup, Samarth; Eubank, Stephen

2013-11-06

Large numbers of transients visit big cities, where they come into contact with many people at crowded areas. However, epidemiological studies have not paid much attention to the role of this subpopulation in disease spread. We evaluate the effect of transients on epidemics by extending a synthetic population model for the Washington DC metro area to include leisure and business travelers. A synthetic population is obtained by combining multiple data sources to build a detailed minute-by-minute simulation of population interaction resulting in a contact network. We simulate an influenza-like illness over the contact network to evaluate the effects of transients on the number of infected residents. We find that there are significantly more infections when transients are considered. Since much population mixing happens at major tourism locations, we evaluate two targeted interventions: closing museums and promoting healthy behavior (such as the use of hand sanitizers, covering coughs, etc.) at museums. Surprisingly, closing museums has no beneficial effect. However, promoting healthy behavior at the museums can both reduce and delay the epidemic peak. We analytically derive the reproductive number and perform stability analysis using an ODE-based model.

Modeling the effect of transient populations on epidemics in Washington DC

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Parikh, Nidhi; Youssef, Mina; Swarup, Samarth; Eubank, Stephen

2013-11-01

Large numbers of transients visit big cities, where they come into contact with many people at crowded areas. However, epidemiological studies have not paid much attention to the role of this subpopulation in disease spread. We evaluate the effect of transients on epidemics by extending a synthetic population model for the Washington DC metro area to include leisure and business travelers. A synthetic population is obtained by combining multiple data sources to build a detailed minute-by-minute simulation of population interaction resulting in a contact network. We simulate an influenza-like illness over the contact network to evaluate the effects of transients on the number of infected residents. We find that there are significantly more infections when transients are considered. Since much population mixing happens at major tourism locations, we evaluate two targeted interventions: closing museums and promoting healthy behavior (such as the use of hand sanitizers, covering coughs, etc.) at museums. Surprisingly, closing museums has no beneficial effect. However, promoting healthy behavior at the museums can both reduce and delay the epidemic peak. We analytically derive the reproductive number and perform stability analysis using an ODE-based model.

Breaking the waves: modelling the potential impact of public health measures to defer the epidemic peak of novel influenza A/H1N1.

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Matthias An der Heiden

Full Text Available BACKGROUND: On June 11, 2009, the World Health Organization declared phase 6 of the novel influenza A/H1N1 pandemic. Although by the end of September 2009, the novel virus had been reported from all continents, the impact in most countries of the northern hemisphere has been limited. The return of the virus in a second wave would encounter populations that are still nonimmune and not vaccinated yet. We modelled the effect of control strategies to reduce the spread with the goal to defer the epidemic wave in a country where it is detected in a very early stage. METHODOLOGY/PRINCIPAL FINDINGS: We constructed a deterministic SEIR model using the age distribution and size of the population of Germany based on the observed number of imported cases and the early findings for the epidemiologic characteristics described by Fraser (Science, 2009. We propose a two-step control strategy with an initial effort to trace, quarantine, and selectively give prophylactic treatment to contacts of the first 100 to 500 cases. In the second step, the same measures are focused on the households of the next 5,000 to 10,000 cases. As a result, the peak of the epidemic could be delayed up to 7.6 weeks if up to 30% of cases are detected. However, the cumulative attack rates would not change. Necessary doses of antivirals would be less than the number of treatment courses for 0.1% of the population. In a sensitivity analysis, both case detection rate and the variation of R0 have major effects on the resulting delay. CONCLUSIONS/SIGNIFICANCE: Control strategies that reduce the spread of the disease during the early phase of a pandemic wave may lead to a substantial delay of the epidemic. Since prophylactic treatment is only offered to the contacts of the first 10,000 cases, the amount of antivirals needed is still very limited.

The feasibility of age-specific travel restrictions during influenza pandemics.

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Lam, Elson H Y; Cowling, Benjamin J; Cook, Alex R; Wong, Jessica Y T; Lau, Max S Y; Nishiura, Hiroshi

2011-11-11

Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (~99%) would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group) were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less of an impact on the economy compared to restricting adult

The feasibility of age-specific travel restrictions during influenza pandemics

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Lam Elson HY

2011-11-01

Full Text Available Abstract Background Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (~99% would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. Methods A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Results Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Conclusions Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less

Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

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Carlos Polanco

2013-01-01

Full Text Available A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010 taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts.

Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

Science.gov (United States)

Castañón-González, Jorge Alberto; Macías, Alejandro E.; Samaniego, José Lino; Buhse, Thomas; Villanueva-Martínez, Sebastián

2013-01-01

A severe respiratory disease epidemic outbreak correlates with a high demand of specific supplies and specialized personnel to hold it back in a wide region or set of regions; these supplies would be beds, storage areas, hemodynamic monitors, and mechanical ventilators, as well as physicians, respiratory technicians, and specialized nurses. We describe an online cumulative sum based model named Overcrowd-Severe-Respiratory-Disease-Index based on the Modified Overcrowd Index that simultaneously monitors and informs the demand of those supplies and personnel in a healthcare network generating early warnings of severe respiratory disease epidemic outbreaks through the interpretation of such variables. A post hoc historical archive is generated, helping physicians in charge to improve the transit and future allocation of supplies in the entire hospital network during the outbreak. The model was thoroughly verified in a virtual scenario, generating multiple epidemic outbreaks in a 6-year span for a 13-hospital network. When it was superimposed over the H1N1 influenza outbreak census (2008–2010) taken by the National Institute of Medical Sciences and Nutrition Salvador Zubiran in Mexico City, it showed that it is an effective algorithm to notify early warnings of severe respiratory disease epidemic outbreaks with a minimal rate of false alerts. PMID:24069063

[Differences in oligomerization of nucleocapsid protein of epidemic human influenza A(H1N1), A(H1N2) and B viruses].

Science.gov (United States)

Prokudina, E N; Semenova, N P; Chumakov, V M; Burtseva, E I; Slepushkin, A N

2003-01-01

A comparative analysis of involving the nucleocapsid protein (NP) into shaping-up of SDS-resistant oligomers was carried out presently in circulating epidemic strains of human influenza, viruses A and B. The study results of viral isolates obtained from clinical samples and recent standard strains revealed that the involvement of NP in the SDS-resistant oligomers, which are different in various subtypes of influenza A viruses. According to this sign, the human viruses A(9H3N2) are close to the avian ones, in which, as proved by us previously, virtually the entire NP transforms itself into the oligomers resistant to SDS. About 10-20% of NP are involved in shaping-up the virus influenza A(H1N1) of SDS-resistant oligomers. No SDS-resistant NP-oligomers were detected in influenza of type B. It is suggested that the prevalence of human viruses A(H3N2) in NP-oligomers are the peculiarities of NP structure and of the presence of the PB1 protein from avian influenza virus.

The highly pathogenic avian influenza A (H7N7) virus epidemic in the Netherlands in 2003 - lessons learned from the first five outbreaks

NARCIS (Netherlands)

Elbers, A.R.W.; Fabri, T.; Vries, T.S.; Wit, de J.J.; Pijpers, A.; Koch, G.

2004-01-01

Clinical signs and gross lesions observed in poultry submitted for postmortem examination (PME) from the first five infected poultry flocks preceding the detection of the primary outbreak of highly pathogenic avian influenza (HPAI) of subtype H7N7 during the 2003 epidemic in the Netherlands are

Pandemic influenza: certain uncertainties

Science.gov (United States)

Morens, David M.; Taubenberger, Jeffery K.

2011-01-01

SUMMARY 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 much more that we do not know. Pandemics arise as a result of various genetic mechanisms, have no predictable patterns of mortality among different age groups, and vary greatly in how and when they arise and recur. Some are followed by new pandemics, whereas others fade gradually or abruptly into long-term endemicity. Human influenza pandemics have been caused by viruses that evolved singly or in co-circulation with other pandemic virus descendants and often have involved significant transmission between, or establishment of, viral reservoirs within other animal hosts. In recent decades, pandemic influenza has continued to produce numerous unanticipated events that expose fundamental gaps in scientific knowledge. Influenza pandemics appear to be not a single phenomenon but a heterogeneous collection of viral evolutionary events whose similarities are overshadowed by important differences, the determinants of which remain poorly understood. These uncertainties make it difficult to predict influenza pandemics and, therefore, to adequately plan to prevent them. PMID:21706672

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

Science.gov (United States)

Carrasco, Luis R; Lee, Vernon J; Chen, Mark I; Matchar, David B; Thompson, James P; Cook, Alex R

2011-09-07

Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic-economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, Guatemala, India, Indonesia, New Zealand, Singapore, the UK, the USA and Zimbabwe. In the model, antivirals stockpiling considerably reduced mortality. There was greater potential avoidance of expected costs in the higher resourced countries (e.g. from $55 billion to $27 billion over a 30 year time horizon for the USA) and large avoidance of fatalities in those less resourced (e.g. from 11.4 to 2.3 million in Indonesia). Under perfect allocation, higher resourced countries should aim to store antiviral stockpiles able to cover at least 15 per cent of their population, rising to 25 per cent with 30 per cent misallocation, to minimize fatalities and economic costs. Stockpiling is estimated not to be cost-effective for two-thirds of the world's population under current antivirals pricing. Lower prices and international cooperation are necessary to make the life-saving potential of antivirals cost-effective in resource-limited countries.

Seasonal Influenza: An Overview

Science.gov (United States)

Li, Christina; Freedman, Marian

2009-01-01

Seasonal influenza is a major cause of morbidity and mortality in the United States. It also has major social and economic consequences in the form of high rates of absenteeism from school and work as well as significant treatment and hospitalization costs. In fact, annual influenza epidemics and the resulting deaths and lost days of productivity…

Viruses associated with human and animal influenza - a review ...

African Journals Online (AJOL)

In this review, the most important viruses associated with human and animal influenza are reported. These include Influenza A,B and C. Influenza viruses are members of the family Orthomyxoviridae. Influenza A virus being the most pathogenic and wide spread with many subtypes has constantly cause epidemics in several ...

Epidemics: Lessons from the past and current patterns of response

Science.gov (United States)

Martin, Paul

2008-09-01

Hippocrates gave the term 'epidemic' its medical meaning. From antiquity to modern times, the meaning of the word epidemic has continued to evolve. Over the centuries, researchers have reached an understanding of the varying aspects of epidemics and have tried to combat them. The role played by travel, trade, and human exchanges in the propagation of epidemic infectious diseases has been understood. In 1948, the World Health Organization was created and given the task of advancing ways of combating epidemics. An early warning system to combat epidemics has been implemented by the WHO. The Global Outbreak Alert and Response Network (GOARN) is collaboration between existing institutions and networks that pool their human and technical resources to fight outbreaks. Avian influenza constitutes currently the most deadly epidemic threat, with fears that it could rapidly reach pandemic proportions and put several thousands of lives in jeopardy. Thanks to the WHO's support, most of the world's countries have mobilised and implemented an 'Action Plan for Pandemic Influenza'. As a result, most outbreaks of the H5N1 avian flu virus have so far been speedily contained. Cases of dengue virus introduction in countries possessing every circumstance required for its epidemic spread provide another example pertinent to the prevention of epidemics caused by vector-borne pathogens.

Immune response to inactivated influenza virus vaccine: antibody reactivity with epidemic influenza B viruses of two highly distinct evolutionary lineages.

Science.gov (United States)

Pyhälä, R; Kleemola, M; Kumpulainen, V; Vartiainen, E; Lappi, S; Pönkä, A; Cantell, K

1992-01-01

Vaccination of adults (healthy female employees potentially capable of transmitting influenza to high-risk persons; n = 104) in autumn 1990 with a trivalent influenza virus vaccine containing B/Yamagata/16/88 induced a low antibody response to B/Finland/150/90, a recent variant of B/Victoria/2/87-like viruses, as compared with the antibody response to B/Finland/172/91, a current variant in the lineage of B/Yamagata/16/88-like viruses. Up to the end of the epidemic season, the antibody status declined but was still significantly better than before the vaccination. The results suggest that the vaccine strain was appropriate for the outbreak of 1990 to 1991 in Finland, but may provide unsatisfactory protection against B/Victoria/2/87-like viruses. Evidence is given that use of Madin-Darby canine kidney (MDCK)-grown virus as an antigen in the haemagglutination inhibition test (HI) may provide more reliable information about the protective antibodies than use of untreated or ether-treated egg-grown viruses. Significantly higher postvaccination and postepidemic antibody titres were recorded among subjects who exhibited the antibody before vaccination than among seronegative subjects. A significantly higher response rate among initially seronegative people than among seropositive people was recorded for antibody to B/Finland/150/90, but no clear evidence was obtained that the pre-existing antibody could have had a negative effect on the antibody production.

The global condition of epidemics: Panoramas in A (H1N1) influenza and their consequences for One World One Health programme.

Science.gov (United States)

Tirado, Francisco; Gómez, Andrés; Rocamora, Verónica

2015-03-01

Among the most relevant elements contributing to define the One World One Health programme we find epidemics. The reason is that in recent decades, infectious diseases such as HIV/SIDA, SARS and Influenza have shown that we need new approaches and concepts in order to understand how biological emergencies and health alerts deploy new scales of action. Especially relevant has been the case of A(H1N1) influenza. This reached the status of global threat virtually from its onset, triggering an international response with a diffusion, visibility and rapidity unparalleled in previous health alerts. This article maintains that this global condition cannot be explained solely by the epidemiologic characteristics of the disease, such as mortality rate, severe cases, propagation capacity, etc. Resorting to the approach proposed by the Actor-Network Theory (ANT), this paper suggests that the action of certain socio-technical operators was what built a heterogeneous network of ideas, concepts and materials that turned the A (H1N1) influenza into a global-scale phenomenon with unprecedented speed. Among these operators, the most important ones were: the speaking position, a discourse about threat, the protocols and guidelines that were used and, lastly, the maps that allowed a real-time monitoring of the influenza. The paper ends with the notion of panorama, as defined by Bruno Latour: a suggestion to describe the common denominator of the aforementioned operators, and a means to foresee the development of global scales for certain health alerts. The paper will conclude by proposing that this type of analysis would allow the One World One Health to understand with greater precision the dynamic of epidemics and thus make its principles of action much more specific as well as its definition of what global health should be. Copyright © 2014 Elsevier Ltd. All rights reserved.

Leveraging social networks for understanding the evolution of epidemics

Science.gov (United States)

2011-01-01

Background To understand how infectious agents disseminate throughout a population it is essential to capture the social model in a realistic manner. This paper presents a novel approach to modeling the propagation of the influenza virus throughout a realistic interconnection network based on actual individual interactions which we extract from online social networks. The advantage is that these networks can be extracted from existing sources which faithfully record interactions between people in their natural environment. We additionally allow modeling the characteristics of each individual as well as customizing his daily interaction patterns by making them time-dependent. Our purpose is to understand how the infection spreads depending on the structure of the contact network and the individuals who introduce the infection in the population. This would help public health authorities to respond more efficiently to epidemics. Results We implement a scalable, fully distributed simulator and validate the epidemic model by comparing the simulation results against the data in the 2004-2005 New York State Department of Health Report (NYSDOH), with similar temporal distribution results for the number of infected individuals. We analyze the impact of different types of connection models on the virus propagation. Lastly, we analyze and compare the effects of adopting several different vaccination policies, some of them based on individual characteristics -such as age- while others targeting the super-connectors in the social model. Conclusions This paper presents an approach to modeling the propagation of the influenza virus via a realistic social model based on actual individual interactions extracted from online social networks. We implemented a scalable, fully distributed simulator and we analyzed both the dissemination of the infection and the effect of different vaccination policies on the progress of the epidemics. The epidemic values predicted by our simulator match

Leveraging social networks for understanding the evolution of epidemics

Directory of Open Access Journals (Sweden)

Martín Gonzalo

2011-12-01

Full Text Available Abstract Background To understand how infectious agents disseminate throughout a population it is essential to capture the social model in a realistic manner. This paper presents a novel approach to modeling the propagation of the influenza virus throughout a realistic interconnection network based on actual individual interactions which we extract from online social networks. The advantage is that these networks can be extracted from existing sources which faithfully record interactions between people in their natural environment. We additionally allow modeling the characteristics of each individual as well as customizing his daily interaction patterns by making them time-dependent. Our purpose is to understand how the infection spreads depending on the structure of the contact network and the individuals who introduce the infection in the population. This would help public health authorities to respond more efficiently to epidemics. Results We implement a scalable, fully distributed simulator and validate the epidemic model by comparing the simulation results against the data in the 2004-2005 New York State Department of Health Report (NYSDOH, with similar temporal distribution results for the number of infected individuals. We analyze the impact of different types of connection models on the virus propagation. Lastly, we analyze and compare the effects of adopting several different vaccination policies, some of them based on individual characteristics -such as age- while others targeting the super-connectors in the social model. Conclusions This paper presents an approach to modeling the propagation of the influenza virus via a realistic social model based on actual individual interactions extracted from online social networks. We implemented a scalable, fully distributed simulator and we analyzed both the dissemination of the infection and the effect of different vaccination policies on the progress of the epidemics. The epidemic values

Mean-field analysis of an inductive reasoning game: application to influenza vaccination.

Science.gov (United States)

Breban, Romulus; Vardavas, Raffaele; Blower, Sally

2007-09-01

Recently we have introduced an inductive reasoning game of voluntary yearly vaccination to establish whether or not a population of individuals acting in their own self-interest would be able to prevent influenza epidemics. Here, we analyze our model to describe the dynamics of the collective yearly vaccination uptake. We discuss the mean-field equations of our model and first order effects of fluctuations. We explain why our model predicts that severe epidemics are periodically expected even without the introduction of pandemic strains. We find that fluctuations in the collective yearly vaccination uptake induce severe epidemics with an expected periodicity that depends on the number of independent decision makers in the population. The mean-field dynamics also reveal that there are conditions for which the dynamics become robust to the fluctuations. However, the transition between fluctuation-sensitive and fluctuation-robust dynamics occurs for biologically implausible parameters. We also analyze our model when incentive-based vaccination programs are offered. When a family-based incentive is offered, the expected periodicity of severe epidemics is increased. This results from the fact that the number of independent decision makers is reduced, increasing the effect of the fluctuations. However, incentives based on the number of years of prepayment of vaccination may yield fluctuation-robust dynamics where severe epidemics are prevented. In this case, depending on prepayment, the transition between fluctuation-sensitive and fluctuation-robust dynamics may occur for biologically plausible parameters. Our analysis provides a practical method for identifying how many years of free vaccination should be provided in order to successfully ameliorate influenza epidemics.

Influenza A (H10N7) Virus Causes Respiratory Tract Disease in Harbor Seals and Ferrets

NARCIS (Netherlands)

van den Brand, Judith M A; Wohlsein, Peter; Herfst, Sander; Bodewes, Rogier; Pfankuche, Vanessa M; van de Bildt, Marco W G; Seehusen, Frauke; Puff, Christina; Richard, Mathilde; Siebert, Ursula; Lehnert, Kristina; Bestebroer, Theo; Lexmond, Pascal; Fouchier, Ron A M; Prenger-Berninghoff, Ellen; Herbst, Werner; Koopmans, Marion; Osterhaus, Albert D M E; Kuiken, Thijs; Baumgärtner, Wolfgang

2016-01-01

Avian influenza viruses sporadically cross the species barrier to mammals, including humans, in which they may cause epidemic disease. Recently such an epidemic occurred due to the emergence of avian influenza virus of the subtype H10N7 (Seal/H10N7) in harbor seals (Phoca vitulina). This epidemic

Universal influenza vaccines, science fiction or soon reality?

Science.gov (United States)

de Vries, Rory D; Altenburg, Arwen F; Rimmelzwaan, Guus F

2015-01-01

Currently used influenza vaccines are only effective when the vaccine strains match the epidemic strains antigenically. To this end, seasonal influenza vaccines must be updated almost annually. Furthermore, seasonal influenza vaccines fail to afford protection against antigenically distinct pandemic influenza viruses. Because of an ever-present threat of the next influenza pandemic and the continuous emergence of drift variants of seasonal influenza A viruses, there is a need for an universal influenza vaccine that induces protective immunity against all influenza A viruses. Here, we summarize some of the efforts that are ongoing to develop universal influenza vaccines.

Influenza as a human disease

Indian Academy of Sciences (India)

First page Back Continue Last page Graphics. Influenza as a human disease. Commonly perceived as a mild disease, affects every one, sometimes a couple of times in a year. Globally, seasonal influenza epidemics result in about three to five million yearly cases of severe illness and about 250,000 to 500,000 yearly ...

Epidemic modeling in complex realities.

Science.gov (United States)

Colizza, Vittoria; Barthélemy, Marc; Barrat, Alain; Vespignani, Alessandro

2007-04-01

In our global world, the increasing complexity of social relations and transport infrastructures are key factors in the spread of epidemics. In recent years, the increasing availability of computer power has enabled both to obtain reliable data allowing one to quantify the complexity of the networks on which epidemics may propagate and to envision computational tools able to tackle the analysis of such propagation phenomena. These advances have put in evidence the limits of homogeneous assumptions and simple spatial diffusion approaches, and stimulated the inclusion of complex features and heterogeneities relevant in the description of epidemic diffusion. In this paper, we review recent progresses that integrate complex systems and networks analysis with epidemic modelling and focus on the impact of the various complex features of real systems on the dynamics of epidemic spreading.

Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study

NARCIS (Netherlands)

Hak, E; van Loon, S; Buskens, E; van Essen, G A; de Bakker, D; Tacken, M A J B; van Hout, B A; Grobbee, D E; Verheij, Th J M

2003-01-01

Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis

The health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) during an annual influenza epidemic and influenza pandemic in China.

Science.gov (United States)

Caldwell, Ronald; Roberts, Craig S; An, Zhijie; Chen, Chieh-I; Wang, Bruce

2015-07-24

China has experienced several severe outbreaks of influenza over the past century: 1918, 1957, 1968, and 2009. Influenza itself can be deadly; however, the increase in mortality during an influenza outbreak is also attributable to secondary bacterial infections, specifically pneumococcal disease. Given the history of pandemic outbreaks and the associated morbidity and mortality, we investigated the cost-effectiveness of a PCV7 vaccination program in China from the context of typical and pandemic influenza seasons. A decision-analytic model was employed to evaluate the impact of a 7-valent pneumococcal vaccine (PCV7) infant vaccination program on the incidence, mortality, and cost associated with pneumococcal disease during a typical influenza season (15% flu incidence) and influenza pandemic (30% flu incidence) in China. The model incorporated Chinese data where available and included both direct and indirect (herd) effects on the unvaccinated population, assuming a point in time following the initial introduction of the vaccine where the impact of the indirect effects has reached a steady state, approximately seven years following the implementation of the vaccine program. Pneumococcal disease incidence, mortality, and costs were evaluated over a one year time horizon. Healthcare costs were calculated using a payer perspective and included vaccination program costs and direct medical expenditures from pneumococcal disease. The model predicted that routine PCV7 vaccination of infants in China would prevent 5,053,453 cases of pneumococcal disease and 76,714 deaths in a single year during a normal influenza season.The estimated incremental-cost-effectiveness ratios were ¥12,281 (US$1,900) per life-year saved and ¥13,737 (US$2,125) per quality-adjusted-life-year gained. During an influenza pandemic, the model estimated that routine vaccination with PCV7 would prevent 8,469,506 cases of pneumococcal disease and 707,526 deaths, and would be cost-saving. Routine

Finding optimal vaccination strategies for pandemic influenza using genetic algorithms.

Science.gov (United States)

Patel, Rajan; Longini, Ira M; Halloran, M Elizabeth

2005-05-21

In the event of pandemic influenza, only limited supplies of vaccine may be available. We use stochastic epidemic simulations, genetic algorithms (GA), and random mutation hill climbing (RMHC) to find optimal vaccine distributions to minimize the number of illnesses or deaths in the population, given limited quantities of vaccine. Due to the non-linearity, complexity and stochasticity of the epidemic process, it is not possible to solve for optimal vaccine distributions mathematically. However, we use GA and RMHC to find near optimal vaccine distributions. We model an influenza pandemic that has age-specific illness attack rates similar to the Asian pandemic in 1957-1958 caused by influenza A(H2N2), as well as a distribution similar to the Hong Kong pandemic in 1968-1969 caused by influenza A(H3N2). We find the optimal vaccine distributions given that the number of doses is limited over the range of 10-90% of the population. While GA and RMHC work well in finding optimal vaccine distributions, GA is significantly more efficient than RMHC. We show that the optimal vaccine distribution found by GA and RMHC is up to 84% more effective than random mass vaccination in the mid range of vaccine availability. GA is generalizable to the optimization of stochastic model parameters for other infectious diseases and population structures.

Contact structures in the poultry industry in Great Britain: Exploring transmission routes for a potential avian influenza virus epidemic

Directory of Open Access Journals (Sweden)

Hyder Kieran

2008-07-01

Full Text Available Abstract Background The commercial poultry industry in United Kingdom (UK is worth an estimated £3.4 billion at retail value, producing over 174 million birds for consumption per year. An epidemic of any poultry disease with high mortality or which is zoonotic, such as avian influenza virus (AIV, would result in the culling of significant numbers of birds, as seen in the Netherlands in 2003 and Italy in 2000. Such an epidemic would cost the UK government millions of pounds in compensation costs, with further economic losses through reduction of international and UK consumption of British poultry. In order to better inform policy advisers and makers on the potential for a large epidemic in GB, we investigate the role that interactions amongst premises within the British commercial poultry industry could play in promoting an AIV epidemic, given an introduction of the virus in a specific part of poultry industry in Great Britain (GB. Results Poultry premises using multiple slaughterhouses lead to a large number of premises being potentially connected, with the resultant potential for large and sometimes widespread epidemics. Catching companies can also potentially link a large proportion of the poultry population. Critical to this is the maximum distance traveled by catching companies between premises and whether or not between-species transmission could occur within individual premises. Premises closely linked by proximity may result in connections being formed between different species and or sectors within the industry. Conclusion Even quite well-contained epidemics have the potential for geographically widespread dissemination, potentially resulting in severe logistical problems for epidemic control, and with economic impact on a large part of the country. Premises sending birds to multiple slaughterhouses or housing multiple species may act as a bridge between otherwise separate sectors of the industry, resulting in the potential for large

Avian Influenza A (H7N9) Virus

Science.gov (United States)

... August 7, 2017 Increase in Human Infections with Avian Influenza A(H7N9) Virus During the Fifth Epidemic — China, October 2016–February 2017 Antigenic and genetic characteristics of zoonotic influenza viruses and candidate vaccine viruses developed for ...

Bestrijding van aviaire influenza onder pluimvee: vaccinatie als aanvullende mogelijkheid

NARCIS (Netherlands)

Aarle, P van; Breytenbach, J; Schueller, S

2006-01-01

Since mid-December 2003, highly pathogenic avian influenza (HPAI) has caused an epidemic in the Asian poultry sector and avian influenza cases have been reported in Europe, the Middle East and Africa. Human fatalities catapulted avian influenza into the public arena with fears of a possible global

Seasonal influenza split vaccines confer partial cross-protection against heterologous influenza virus in ferrets when combined with the CAF01 adjuvant

DEFF Research Database (Denmark)

Christensen, Dennis; Christensen, Jan P.; Korsholm, Karen S.

2018-01-01

Influenza epidemics occur annually, and estimated 5-10% of the adult population and 20-30% of children will become ill from influenza infection. Seasonal vaccines primarily work through the induction of neutralizing antibodies against the principal surface antigen hemagglutinin (HA). This important...... role of HA-specific antibodies explains why previous pandemics have emerged when new HAs have appeared in circulating human viruses. It has long been recognized that influenza virus-specific CD4(+) T cells are important in protection from infection through direct effector mechanisms or by providing...... help to B cells and CD8(+) T cells. However, the seasonal influenza vaccine is poor at inducing CD4(+) T-cell responses and needs to be combined with an adjuvant facilitating this response. In this study, we applied the ferret model to investigate the cross-protective efficacy of a heterologous...

Epidemiology, Evolution, and Pathogenesis of H7N9 Influenza Viruses in Five Epidemic Waves since 2013 in China.

Science.gov (United States)

Su, Shuo; Gu, Min; Liu, Di; Cui, Jie; Gao, George F; Zhou, Jiyong; Liu, Xiufan

2017-09-01

H7N9 influenza viruses were first isolated in 2013 and continue to cause human infections. H7N9 infections represent an ongoing public health threat that has resulted in 1344 cases with 511 deaths as of April 9, 2017. This highlights the continued threat posed by the current poultry trade and live poultry market system in China. Until now, there have been five H7N9 influenza epidemic waves in China; however, the steep increase in the number of humans infected with H7N9 viruses observed in the fifth wave, beginning in October 2016, the spread into western provinces, and the emergence of highly pathogenic (HP) H7N9 influenza outbreaks in chickens and infection in humans have caused domestic and international concern. In this review, we summarize and compare the different waves of H7N9 regarding their epidemiology, pathogenesis, evolution, and characteristic features, and speculate on factors behind the recent increase in the number of human cases and sudden outbreaks in chickens. The continuous evolution of the virus poses a long-term threat to public health and the poultry industry, and thus it is imperative to strengthen prevention and control strategies. Copyright © 2017. Published by Elsevier Ltd.

Modeling Epidemics Spreading on Social Contact Networks.

Science.gov (United States)

Zhang, Zhaoyang; Wang, Honggang; Wang, Chonggang; Fang, Hua

2015-09-01

Social contact networks and the way people interact with each other are the key factors that impact on epidemics spreading. However, it is challenging to model the behavior of epidemics based on social contact networks due to their high dynamics. Traditional models such as susceptible-infected-recovered (SIR) model ignore the crowding or protection effect and thus has some unrealistic assumption. In this paper, we consider the crowding or protection effect and develop a novel model called improved SIR model. Then, we use both deterministic and stochastic models to characterize the dynamics of epidemics on social contact networks. The results from both simulations and real data set conclude that the epidemics are more likely to outbreak on social contact networks with higher average degree. We also present some potential immunization strategies, such as random set immunization, dominating set immunization, and high degree set immunization to further prove the conclusion.

Scenario-ontwikkeling zorgvraag bij een influenza-pandemie

NARCIS (Netherlands)

Genugten MLL van; Heijnen MLA; Jager JC; CZO; CIE

2001-01-01

Another influenza pandemic, following the 1918, 1957 and the 1968 pandemic, is likely if not inevitable. In a 'regular' influenza-epidemic 5-20% of the population is to become clinically ill; during a pandemic this percentage can mount to 30 or even 50%. A pandemic could cause substantial social

Emerging influenza viruses and the prospect of a universal influenza virus vaccine.

Science.gov (United States)

Krammer, Florian

2015-05-01

Influenza viruses cause annual seasonal epidemics and pandemics at irregular intervals. Several cases of human infections with avian and swine influenza viruses have been detected recently, warranting enhanced surveillance and the development of more effective countermeasures to address the pandemic potential of these viruses. The most effective countermeasure against influenza virus infection is the use of prophylactic vaccines. However, vaccines that are currently in use for seasonal influenza viruses have to be re-formulated and re-administered in a cumbersome process every year due to the antigenic drift of the virus. Furthermore, current seasonal vaccines are ineffective against novel pandemic strains. This paper reviews zoonotic influenza viruses with pandemic potential and technological advances towards better vaccines that induce broad and long lasting protection from influenza virus infection. Recent efforts have focused on the development of broadly protective/universal influenza virus vaccines that can provide immunity against drifted seasonal influenza virus strains but also against potential pandemic viruses. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Integrated travel network model for studying epidemics: Interplay between journeys and epidemic

Science.gov (United States)

Ruan, Zhongyuan; Wang, Chaoqing; Ming Hui, Pak; Liu, Zonghua

2015-06-01

The ease of travelling between cities has contributed much to globalization. Yet, it poses a threat on epidemic outbreaks. It is of great importance for network science and health control to understand the impact of frequent journeys on epidemics. We stress that a new framework of modelling that takes a traveller’s viewpoint is needed. Such integrated travel network (ITN) model should incorporate the diversity among links as dictated by the distances between cities and different speeds of different modes of transportation, diversity among nodes as dictated by the population and the ease of travelling due to infrastructures and economic development of a city, and round-trip journeys to targeted destinations via the paths of shortest travel times typical of human journeys. An example is constructed for 116 cities in China with populations over one million that are connected by high-speed train services and highways. Epidemic spread on the constructed network is studied. It is revealed both numerically and theoretically that the traveling speed and frequency are important factors of epidemic spreading. Depending on the infection rate, increasing the traveling speed would result in either an enhanced or suppressed epidemic, while increasing the traveling frequency enhances the epidemic spreading.

Heterosybtypic T-cell immunity to influenza in humans: challenges for universal T-cell influenza vaccines

Directory of Open Access Journals (Sweden)

Saranya eSridhar

2016-05-01

Full Text Available Influenza A virus (IAV remains a significant global health issue causing annual epidemics, pandemics and sporadic human infections with highly pathogenic avian or swine influenza viruses. Current inactivated and live vaccines are the mainstay of the public health response to influenza although vaccine efficacy is lower against antigenically distinct viral strains. The first pandemic of the 21st century underlined the urgent need to develop new vaccines capable of protection against a broad range of influenza strains. Such universal influenza vaccines are based on the idea of heterosubtypic immunity wherein immune responses to epitopes conserved across IAV strains can confer protection against subsequent infection and disease. T-cells recognising conserved antigens are a key contributor to reducing viral load and limiting disease severity during heterosubtypic infection in animal models. Recent studies undertaken during the 2009 H1N1 pandemic provided key insights into the role of cross-reactive T-cells in mediating heterosubtypic protection in humans. This review focuses on human influenza to discuss the epidemiological observations that underpin cross-protective immunity, the role of T-cells as key players in mediating heterosubtypic immunity including recent data from natural history cohort studies and the ongoing clinical development of T-cell inducing universal influenza vaccines. The challenges and knowledge gaps for developing vaccines to generate long-lived protective T-cell responses is discussed.

Comparative epidemiology of influenza A and B viral infection in a subtropical region: a 7-year surveillance in Okinawa, Japan

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Yoshikazu Iha

2016-11-01

Full Text Available Abstract Background The epidemic patterns of influenza B infection and their association with climate conditions are not well understood. Influenza surveillance in Okinawa is important for clarifying transmission patterns in both temperate and tropical regions. Using surveillance data, collected over 7 years in the subtropical region of Japan, this study aims to characterize the epidemic patterns of influenza B infection and its association with ambient temperature and relative humidity, in a parallel comparison with influenza A. Methods From January 2007 until March 2014, two individual influenza surveillance datasets were collected from external sources. The first dataset, included weekly rapid antigen test (RAT results from four representative general hospitals, located in the capital city of Okinawa. A nation-wide surveillance of influenza, diagnosed by RAT results and/or influenza-like illness symptoms, included the age distribution of affected patients and was used as the second dataset. To analyze the association between infection and local climate conditions, ambient temperature and relative humidity during the study period were retrieved from the Japanese Meteorological Agency website. Results Although influenza A maintained high number of infections from December through March, epidemics of influenza B infection were observed annually from March through July. The only observed exception was 2010, when the pandemic strain of 2009 dominated. During influenza B outbreaks, influenza patients aged 5 to 9 years old and 10 to 14 years old more frequently visited sentinel sites. Although both ambient temperature and relative humidity are inversely associated with influenza A infection, influenza B infection was found to be directly associated with high relative humidity. Conclusion Further studies are needed to elucidate the complex epidemiology of influenza B and its relationship with influenza A. In the subtropical setting of Okinawa

No serological evidence that harbour porpoises are additional hosts of influenza B viruses

NARCIS (Netherlands)

R. Bodewes (Rogier); M.W.G. van de Bildt (Marco); C.E. van Elk; P.E. Bunskoek (Paulien); D.A.M.C. van de Vijver (David); S.L. Smits (Saskia); A.D.M.E. Osterhaus (Albert); T. Kuiken (Thijs)

2014-01-01

textabstractInfluenza A and B viruses circulate among humans causing epidemics almost annually. While various hosts for influenza A viruses exist, influenza B viruses have been detected only in humans and seals. However, recurrent infections of seals in Dutch coastal waters with influenza B viruses

Do recommended high-risk adults benefit from a first influenza vaccination?

NARCIS (Netherlands)

Hak, E; Buskens, E; Nichol, K L; Verheij, T J M

2006-01-01

It is unknown whether a first influenza vaccination protects high-risk adults from severe morbidity and mortality during influenza epidemics. As part of the PRISMA nested case-control study, we aimed to evaluate the effectiveness of first-time and repeat influenza vaccinations in adult persons

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

Science.gov (United States)

Kubar', O I; Asatrian, A Zh

2012-01-01

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

A Data-Driven Air Transportation Delay Propagation Model Using Epidemic Process Models

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B. Baspinar

2016-01-01

Full Text Available In air transport network management, in addition to defining the performance behavior of the system’s components, identification of their interaction dynamics is a delicate issue in both strategic and tactical decision-making process so as to decide which elements of the system are “controlled” and how. This paper introduces a novel delay propagation model utilizing epidemic spreading process, which enables the definition of novel performance indicators and interaction rates of the elements of the air transportation network. In order to understand the behavior of the delay propagation over the network at different levels, we have constructed two different data-driven epidemic models approximating the dynamics of the system: (a flight-based epidemic model and (b airport-based epidemic model. The flight-based epidemic model utilizing SIS epidemic model focuses on the individual flights where each flight can be in susceptible or infected states. The airport-centric epidemic model, in addition to the flight-to-flight interactions, allows us to define the collective behavior of the airports, which are modeled as metapopulations. In network model construction, we have utilized historical flight-track data of Europe and performed analysis for certain days involving certain disturbances. Through this effort, we have validated the proposed delay propagation models under disruptive events.

Clinicopathologic Characteristics of Influenza А(H1n1pdm during 2015–2016 Epidemic Period in Elderly Persons

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O.N. Domashenko

2016-09-01

Full Text Available The objective of the study is to investigate clinical progression of influenza A(H1N1, influenzal pneumonia, pathomorphological pulmonary changes in the lungs in elderly persons in 2015–2016. Materials and methods. During 2015–2016 epidemic period 36 patients suffering from influenza А(H1N1 aged of 60–84 years old (24 male and 12 female patients were attended to the Donetsk Central Municipal Clinical Hospital № 1. Influenza with pneumonia was diagnosed in 24 patients (66.7 %. In 33.3 % the diagnosis of influenza А(H1N1 was confirmed by viral serology testing (hemagglutination-inhibition test, in 63.9 % — by the polymerase chain reaction method, including 87.5 % of deceased patients. Research findings. During 5 years prior to the disease there was no history of influenza vaccination in all patients. On the 5–9th sick day 66.7 % of the patients were hospitalized, 1 female patient (2.8 % was admitted to the department in 2 weeks after the disease onset. Apparent intoxication syndrome was observed from the first day of the disease in 41.7 % of patients with uncomplicated influenza. The duration of fever was 8.7 ± 2.6 days. All elderly patients with uncomplicated influenza recovered. Influenza complicated by pneumonia was diagnosed in 24 patients (66.7 %. In 36.1 % of patients pneumonia was total or subtotal, complicated by respiratory failure of II–III degree of severity. Patients suffering from influenza and influenzal pneumonia did not receive antiviral treatment with oseltamyvirum (Tamiflu due to the lack of this medicinal product in the pharmacy network under the conditions of the local armed conflict. Antibacterial therapy included intravenous meropenum, protected 3rd generation cephalosporins, respiratory fluoroquinolones, macrolides in usual dosages. Oxygen therapy was an indispensable condition for the complex treatment of patients with influenzal pneumonia via a facemask, airtight reservoir bag mask, airtight

Chapter 2. Surge capacity and infrastructure considerations for mass critical care. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster

NARCIS (Netherlands)

Hick, John L.; Christian, Michael D.; Sprung, Charles L.; Camargo, Ruben; Ceraso, Daniel; Azoulay, Elie; Duguet, Alexandre; Guery, Benoit; Reinhart, Konrad; Adini, Bruria; Barlavie, Yaron; Benin-Goren, Odeda; Cohen, Robert; Klein, Motti; Leoniv, Yuval; Margalit, Gila; Rubinovitch, Bina; Sonnenblick, Moshe; Steinberg, Avraham; Weissman, Charles; Wolff, Donna; Kesecioglu, Jozef; de Jong, Menno; Moreno, Rui; An, Youzhong; Du, Bin; Joynt, Gavin M.; Colvin, John; Loo, Shi; Richards, Guy; Artigas, Antonio; Pugin, Jerome; Amundson, Dennis; Devereaux, Asha; Beigel, John; Danis, Marion; Farmer, Chris; Maki, Dennis; Masur, Henry; Rubinson, Lewis; Sandrock, Christian; Talmor, Daniel; Truog, Robert; Zimmerman, Janice; Brett, Steve; Montgomery, Hugh; Rhodes, Andrew; Sanderson, Frances; Taylor, Bruce; Monrgomery, Hugh

2010-01-01

To provide recommendations and standard operating procedures for intensive care unit (ICU) and hospital preparations for a mass disaster or influenza epidemic with a specific focus on surge capacity and infrastructure considerations. Based on a literature review and expert opinion, a Delphi process

The role of genomics in tracking the evolution of influenza A virus.

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Alice Carolyn McHardy

2009-10-01

Full Text Available Influenza A virus causes annual epidemics and occasional pandemics of short-term respiratory infections associated with considerable morbidity and mortality. The pandemics occur when new human-transmissible viruses that have the major surface protein of influenza A viruses from other host species are introduced into the human population. Between such rare events, the evolution of influenza is shaped by antigenic drift: the accumulation of mutations that result in changes in exposed regions of the viral surface proteins. Antigenic drift makes the virus less susceptible to immediate neutralization by the immune system in individuals who have had a previous influenza infection or vaccination. A biannual reevaluation of the vaccine composition is essential to maintain its effectiveness due to this immune escape. The study of influenza genomes is key to this endeavor, increasing our understanding of antigenic drift and enhancing the accuracy of vaccine strain selection. Recent large-scale genome sequencing and antigenic typing has considerably improved our understanding of influenza evolution: epidemics around the globe are seeded from a reservoir in East-Southeast Asia with year-round prevalence of influenza viruses; antigenically similar strains predominate in epidemics worldwide for several years before being replaced by a new antigenic cluster of strains. Future in-depth studies of the influenza reservoir, along with large-scale data mining of genomic resources and the integration of epidemiological, genomic, and antigenic data, should enhance our understanding of antigenic drift and improve the detection and control of antigenically novel emerging strains.

Influenza virus infection among pediatric patients reporting diarrhea and influenza-like illness

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Uyeki Timothy M

2010-01-01

Full Text Available Abstract Background Influenza is a major cause of morbidity and hospitalization among children. While less often reported in adults, gastrointestinal symptoms have been associated with influenza in children, including abdominal pain, nausea, vomiting, and diarrhea. Methods From September 2005 and April 2008, pediatric patients in Indonesia presenting with concurrent diarrhea and influenza-like illness were enrolled in a study to determine the frequency of influenza virus infection in young patients presenting with symptoms less commonly associated with an upper respiratory tract infection (URTI. Stool specimens and upper respiratory swabs were assayed for the presence of influenza virus. Results Seasonal influenza A or influenza B viral RNA was detected in 85 (11.6% upper respiratory specimens and 21 (2.9% of stool specimens. Viable influenza B virus was isolated from the stool specimen of one case. During the time of this study, human infections with highly pathogenic avian influenza A (H5N1 virus were common in the survey area. However, among 733 enrolled subjects, none had evidence of H5N1 virus infection. Conclusions The detection of influenza viral RNA and viable influenza virus from stool suggests that influenza virus may be localized in the gastrointestinal tract of children, may be associated with pediatric diarrhea and may serve as a potential mode of transmission during seasonal and epidemic influenza outbreaks.

Characterization of regional influenza seasonality patterns in China and implications for vaccination strategies: spatio-temporal modeling of surveillance data.

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Hongjie Yu

2013-11-01

Full Text Available The complexity of influenza seasonal patterns in the inter-tropical zone impedes the establishment of effective routine immunization programs. China is a climatologically and economically diverse country, which has yet to establish a national influenza vaccination program. Here we characterize the diversity of influenza seasonality in China and make recommendations to guide future vaccination programs.We compiled weekly reports of laboratory-confirmed influenza A and B infections from sentinel hospitals in cities representing 30 Chinese provinces, 2005-2011, and data on population demographics, mobility patterns, socio-economic, and climate factors. We applied linear regression models with harmonic terms to estimate influenza seasonal characteristics, including the amplitude of annual and semi-annual periodicities, their ratio, and peak timing. Hierarchical Bayesian modeling and hierarchical clustering were used to identify predictors of influenza seasonal characteristics and define epidemiologically-relevant regions. The annual periodicity of influenza A epidemics increased with latitude (mean amplitude of annual cycle standardized by mean incidence, 140% [95% CI 128%-151%] in the north versus 37% [95% CI 27%-47%] in the south, p0.6 in provinces located within 27.4°N-31.3°N, slope of latitudinal gradient with latitude -0.016 [95% CI -0.025 to -0.008], p<0.001. In contrast, influenza B activity predominated in colder months throughout most of China. Climate factors were the strongest predictors of influenza seasonality, including minimum temperature, hours of sunshine, and maximum rainfall. Our main study limitations include a short surveillance period and sparse influenza sampling in some of the southern provinces.Regional-specific influenza vaccination strategies would be optimal in China; in particular, annual campaigns should be initiated 4-6 months apart in Northern and Southern China. Influenza surveillance should be strengthened in mid

Public health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7 in the context of the annual influenza epidemic and a severe influenza pandemic

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Strutton David R

2010-01-01

Full Text Available Abstract Background Influenza pandemic outbreaks occurred in the US in 1918, 1957, and 1968. Historical evidence suggests that the majority of influenza-related deaths during the 1918 US pandemic were attributable to bacterial pneumococcal infections. The 2009 novel influenza A (H1N1 outbreak highlights the importance of interventions that may mitigate the impact of a pandemic. Methods A decision-analytic model was constructed to evaluate the impact of 7-valent pneumococcal conjugate vaccine (PCV7 on pneumococcal disease incidence and mortality during a typical influenza season (13/100 and a severe influenza pandemic (30/100. Outcomes were compared for current PCV7 vaccination practices vs. no vaccination. The model was estimated using published sources and includes indirect (herd protection of non-vaccinated persons. Results The model predicts that PCV7 vaccination in the US is cost saving for a normal influenza season, reducing pneumococcal-related costs by $1.6 billion. In a severe influenza pandemic, vaccination would save $7.3 billion in costs and prevent 512,000 cases of IPD, 719,000 cases of pneumonia, 62,000 IPD deaths, and 47,000 pneumonia deaths; 84% of deaths are prevented due to indirect (herd protection in the unvaccinated. Conclusions PCV7 vaccination is highly effective and cost saving in both normal and severe pandemic influenza seasons. Current infant vaccination practices may prevent >1 million pneumococcal-related deaths in a severe influenza pandemic, primarily due to herd protection.

Public health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) in the context of the annual influenza epidemic and a severe influenza pandemic.

Science.gov (United States)

Rubin, Jaime L; McGarry, Lisa J; Klugman, Keith P; Strutton, David R; Gilmore, Kristen E; Weinstein, Milton C

2010-01-21

Influenza pandemic outbreaks occurred in the US in 1918, 1957, and 1968. Historical evidence suggests that the majority of influenza-related deaths during the 1918 US pandemic were attributable to bacterial pneumococcal infections. The 2009 novel influenza A (H1N1) outbreak highlights the importance of interventions that may mitigate the impact of a pandemic. A decision-analytic model was constructed to evaluate the impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal disease incidence and mortality during a typical influenza season (13/100) and a severe influenza pandemic (30/100). Outcomes were compared for current PCV7 vaccination practices vs. no vaccination. The model was estimated using published sources and includes indirect (herd) protection of non-vaccinated persons. The model predicts that PCV7 vaccination in the US is cost saving for a normal influenza season, reducing pneumococcal-related costs by $1.6 billion. In a severe influenza pandemic, vaccination would save $7.3 billion in costs and prevent 512,000 cases of IPD, 719,000 cases of pneumonia, 62,000 IPD deaths, and 47,000 pneumonia deaths; 84% of deaths are prevented due to indirect (herd) protection in the unvaccinated. PCV7 vaccination is highly effective and cost saving in both normal and severe pandemic influenza seasons. Current infant vaccination practices may prevent >1 million pneumococcal-related deaths in a severe influenza pandemic, primarily due to herd protection.

[A prognostic model of a cholera epidemic].

Science.gov (United States)

Boev, B V; Bondarenko, V M; Prokop'eva, N V; San Román, R T; Raygoza-Anaya, M; García de Alba, R

1994-01-01

A new model for the prognostication of cholera epidemic on the territory of a large city is proposed. This model reflects the characteristic feature of contacting infection by sensitive individuals due to the preservation of Vibrio cholerae in their water habitat. The mathematical model of the epidemic quantitatively reflects the processes of the spread of infection by kinetic equations describing the interaction of the streams of infected persons, the causative agents and susceptible persons. The functions and parameters of the model are linked with the distribution of individuals according to the duration of the incubation period and infectious process, as well as the period of asymptomatic carrier state. The computer realization of the model by means of IBM PC/AT made it possible to study the cholera epidemic which took place in Mexico in 1833. The verified model of the cholera epidemic was used for the prognostication of the possible spread of this infection in Guadalajara, taking into account changes in the epidemiological situation and the size of the population, as well as improvements in sanitary and hygienic conditions, in the city.

Delayed norovirus epidemic in the 2009-2010 season in Japan: potential relationship with intensive hand sanitizer use for pandemic influenza.

Science.gov (United States)

Inaida, S; Shobugawa, Y; Matsuno, S; Saito, R; Suzuki, H

2016-09-01

Norovirus (NoV) epidemics normally peak in December in Japan; however, the peak in the 2009-2010 season was delayed until the fourth week of January 2010. We suspected intensive hand hygiene that was conducted for a previous pandemic influenza in 2009 as the cause of this delay. We analysed the NoV epidemic trend, based on national surveillance data, and its associations with monthly output data for hand hygiene products, including alcohol-based skin antiseptics and hand soap. The delayed peak in the NoV incidence in the 2009-2010 season had the lowest number of recorded cases of the five seasons studied (2006-2007 to 2010-2011). GII.4 was the most commonly occurring genotype. The monthly relative risk of NoV and monthly output of both alcohol-based skin antiseptics and hand soap were significantly and negatively correlated. Our findings suggest an association between hand hygiene using these products and prevention of NoV transmission.

An epidemic model for the future progression of the current Haiti cholera epidemic

Science.gov (United States)

Bertuzzo, E.; Mari, L.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

2012-04-01

As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to December 2011, climb to 522,000 cases and 7,000 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of Vibrio cholera, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan project). The model directly accounts for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. To this end, we generate realistic scenario of future precipitation in order to forecast possible epidemic paths up to the end of the 2013. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations

Viral vector-based influenza vaccines

Science.gov (United States)

de Vries, Rory D.; Rimmelzwaan, Guus F.

2016-01-01

ABSTRACT Antigenic drift of seasonal influenza viruses and the occasional introduction of influenza viruses of novel subtypes into the human population complicate the timely production of effective vaccines that antigenically match the virus strains that cause epidemic or pandemic outbreaks. The development of game-changing vaccines that induce broadly protective immunity against a wide variety of influenza viruses is an unmet need, in which recombinant viral vectors may provide. Use of viral vectors allows the delivery of any influenza virus antigen, or derivative thereof, to the immune system, resulting in the optimal induction of virus-specific B- and T-cell responses against this antigen of choice. This systematic review discusses results obtained with vectored influenza virus vaccines and advantages and disadvantages of the currently available viral vectors. PMID:27455345

Different Epidemic Models on Complex Networks

International Nuclear Information System (INIS)

Zhang Haifeng; Small, Michael; Fu Xinchu

2009-01-01

Models for diseases spreading are not just limited to SIS or SIR. For instance, for the spreading of AIDS/HIV, the susceptible individuals can be classified into different cases according to their immunity, and similarly, the infected individuals can be sorted into different classes according to their infectivity. Moreover, some diseases may develop through several stages. Many authors have shown that the individuals' relation can be viewed as a complex network. So in this paper, in order to better explain the dynamical behavior of epidemics, we consider different epidemic models on complex networks, and obtain the epidemic threshold for each case. Finally, we present numerical simulations for each case to verify our results.

Demands and Claims of Cuenca Physicians during the Influenza Epidemic in Spain, 1918-1919

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Alberto González García

2016-01-01

Full Text Available During the 1918-1919 influenza epidemic, Spanish physicians were in a professional renewal based on the belief that their working conditions had significantly diminished. The aim of this paper is to analyze the demands of Cuenca physicians in order to assess if their claims were similar to those which were taking place in the capital of the country. For this purpose, news appeared in La Información Médica journal, the bulletin of the Medical College of Cuenca (Spain, were selected. The methodology used is the bulletin’s discursive content analysis on the premise that the study of the context was relevant. Cuenca medical elite was not influenced by the Madrid medical interests despite the centralized state structure and geographical proximity. The demands in Cuenca depended on the social, economic and health situation in the province, and were conditioned by the cacique’s influence. A strong social criticism of conventional medicine was taking place at that moment.

Chimeric Hemagglutinin Constructs Induce Broad Protection against Influenza B Virus Challenge in the Mouse Model.

Science.gov (United States)

Ermler, Megan E; Kirkpatrick, Ericka; Sun, Weina; Hai, Rong; Amanat, Fatima; Chromikova, Veronika; Palese, Peter; Krammer, Florian

2017-06-15

Seasonal influenza virus epidemics represent a significant public health burden. Approximately 25% of all influenza virus infections are caused by type B viruses, and these infections can be severe, especially in children. Current influenza virus vaccines are an effective prophylaxis against infection but are impacted by rapid antigenic drift, which can lead to mismatches between vaccine strains and circulating strains. Here, we describe a broadly protective vaccine candidate based on chimeric hemagglutinins, consisting of globular head domains from exotic influenza A viruses and stalk domains from influenza B viruses. Sequential vaccination with these constructs in mice leads to the induction of broadly reactive antibodies that bind to the conserved stalk domain of influenza B virus hemagglutinin. Vaccinated mice are protected from lethal challenge with diverse influenza B viruses. Results from serum transfer experiments and antibody-dependent cell-mediated cytotoxicity (ADCC) assays indicate that this protection is antibody mediated and based on Fc effector functions. The present data suggest that chimeric hemagglutinin-based vaccination is a viable strategy to broadly protect against influenza B virus infection. IMPORTANCE While current influenza virus vaccines are effective, they are affected by mismatches between vaccine strains and circulating strains. Furthermore, the antiviral drug oseltamivir is less effective for treating influenza B virus infections than for treating influenza A virus infections. A vaccine that induces broad and long-lasting protection against influenza B viruses is therefore urgently needed. Copyright © 2017 American Society for Microbiology.

Spatial distribution and risk factors of influenza in Jiangsu province, China, based on geographical information system

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Jia-Cheng Zhang

2014-05-01

Full Text Available Influenza poses a constant, heavy burden on society. Recent research has focused on ecological factors associated with influenza incidence and has also studied influenza with respect to its geographic spread at different scales. This research explores the temporal and spatial parameters of influenza and identifies factors influencing its transmission. A spatial autocorrelation analysis, a spatial-temporal cluster analysis and a spatial regression analysis of influenza rates, carried out in Jiangsu province from 2004 to 2011, found that influenza rates to be spatially dependent in 2004, 2005, 2006 and 2008. South-western districts consistently revealed hotspots of high-incidence influenza. The regression analysis indicates that railways, rivers and lakes are important predictive environmental variables for influenza risk. A better understanding of the epidemic pattern and ecological factors associated with pandemic influenza should benefit public health officials with respect to prevention and controlling measures during future epidemics.

Waves of El Nino-southern Oscillation and Influenza Pandemics

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Olusegun Steven Ayodele Oluwole

2016-04-01

Full Text Available Influenza pandemics have occurred at irregular intervals for over 500 years, unlike seasonal influenza epidemics which occur annually. Although the risk factors are known, the basis for the timing of influenza pandemic waves are unknown. Coherence of peaks of El Niño and influenza pandemic in 2009–2010, however, suggests that both waves are coupled. This study was done to determine the relation of influenza pandemics to the peaks and waveforms of El Niño southern oscillation (ENSO. ENSO cycles from 1871–2015 which had El Niño phases were windowed from Multivariate El Niño Index. Influenza pandemic peaks were mapped to ENSO monthly time series. ENSO waveforms were compared graphically, and fitted to nonstationary cosinor models. Second order polynomial regression model was fitted to the peak and duration of El Niño. Agglomerative hierarchical cluster of ENSO waveforms was performed. All influenza pandemic peaks mapped to El Niño peaks, with lags of 0–5 months. ENSO waveforms during influenza pandemics share parameters of oscillation. Nonstationary cosinor models showed that ENSO cycles are complex waves. There was second order polynomial relationship between peak and duration of El Niños, p < 0.0001. ENSO waveforms clustered into four distinct groups. ENSO waveforms during influenza pandemics of 1889–1900, 1957–1958, and 1968–1969 linked closely. ENSO indices were significantly high from 7–16 months after onset of cycles, p < 0.0001. Surveillance for El Niño events to forecast periods of maximal transmission and survival of influenza A viruses is, therefore, crucial for public health control strategies.

Virulence determinants of pandemic influenza viruses

Science.gov (United States)

Tscherne, Donna M.; García-Sastre, Adolfo

2011-01-01

Influenza A viruses cause recurrent, seasonal epidemics and occasional global pandemics with devastating levels of morbidity and mortality. The ability of influenza A viruses to adapt to various hosts and undergo reassortment events ensures constant generation of new strains with unpredictable degrees of pathogenicity, transmissibility, and pandemic potential. Currently, the combination of factors that drives the emergence of pandemic influenza is unclear, making it impossible to foresee the details of a future outbreak. Identification and characterization of influenza A virus virulence determinants may provide insight into genotypic signatures of pathogenicity as well as a more thorough understanding of the factors that give rise to pandemics. PMID:21206092

[Swine influenza virus: evolution mechanism and epidemic characterization--a review].

Science.gov (United States)

Qi, Xian; Lu, Chengping

2009-09-01

Pigs may play an important role in the evolution and ecology of influenza A virus. The tracheal epithelium of pigs contain both SA alpha 2,6 Gal and SA alpha 2,3 Gal receptors and can be infected with swine, human and avian viruses, therefore, pigs have been considered as an intermediate host for the adaptation of avian influenza viruses to humans or as mixing vessels for the generation of genetically reassortant viruses. Evolution patterns among swine influenza viruses including evolution of host adaptation, antigenic drift and genetic reassortment, and the latter is the main one. Unlike human influenza viruses, swine viruses have different epizootiological patterns in different areas of world, which is enzootic and geographic dependence. Currently, three predominant subtypes of influenza virus are prevalent in pig populations worldwide: H1N1, H3N2, and H1N2, and these include classical swine H1N1, avian-like H1N1, human-like H3N2, reassortant H3N2 and various genotype H1N2 viruses. In Europe, North America and China, influenza A viruses circulating in pigs are distinct in the genetic characteristics and genetic sources. Since 1979, three subtypes, avian-like H1N1, reassortant H1N2 and H3N2 viruses, have been co-circulating in European swine. Before 1998, classical H1N1 viruses were the exclusive cause of swine influenza in North America. However, after that, three triple-reassortant H1N2, H3N2 and H1N1 viruses with genes of human, swine and avian virus began to emerge in pigs. Genetically, the pandemic viruses emerging in human, so called influenza A (H1N1) viruses, contain genes from both Europe and North American SIV lineages. SIV is not the same as Europe and the United States in the prevalence and genetic background in China, mainly classical swine H1N1 and human-like H3N2 type virus. However, in recent years, SIV from Europe and North America have been introduced into Chinese pig herds, so more attention should be given on the evolutionary of SIV in China

The influence of meteorology on the spread of influenza: survival analysis of an equine influenza (A/H3N8) outbreak.

Science.gov (United States)

Firestone, Simon M; Cogger, Naomi; Ward, Michael P; Toribio, Jenny-Ann L M L; Moloney, Barbara J; Dhand, Navneet K

2012-01-01

The influences of relative humidity and ambient temperature on the transmission of influenza A viruses have recently been established under controlled laboratory conditions. The interplay of meteorological factors during an actual influenza epidemic is less clear, and research into the contribution of wind to epidemic spread is scarce. By applying geostatistics and survival analysis to data from a large outbreak of equine influenza (A/H3N8), we quantified the association between hazard of infection and air temperature, relative humidity, rainfall, and wind velocity, whilst controlling for premises-level covariates. The pattern of disease spread in space and time was described using extraction mapping and instantaneous hazard curves. Meteorological conditions at each premises location were estimated by kriging daily meteorological data and analysed as time-lagged time-varying predictors using generalised Cox regression. Meteorological covariates time-lagged by three days were strongly associated with hazard of influenza infection, corresponding closely with the incubation period of equine influenza. Hazard of equine influenza infection was higher when relative humidity was 30 km hour(-1) from the direction of nearby infected premises were associated with increased hazard of infection. Through combining detailed influenza outbreak and meteorological data, we provide empirical evidence for the underlying environmental mechanisms that influenced the local spread of an outbreak of influenza A. Our analysis supports, and extends, the findings of studies into influenza A transmission conducted under laboratory conditions. The relationships described are of direct importance for managing disease risk during influenza outbreaks in horses, and more generally, advance our understanding of the transmission of influenza A viruses under field conditions.

Seasonal influenza activity for 2005-2006 season seems to be ending in most European countries.

NARCIS (Netherlands)

Paget, W.J.; Meijer, A.; Falcao, J.M.; Jong, J.C. de; Kyncl, J.; Meerhoff, T.J.; Meuwissen, L.E.; Nicoll, A.; Velden, J. van der

2006-01-01

During the 2005-2006 season, seasonal influenza epidemics started late in countries across Europe. Clinical influenza activity has only reached moderate levels and has mainly been associated with influenza B viruses. There has been co-circulation of influenza A and B viruses in many countries, and

Detecting signals of seasonal influenza severity through age dynamics

DEFF Research Database (Denmark)

Lee, Elizabeth C.; Viboud, Cécile; Simonsen, Lone

2015-01-01

stages of an outbreak. To address the limitations of traditional indicators, we propose a novel severity index based on influenza age dynamics estimated from routine physician diagnosis data that can be used retrospectively and for early warning. METHODS: We developed a quantitative 'ground truth......' severity benchmark that synthesizes multiple traditional severity indicators from publicly available influenza surveillance data in the United States. Observing that the age distribution of cases may signal severity early in an epidemic, we constructed novel retrospective and early warning severity indexes....... The retrospective index was well correlated with the severity benchmark and correctly identified the two most severe seasons. The early warning index performance varied, but it projected 2007-08 as relatively severe 10 weeks prior to the epidemic peak. Influenza severity varied significantly among states within...

Predicting extinction rates in stochastic epidemic models

International Nuclear Information System (INIS)

Schwartz, Ira B; Billings, Lora; Dykman, Mark; Landsman, Alexandra

2009-01-01

We investigate the stochastic extinction processes in a class of epidemic models. Motivated by the process of natural disease extinction in epidemics, we examine the rate of extinction as a function of disease spread. We show that the effective entropic barrier for extinction in a susceptible–infected–susceptible epidemic model displays scaling with the distance to the bifurcation point, with an unusual critical exponent. We make a direct comparison between predictions and numerical simulations. We also consider the effect of non-Gaussian vaccine schedules, and show numerically how the extinction process may be enhanced when the vaccine schedules are Poisson distributed

The need for data science in epidemic modelling. Comment on: "Mathematical models to characterize early epidemic growth: A review" by Gerardo Chowell et al.

Science.gov (United States)

Danon, Leon; Brooks-Pollock, Ellen

2016-09-01

In their review, Chowell et al. consider the ability of mathematical models to predict early epidemic growth [1]. In particular, they question the central prediction of classical differential equation models that the number of cases grows exponentially during the early stages of an epidemic. Using examples including HIV and Ebola, they argue that classical models fail to capture key qualitative features of early growth and describe a selection of models that do capture non-exponential epidemic growth. An implication of this failure is that predictions may be inaccurate and unusable, highlighting the need for care when embarking upon modelling using classical methodology. There remains a lack of understanding of the mechanisms driving many observed epidemic patterns; we argue that data science should form a fundamental component of epidemic modelling, providing a rigorous methodology for data-driven approaches, rather than trying to enforce established frameworks. The need for refinement of classical models provides a strong argument for the use of data science, to identify qualitative characteristics and pinpoint the mechanisms responsible for the observed epidemic patterns.

Rationing of resources: ethical issues in disasters and epidemic situations.

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Lin, Janet Y; Anderson-Shaw, Lisa

2009-01-01

In an epidemic situation or large-scale disaster, medical and human resources may be stretched to the point of exhaustion. Appropriate planning must incorporate plans of action that minimize public health morbidity and mortality while maximizing the appropriate use of medical and human healthcare resources. While the current novel H1N1 influenza has spread throughout the world, the severity of this strain of influenza appears to be relatively less virulent and lethal compared to the 1918 influenza pandemic. However, the presence of this new influenza strain has reignited interest in pandemic planning. Amongst other necessary resources needed to combat pandemic influenza, a major medical resource concern is the limited number of mechanical ventilators that would be available to be used to treat ill patients. Recent reported cases of avian influenza suggest that mechanical ventilation will be required for the successful recovery of many individuals ill with this strain of virus. However, should the need for ventilators exceed the number of available machines, how will care providers make the difficult ethical decisions as to who should be placed or who should remain on these machines as more influenza patients arrive in need of care? This paper presents a decision-making model for clinicians that is based upon the bioethical principles of beneficence and justice. The model begins with the basic assumptions of triage and progresses into a useful algorithm based upon utilitarian principles. The model is intended to be used as a guide for clinicians in making decisions about the allocation of scarce resources in a just manner and to serve as an impetus for institutions to create or adapt plans to address resource allocation issues should the need arise.

Mathematical Analysis of an Epidemic System in the Presence of Optimal Control and Population Dispersal

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Nandi, Swapan Kumar; Jana, Soovoojeet; Mandal, Manotosh; Kar, T. K.

In this paper, we proposed and analyzed a susceptible-infected-recovered (SIR) type epidemic model to investigate the effect of transport-related infectious diseases namely tuberculosis, measles, rubella, influenza, sexually transmitted diseases, etc. The existence and stability criteria of both the diseases include free equilibrium point and endemic equilibrium point which are established and the threshold parametric condition for which the system passes through a transcritical bifurcation is also obtained. Optimal control strategy for control parameters is formulated and solved both theoretically and numerically. Lastly, we not only illustrate our theoretical results through graphical illustrations but also computer simulation is used to show that our model would be a good model to study the SARS epidemic in 2003.

[Pandemic influenza A (H1N1 virus) on Futuna Island in the Pacific, from August to September 2009].

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Chenaitia, Hichem; Massa, Horace; Garry, Philippe; Puget, André; Yvon, Jean-Francois; Dutaut, Elisabeth; Bessereau, Jacques; Michelet, Pierre; Auffray, Jean-Pierre; Delmont, Jean

2011-03-01

The aim of this study is to report the observation of the pandemic of influenza A (H1N1 virus) from August to September 2009 on the island of Futuna, in a context of isolated island that may mimic an environment closed. We conducted a prospective observational study of influenza-like illness, from the first confirmed case of influenza A on the island until the end of the epidemic wave. From August 15 to September 20, 2009, 1536 cases of influenza syndrome were identified. The estimate of the overall clinical attack rate was 36 %. The evolution of the epidemic shows an explosion of new cases of influenza A and subsequently a rapid decline of the epidemic. The spread of the infection was made by contiguity, jumping from one city to another. The cumulative number of cases by age group shows that the majority of cases were children and young adults under the age of 20 years. The most frequent symptoms were cough, rhinorrhea, headache, myalgia or asthenia, and fever. This study, despite these limitations, shows an explosive epidemic of influenza A, which can be explained by the circulation of virus that has been fostered by gatherings of public and closed environment. Age group classification shows that majority of cases were young, in contrast to seasonal influenza, but the symptoms were alike. This study highlights the difficulties to manage an epidemic surveillance system at high level and given the quick spread of the disease. Copyright © 2010. Published by Elsevier Masson SAS.

The new school absentees reporting system for pandemic influenza A/H1N1 2009 infection in Japan.

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Takeshi Suzue

Full Text Available To evaluate the new Japanese School Absentees Reporting System for Infectious Disease (SARSID for pandemic influenza A/H1N1 2009 infection in comparison with the National epidemiological Surveillance of Infectious Disease (NESID.We used data of 53,223 students (97.7% in Takamatsu city Japan. Data regarding school absentees in SARSID was compared with that in NESID from Oct 13, 2009 to Jan 12, 2010.Similar trends were observed both in SARSID and NESID. However, the epidemic trend for influenza in SARSID was thought to be more sensitive than that in NESID.The epidemic trend for influenza among school-aged children could be easily and rapidly assessed by SARSID compared to NESID. SARSID might be useful for detecting the epidemic trend of influenza.

Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.

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T Déirdre Hollingsworth

Full Text Available Mitigation of a severe influenza pandemic can be achieved using a range of interventions to reduce transmission. Interventions can reduce the impact of an outbreak and buy time until vaccines are developed, but they may have high social and economic costs. The non-linear effect on the epidemic dynamics means that suitable strategies crucially depend on the precise aim of the intervention. National pandemic influenza plans rarely contain clear statements of policy objectives or prioritization of potentially conflicting aims, such as minimizing mortality (depending on the severity of a pandemic or peak prevalence or limiting the socio-economic burden of contact-reducing interventions. We use epidemiological models of influenza A to investigate how contact-reducing interventions and availability of antiviral drugs or pre-pandemic vaccines contribute to achieving particular policy objectives. Our analyses show that the ideal strategy depends on the aim of an intervention and that the achievement of one policy objective may preclude success with others, e.g., constraining peak demand for public health resources may lengthen the duration of the epidemic and hence its economic and social impact. Constraining total case numbers can be achieved by a range of strategies, whereas strategies which additionally constrain peak demand for services require a more sophisticated intervention. If, for example, there are multiple objectives which must be achieved prior to the availability of a pandemic vaccine (i.e., a time-limited intervention, our analysis shows that interventions should be implemented several weeks into the epidemic, not at the very start. This observation is shown to be robust across a range of constraints and for uncertainty in estimates of both R(0 and the timing of vaccine availability. These analyses highlight the need for more precise statements of policy objectives and their assumed consequences when planning and implementing strategies

Changing human mobility and the spreading rate of global influenza outbreaks

NARCIS (Netherlands)

Slaa, Jan Willem

2010-01-01

Influenza, commonly called the flu, is an infectious disease which causes up to 500,000 deaths annually during seasonal epidemics. Influenza viruses circulate in many different types and in many species, such as birds, swines and humans. When a new human

The Dynamics of Avian Influenza: Individual-Based Model with Intervention Strategies in Traditional Trade Networks in Phitsanulok Province, Thailand

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Chaiwat Wilasang

2016-01-01

Full Text Available Avian influenza virus subtype H5N1 is endemic to Southeast Asia. In Thailand, avian influenza viruses continue to cause large poultry stock losses. The spread of the disease has a serious impact on poultry production especially among rural households with backyard chickens. The movements and activities of chicken traders result in the spread of the disease through traditional trade networks. In this study, we investigate the dynamics of avian influenza in the traditional trade network in Phitsanulok Province, Thailand. We also propose an individual-based model with intervention strategies to control the spread of the disease. We found that the dynamics of the disease mainly depend on the transmission probability and the virus inactivation period. This study also illustrates the appropriate virus disinfection period and the target for intervention strategies on traditional trade network. The results suggest that good hygiene and cleanliness among household traders and trader of trader areas and ensuring that any equipment used is clean can lead to a decrease in transmission and final epidemic size. These results may be useful to epidemiologists, researchers, and relevant authorities in understanding the spread of avian influenza through traditional trade networks.

Epidemic spread in coupled populations with seasonally varying migration rates

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Muzyczyn, Adam; Shaw, Leah B.

2009-03-01

The H5N1 strain of avian influenza has spread worldwide, and this spread may be due to seasonal migration of birds and mixing of birds from different regions in the wintering grounds. We studied a multipatch model for avian influenza with seasonally varying migration rates. The bird population was divided into two spatially distinct patches, or subpopulations. Within each patch, the disease followed the SIR (susceptible-infected-recovered) model for epidemic spread. Migration rates were varied periodically, with a net flux toward the breeding grounds during the spring and towards the wintering grounds during the fall. The case of two symmetric patches reduced to single-patch SIR dynamics. However, asymmetry in the birth and contact rates in the breeding grounds and wintering grounds led to bifurcations to longer period orbits and chaotic dynamics. We studied the bifurcation structure of the model and the phase relationships between outbreaks in the two patches.

Establishment and evaluation of a theater influenza monitoring platform.

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Wang, Jian; Yang, Hui-Suo; Deng, Bing; Shi, Meng-Jing; Li, Xiang-Da; Nian, Qing-Gong; Song, Wen-Jing; Bing, Feng; Li, Qing-Feng

2017-11-20

Influenza is an acute respiratory infectious disease with a high incidence rate in the Chinese army, which directly disturbs military training and affects soldiers' health. Influenza surveillance systems are widely used around the world and play an important role in influenza epidemic prevention and control. As a theater centers for disease prevention and control, we established an influenza monitoring platform (IMP) in 2014 to strengthen the monitoring of influenza-like illness and influenza virus infection. In this study, we introduced the constitution, influenza virus detection, and quality control for an IMP. The monitoring effect was also evaluated by comparing the monitoring data with data from national influenza surveillance systems. The experiences and problems associated with the platform also were summarized. A theater IMP was established based on 3 levels of medical units, including monitoring sites, testing laboratories and a checking laboratory. A series of measures were taken to guarantee the quality of monitoring, such as technical training, a unified process, sufficient supervision and timely communication. The platform has run smoothly for 3 monitoring years to date. In the 2014-2015 and 2016-2017 monitoring years, sample amount coincided with that obtained from the National Influenza Surveillance program. In the 2015-2016 monitoring year, due to the strict prevention and control measures, an influenza epidemic peak was avoided in monitoring units, and the monitoring data did not coincide with that of the National Influenza Surveillance program. Several problems, including insufficient attention, unreasonable administrative intervention or subordination relationships, and the necessity of detection in monitoring sites were still observed. A theater IMP was established rationally and played a deserved role in the prevention and control of influenza. However, several problems remain to be solved.

Using the information on cosmic rays to predict influenza epidemics

International Nuclear Information System (INIS)

Yu, Z.D.

1985-01-01

A correlation between the incidence of influenza pandemics and increased cosmic ray activity is made. A correlation is also made between the occurrence of these pandemics and the appearance of bright novae, e.g., Nova Eta Car. Four indices based on increased cosmic ray activity and novae are proposed to predict future influenza pandemics and viral antigenic shifts

Past Life and Future Effects—How Heterologous Infections Alter Immunity to Influenza Viruses

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Aisha Souquette

2018-05-01

Full Text Available Influenza virus frequently mutates due to its error-prone polymerase. This feature contributes to influenza virus’s ability to evade pre-existing immunity, leading to annual epidemics and periodic pandemics. T cell memory plays a key protective role in the face of an antigenically distinct influenza virus strain because T cell targets are often derived from conserved internal proteins, whereas humoral immunity targets are often sites of increased mutation rates that are tolerated by the virus. Most studies of influenza T cell memory are conducted in naive, specific pathogen free mice and do not account for repetitive influenza infection throughout a lifetime, sequential acute heterologous infections between influenza infections, or heterologous chronic co-infections. By contrast to these mouse models, humans often experience numerous influenza infections, encounter heterologous acute infections between influenza infections, and are infected with at least one chronic virus. In this review, we discuss recent advances in understanding the effects of heterologous infections on the establishment and maintenance of CD8+ T cell immunological memory. Understanding the various factors that affect immune memory can provide insights into the development of more effective vaccines and increase reproducibility of translational studies between animal models and clinical results.

Trivalent MDCK cell culture-derived influenza vaccine Optaflu (Novartis Vaccines).

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Doroshenko, Alexander; Halperin, Scott A

2009-06-01

Annual influenza epidemics continue to have a considerable impact in both developed and developing countries. Vaccination remains the principal measure to prevent seasonal influenza and reduce associated morbidity and mortality. The WHO recommends using established mammalian cell culture lines as an alternative to egg-based substrates in the manufacture of influenza vaccine. In June 2007, the EMEA approved Optaflu, a Madin Darby canine kidney cell culture-derived influenza vaccine manufactured by Novartis Vaccines. This review examines the advantages and disadvantages of cell culture-based technology for influenza vaccine production, compares immunogenicity and safety data for Optaflu with that of currently marketed conventional egg-based influenza vaccines, and considers the prospects for wider use of cell culture-based influenza vaccines.

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

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Nelson Peter

2006-11-01

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

Risk maps for the spread of highly pathogenic avian influenza in poultry.

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Gert Jan Boender

2007-04-01

Full Text Available Devastating epidemics of highly contagious animal diseases such as avian influenza, classical swine fever, and foot-and-mouth disease underline the need for improved understanding of the factors promoting the spread of these pathogens. Here the authors present a spatial analysis of the between-farm transmission of a highly pathogenic H7N7 avian influenza virus that caused a large epidemic in The Netherlands in 2003. The authors developed a method to estimate key parameters determining the spread of highly transmissible animal diseases between farms based on outbreak data. The method allows for the identification of high-risk areas for propagating spread in an epidemiologically underpinned manner. A central concept is the transmission kernel, which determines the probability of pathogen transmission from infected to uninfected farms as a function of interfarm distance. The authors show how an estimate of the transmission kernel naturally provides estimates of the critical farm density and local reproduction numbers, which allows one to evaluate the effectiveness of control strategies. For avian influenza, the analyses show that there are two poultry-dense areas in The Netherlands where epidemic spread is possible, and in which local control measures are unlikely to be able to halt an unfolding epidemic. In these regions an epidemic can only be brought to an end by the depletion of susceptible farms by infection or massive culling. The analyses provide an estimate of the spatial range over which highly pathogenic avian influenza viruses spread between farms, and emphasize that control measures aimed at controlling such outbreaks need to take into account the local density of farms.

A simple model for behaviour change in epidemics

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Brauer Fred

2011-02-01

Full Text Available Abstract Background People change their behaviour during an epidemic. Infectious members of a population may reduce the number of contacts they make with other people because of the physical effects of their illness and possibly because of public health announcements asking them to do so in order to decrease the number of new infections, while susceptible members of the population may reduce the number of contacts they make in order to try to avoid becoming infected. Methods We consider a simple epidemic model in which susceptible and infectious members respond to a disease outbreak by reducing contacts by different fractions and analyze the effect of such contact reductions on the size of the epidemic. We assume constant fractional reductions, without attempting to consider the way in which susceptible members might respond to information about the epidemic. Results We are able to derive upper and lower bounds for the final size of an epidemic, both for simple and staged progression models. Conclusions The responses of uninfected and infected individuals in a disease outbreak are different, and this difference affects estimates of epidemic size.

Molecular Epidemiology of a novel re-assorted epidemic strain of equine influenza virus in Pakistan in 2015-16.

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Khan, Amjad; Mushtaq, Muhammad Hassan; Ahmad, Mansur Ud Din; Nazir, Jawad; Farooqi, Shahid Hussain; Khan, Asghar

2017-08-15

A widespread epidemic of equine influenza (EI) occurred in nonvaccinated equine population across multiple districts in Khyber Pakhtunkhwa Province of Pakistan during 2015-2016. An epidemiological surveillance study was conducted from Oct 2015 to April 2016 to investigate the outbreak. EI virus strains were isolated in embryonated eggs from suspected equines swab samples and were subjected to genome sequencing using M13 tagged segment specific primers. Phylogenetic analyses of the nucleotide sequences were concluded using Geneious. Haemagglutinin (HA), Neuraminidase (NA), Matrix (M) and nucleoprotein (NP) genes nucleotide and amino acid sequences of the isolated viruses were aligned with those of OIE recommended, FC-1, FC-2, and contemporary isolates of influenza A viruses from other species. HA and NA genes amino acid sequences were very similar to Tennessee/14 and Malaysia/15 of FC-1 and clustered with the contemporary isolates recently reported in the USA. Phylogenetic analysis showed that these viruses were mostly identical (with 99.6% and 97.4% nucleotide homology) to, and were reassortants containing chicken/Pakistan/14 (H7N3) and Canine/Beijing/10 (H3N2) like M and NP genes. Genetic analysis indicated that A/equine/Pakistan/16 viruses were most probably the result of several re-assortments between the co-circulating avian and equine viruses, and were genetically unlike the other equine viruses due to the presence of H7N3 or H3N2 like M and NP genes. Epidemiological data analysis indicated the potential chance of mixed, and management such as mixed farming system by keeping equine, canine and backyard poultry together in confined premises as the greater risk factors responsible for the re-assortments. Other factors might have contributed to the spread of the epidemic, including low awareness level, poor control of equine movements, and absence of border control disease strategies. Copyright © 2017 Elsevier B.V. All rights reserved.

Public health interventions for epidemics: implications for multiple infection waves.

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Wessel, Lindsay; Hua, Yi; Wu, Jianhong; Moghadas, Seyed M

2011-02-25

Epidemics with multiple infection waves have been documented for some human diseases, most notably during past influenza pandemics. While pathogen evolution, co-infection, and behavioural changes have been proposed as possible mechanisms for the occurrence of subsequent outbreaks, the effect of public health interventions remains undetermined. We develop mean-field and stochastic epidemiological models for disease transmission, and perform simulations to show how control measures, such as drug treatment and isolation of ill individuals, can influence the epidemic profile and generate sequences of infection waves with different characteristics. We demonstrate the impact of parameters representing the effectiveness and adverse consequences of intervention measures, such as treatment and emergence of drug resistance, on the spread of a pathogen in the population. If pathogen resistant strains evolve under drug pressure, multiple outbreaks are possible with variability in their characteristics, magnitude, and timing. In this context, the level of drug use and isolation capacity play an important role in the occurrence of subsequent outbreaks. Our simulations for influenza infection as a case study indicate that the intensive use of these interventions during the early stages of the epidemic could delay the spread of disease, but it may also result in later infection waves with possibly larger magnitudes. The findings highlight the importance of intervention parameters in the process of public health decision-making, and in evaluating control measures when facing substantial uncertainty regarding the epidemiological characteristics of an emerging infectious pathogen. Critical factors that influence population health including evolutionary responses of the pathogen under the pressure of different intervention measures during an epidemic should be considered for the design of effective strategies that address short-term targets compatible with long-term disease outcomes.

Prognostic factors for influenza-associated hospitalization and death during an epidemic

NARCIS (Netherlands)

Hak, E; Verheij, T J; van Essen, G A; Lafeber, A B; Grobbee, D E; Hoes, A W

To predict which patients with current high-risk disease in the community may benefit most from additional preventive or therapeutic measures for influenza, we determined prognostic factors for influenza-associated hospitalization and death in a general practice-based case-control study among this

Eight challenges for network epidemic models

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Lorenzo Pellis

2015-03-01

Full Text Available Networks offer a fertile framework for studying the spread of infection in human and animal populations. However, owing to the inherent high-dimensionality of networks themselves, modelling transmission through networks is mathematically and computationally challenging. Even the simplest network epidemic models present unanswered questions. Attempts to improve the practical usefulness of network models by including realistic features of contact networks and of host–pathogen biology (e.g. waning immunity have made some progress, but robust analytical results remain scarce. A more general theory is needed to understand the impact of network structure on the dynamics and control of infection. Here we identify a set of challenges that provide scope for active research in the field of network epidemic models.

Avian influenza virus transmission to mammals.

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Herfst, S; Imai, M; Kawaoka, Y; Fouchier, R A M

2014-01-01

Influenza A viruses cause yearly epidemics and occasional pandemics. In addition, zoonotic influenza A viruses sporadically infect humans and may cause severe respiratory disease and fatalities. Fortunately, most of these viruses do not have the ability to be efficiently spread among humans via aerosols or respiratory droplets (airborne transmission) and to subsequently cause a pandemic. However, adaptation of these zoonotic viruses to humans by mutation or reassortment with human influenza A viruses may result in airborne transmissible viruses with pandemic potential. Although our knowledge of factors that affect mammalian adaptation and transmissibility of influenza viruses is still limited, we are beginning to understand some of the biological traits that drive airborne transmission of influenza viruses among mammals. Increased understanding of the determinants and mechanisms of airborne transmission may aid in assessing the risks posed by avian influenza viruses to human health, and preparedness for such risks. This chapter summarizes recent discoveries on the genetic and phenotypic traits required for avian influenza viruses to become airborne transmissible between mammals.

Universal immunity to influenza must outwit immune evasion

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Sergio Manuel Quinones-Parra

2014-06-01

Full Text Available Although an influenza vaccine has been available for 70 years, influenza virus still causes seasonal epidemics and worldwide pandemics. Currently available vaccines elicit strain-specific antibody responses to the surface haemagglutinin (HA and neuraminidase (NA proteins, but these can be ineffective against serologically-distinct viral variants and novel subtypes. Thus, there is a need for cross-protective or universal influenza vaccines to overcome the necessity for annual immunisation against seasonal influenza and to provide immunity to reduce the severity of infection with pandemic or outbreak viruses. It is well established that natural influenza infection can provide cross-reactive immunity that can reduce the impact of infection with distinct influenza type A strains and subtypes, including H1N1, H3N2, H2N2, H5N1 and H7N9. The key to generating universal influenza immunity via vaccination is to target functionally-conserved regions of the virus, which include epitopes on the internal proteins for cross-reactive T cell immunity or on the HA stem for broadly reactive antibody responses. In the wake of the 2009 H1N1 pandemic, broadly neutralizing antibodies have been characterized and isolated from convalescent and vaccinated individuals, inspiring development of new vaccination techniques to elicit such responses. Induction of influenza-specific T cell responses through vaccination has also been examined in clinical trials. Strong evidence is available from human and animal models of influenza to show that established influenza-specific T cell memory can reduce viral shedding and symptom severity. However, the published evidence also shows that CD8+ T cells can efficiently select immune escape mutants early after influenza virus infection. Here, we discuss universal immunity to influenza viruses mediated by both cross-reactive T cells and antibodies, the mechanisms of immune evasion in influenza, and how to counteract commonly occurring

Timeliness of syndromic influenza surveillance through work and school absenteeism

OpenAIRE

Bollaerts, K; Antoine, J; Robesyn, E; Van Proeyen, L; Vomberg, J; Feys, E; De Decker, E; Catry, B

2010-01-01

In this paper, we investigate the usefulness of work and school absenteeism surveillance as an early warning system for influenza. In particular, time trends in daily absenteeism rates collected during the A(H1N1)2009 pandemic are compared with weekly incidence rates of influenza-like illness (ILI) obtained from the Belgian Sentinel General Practitioner (SGP) network. The results indicate a rise in absenteeism rates prior to the onset of the influenza epidemic, suggesting that absenteeism sur...

Improving risk models for avian influenza: the role of intensive poultry farming and flooded land during the 2004 Thailand epidemic.

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Van Boeckel, Thomas P; Thanapongtharm, Weerapong; Robinson, Timothy; Biradar, Chandrashekhar M; Xiao, Xiangming; Gilbert, Marius

2012-01-01

Since 1996 when Highly Pathogenic Avian Influenza type H5N1 first emerged in southern China, numerous studies sought risk factors and produced risk maps based on environmental and anthropogenic predictors. However little attention has been paid to the link between the level of intensification of poultry production and the risk of outbreak. This study revised H5N1 risk mapping in Central and Western Thailand during the second wave of the 2004 epidemic. Production structure was quantified using a disaggregation methodology based on the number of poultry per holding. Population densities of extensively- and intensively-raised ducks and chickens were derived both at the sub-district and at the village levels. LandSat images were used to derive another previously neglected potential predictor of HPAI H5N1 risk: the proportion of water in the landscape resulting from floods. We used Monte Carlo simulation of Boosted Regression Trees models of predictor variables to characterize the risk of HPAI H5N1. Maps of mean risk and uncertainty were derived both at the sub-district and the village levels. The overall accuracy of Boosted Regression Trees models was comparable to that of logistic regression approaches. The proportion of area flooded made the highest contribution to predicting the risk of outbreak, followed by the densities of intensively-raised ducks, extensively-raised ducks and human population. Our results showed that as little as 15% of flooded land in villages is sufficient to reach the maximum level of risk associated with this variable. The spatial pattern of predicted risk is similar to previous work: areas at risk are mainly located along the flood plain of the Chao Phraya river and to the south-east of Bangkok. Using high-resolution village-level poultry census data, rather than sub-district data, the spatial accuracy of predictions was enhanced to highlight local variations in risk. Such maps provide useful information to guide intervention.

Improving risk models for avian influenza: the role of intensive poultry farming and flooded land during the 2004 Thailand epidemic.

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Thomas P Van Boeckel

Full Text Available Since 1996 when Highly Pathogenic Avian Influenza type H5N1 first emerged in southern China, numerous studies sought risk factors and produced risk maps based on environmental and anthropogenic predictors. However little attention has been paid to the link between the level of intensification of poultry production and the risk of outbreak. This study revised H5N1 risk mapping in Central and Western Thailand during the second wave of the 2004 epidemic. Production structure was quantified using a disaggregation methodology based on the number of poultry per holding. Population densities of extensively- and intensively-raised ducks and chickens were derived both at the sub-district and at the village levels. LandSat images were used to derive another previously neglected potential predictor of HPAI H5N1 risk: the proportion of water in the landscape resulting from floods. We used Monte Carlo simulation of Boosted Regression Trees models of predictor variables to characterize the risk of HPAI H5N1. Maps of mean risk and uncertainty were derived both at the sub-district and the village levels. The overall accuracy of Boosted Regression Trees models was comparable to that of logistic regression approaches. The proportion of area flooded made the highest contribution to predicting the risk of outbreak, followed by the densities of intensively-raised ducks, extensively-raised ducks and human population. Our results showed that as little as 15% of flooded land in villages is sufficient to reach the maximum level of risk associated with this variable. The spatial pattern of predicted risk is similar to previous work: areas at risk are mainly located along the flood plain of the Chao Phraya river and to the south-east of Bangkok. Using high-resolution village-level poultry census data, rather than sub-district data, the spatial accuracy of predictions was enhanced to highlight local variations in risk. Such maps provide useful information to guide

Five challenges for stochastic epidemic models involving global transmission

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Tom Britton

2015-03-01

Full Text Available The most basic stochastic epidemic models are those involving global transmission, meaning that infection rates depend only on the type and state of the individuals involved, and not on their location in the population. Simple as they are, there are still several open problems for such models. For example, when will such an epidemic go extinct and with what probability (questions depending on the population being fixed, changing or growing? How can a model be defined explaining the sometimes observed scenario of frequent mid-sized epidemic outbreaks? How can evolution of the infectious agent transmission rates be modelled and fitted to data in a robust way?

"It's as bad as anything can be": Patients, identity, and the influenza pandemic.

Science.gov (United States)

Bristow, Nancy K

2010-04-01

Americans were stunned when pandemic influenza hit the United States in 1918. Recent advances in bacteriology and public health allowed Americans to imagine a future free of infectious disease, even as their familiarity with influenza tempered their fears of it. They soon realized this influenza was something unprecedented, as it shocked them with its pace, virulence, mortality patterns, and symptoms. Patients endured and frequently succumbed to a miserable illness, their suffering often made worse by the chaotic circumstances the epidemic produced in families and communities and shaped in significant and sometimes discriminatory ways by their gender, class, and race. While the nation's public culture soon forgot the epidemic, it lived on in lives changed irrevocably by its consequences. As they face present and future influenza pandemics, Americans can learn from this earlier experience, guarding against identity-based discrimination and acknowledging and remembering the grief and loss fellow citizens suffered.

Fatal Cases of Seasonal Influenza in Russia in 2015-2016.

Science.gov (United States)

Ilyicheva, T; Durymanov, A; Susloparov, I; Kolosova, N; Goncharova, N; Svyatchenko, S; Petrova, O; Bondar, A; Mikheev, V; Ryzhikov, A

2016-01-01

The influenza epidemic in 2015-2016 in Russia is characterized by a sharp increase of influenza cases (beginning from the second week of 2016) with increased fatalities. Influenza was confirmed in 20 fatal cases registered among children (0-10 years), in 5 cases among pregnant women, and in 173 cases among elderly people (60 years and older). Two hundred and ninety nine people died from influenza were patients with some chronic problems. The overwhelming majority among the deceased (more than 98%) were not vaccinated against influenza. We isolated 109 influenza A(H1N1)pdm09 and one A(H3N2) virus strains from 501 autopsy material samples. The antigenic features of the strains were similar to the vaccine strains. A phylogenic analysis of hemagglutinin revealed that influenza A(H1N1)pdm09 virus strains belonged to 6B genetic group that had two main dominant subgroups during the 2015-2016 season. In Russia strains of the first group predominated. We registered an increased proportion of strains with D222G mutation in receptor-binding site. A herd immunity analysis carried out immediately prior to the epidemic showed that 34.4% blood sera samples collected in different regions of Russia were positive to A/California/07/09(H1N1)pdm09. We came to a conclusion that public awareness enhancement is necessary to reduce unreasonable refusals of vaccination.

A social contagious model of the obesity epidemic

Science.gov (United States)

Huang, He; Yan, Zhijun; Chen, Yahong; Liu, Fangyan

2016-11-01

Obesity has been recognized as a global epidemic by WHO, followed by many empirical evidences to prove its infectiousness. However, the inter-person spreading dynamics of obesity are seldom studied. A distinguishing feature of the obesity epidemic is that it is driven by a social contagion process which cannot be perfectly described by the infectious disease models. In this paper, we propose a novel belief decision model based on the famous Dempster-Shafer theory of evidence to model obesity epidemic as the competing spread of two obesity-related behaviors: physical inactivity and physical activity. The transition of health states is described by an SIS model. Results reveal the existence of obesity epidemic threshold, above which obesity is quickly eradicated. When increasing the fading level of information spread, enlarging the clustering of initial obese seeds, or introducing small-world characteristics into the network topology, the threshold is easily met. Social discrimination against the obese people plays completely different roles in two cases: on one hand, when obesity cannot be eradicated, social discrimination can reduce the number of obese people; on the other hand, when obesity is eradicable, social discrimination may instead cause it breaking out.

Disparities in spread and control of influenza in slums of Delhi: findings from an agent-based modelling study

Science.gov (United States)

Adiga, Abhijin; Chu, Shuyu; Eubank, Stephen; Kuhlman, Christopher J; Lewis, Bryan; Marathe, Achla; Marathe, Madhav; Nordberg, Eric K; Swarup, Samarth; Vullikanti, Anil; Wilson, Mandy L

2018-01-01

Objectives This research studies the role of slums in the spread and control of infectious diseases in the National Capital Territory of India, Delhi, using detailed social contact networks of its residents. Methods We use an agent-based model to study the spread of influenza in Delhi through person-to-person contact. Two different networks are used: one in which slum and non-slum regions are treated the same, and the other in which 298 slum zones are identified. In the second network, slum-specific demographics and activities are assigned to the individuals whose homes reside inside these zones. The main effects of integrating slums are that the network has more home-related contacts due to larger family sizes and more outside contacts due to more daily activities outside home. Various vaccination and social distancing interventions are applied to control the spread of influenza. Results Simulation-based results show that when slum attributes are ignored, the effectiveness of vaccination can be overestimated by 30%–55%, in terms of reducing the peak number of infections and the size of the epidemic, and in delaying the time to peak infection. The slum population sustains greater infection rates under all intervention scenarios in the network that treats slums differently. Vaccination strategy performs better than social distancing strategies in slums. Conclusions Unique characteristics of slums play a significant role in the spread of infectious diseases. Modelling slums and estimating their impact on epidemics will help policy makers and regulators more accurately prioritise allocation of scarce medical resources and implement public health policies. PMID:29358419

Stochastic population and epidemic models persistence and extinction

CERN Document Server

Allen, Linda J S

2015-01-01

This monograph provides a summary of the basic theory of branching processes for single-type and multi-type processes. Classic examples of population and epidemic models illustrate the probability of population or epidemic extinction obtained from the theory of branching processes. The first chapter develops the branching process theory, while in the second chapter two applications to population and epidemic processes of single-type branching process theory are explored. The last two chapters present multi-type branching process applications to epidemic models, and then continuous-time and continuous-state branching processes with applications. In addition, several MATLAB programs for simulating stochastic sample paths  are provided in an Appendix. These notes originated as part of a lecture series on Stochastics in Biological Systems at the Mathematical Biosciences Institute in Ohio, USA. Professor Linda Allen is a Paul Whitfield Horn Professor of Mathematics in the Department of Mathematics and Statistics ...

A qualitative study of the coverage of influenza vaccination on Dutch news sites and social media websites.

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Lehmann, Birthe A; Ruiter, Robert A C; Kok, Gerjo

2013-06-05

Information about influenza and the effectiveness of vaccination against influenza is largely available on the Internet, and may influence individual decision making about participation in future influenza vaccination rounds. E-health information has often been found to be inaccurate, or even to contradict Health Authority recommendations, especially when it concerns controversial topics. By means of an online media monitoring programme, Dutch news sites and social media websites were scanned for the Dutch counterparts of the terms influenza, vaccination, vaccine and epidemic during February, March and April 2012. Data were processed with QSR NVivo 8.0 and analysed using a general inductive approach. Three overarching themes were found in both media sources: (1) the (upcoming) influenza epidemic, (2) general information regarding the virus, its prevention and treatment, and (3) uncertainty and mistrust regarding influenza vaccination. Social media tended to report earlier on developments such as the occurrence of an influenza epidemic. The greatest difference was that in social media, influenza was not considered to be a serious disease, and more opposition to the flu shot was expressed in social media, as compared to news media. News media and social media discussed the same topics regarding influenza, but differed in message tone. Whereas news media reports tended to be more objective and non-judgmental, social media more critically evaluated the harmfulness of influenza and the necessity of the flu shot. Media may influence decision making and behaviours of Internet users and may thereby influence the success of vaccination campaigns and recommendations made by health authorities. Social media may be more of a problem in this sense, since it is neither controlled nor censored. Future research should investigate the actual impact of Internet media on the influenza decision making process of its users.

Modeling and Analysis of Epidemic Diffusion within Small-World Network

Directory of Open Access Journals (Sweden)

Ming Liu

2012-01-01

Full Text Available To depict the rule of epidemic diffusion, two different models, the Susceptible-Exposure-Infected-Recovered-Susceptible (SEIRS model and the Susceptible-Exposure-Infected-Quarantine-Recovered-Susceptible (SEIQRS model, are proposed and analyzed within small-world network in this paper. Firstly, the epidemic diffusion models are constructed with mean-filed theory, and condition for the occurrence of disease diffusion is explored. Then, the existence and global stability of the disease-free equilibrium and the endemic equilibrium for these two complex epidemic systems are proved by differential equations knowledge and Routh-Hurwiz theory. At last, a numerical example which includes key parameters analysis and critical topic discussion is presented to test how well the proposed two models may be applied in practice. These works may provide some guidelines for decision makers when coping with epidemic diffusion controlling problems.

INFLUENZA SURVEILLANCE IN RUSSIA BASED ON EPIDEMIOLOGICAL AND LABORATORY DATA FOR THE PERIOD FROM 2005 TO 2012

Science.gov (United States)

Anna, Sominina; Burtseva, Elena; Eropkin, Mikhail; Karpova, Ludmila; Zarubaev, Vladimir; Smorodintseva, Elizaveta; Konovalova, Nadezhda; Danilenko, Daria; Prokopetz, Alexandra; Grudinin, Mikhail; Pisareva, Maria; Anfimov, Pavel; Stolyarov, Kirill; Kiselev, Oleg; Shevchenko, Elena; Ivanova, Valeriya; Trushakova, Svetlana; Breslav, Nataliya; Lvov, Dmitriy; Klimov, Alexander; Moen, Ann; Cox, Nancy

2015-01-01

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

Interspecies Interactions and Potential Influenza A Virus Risk in Small Swine Farms in Peru

Science.gov (United States)

2012-03-15

and swine influenza viruses : our current understanding of the zoonotic risk. Vet Res 2007, 38(2):243–260. 4. Wertheim JO: When pigs fly: the avian ...first authors. Abstract Background The recent avian influenza epidemic in Asia and the H1N1 pandemic demonstrated that influenza A viruses pose a...prime “mixing vessels” due to the dual receptivity of their trachea to human and avian strains. Additionally, avian and human influenza viruses

Epidemic Intelligence. Langmuir and the Birth of Disease Surveillance

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Lyle Fearnley

2010-12-01

Full Text Available In the wake of the SARS and influenza epidemics of the past decade, one public health solution has become a refrain: surveillance systems for detection of disease outbreaks. This paper is an effort to understand how disease surveillance for outbreak detection gained such paramount rationality in contemporary public health. The epidemiologist Alexander Langmuir is well known as the creator of modern disease surveillance. But less well known is how he imagined disease surveillance as one part of what he called “epidemic intelligence.” Langmuir developed the practice of disease surveillance during an unprecedented moment in which the threat of biological warfare brought civil defense experts and epidemiologists together around a common problem. In this paper, I describe how Langmuir navigated this world, experimenting with new techniques and rationales of epidemic control. Ultimately, I argue, Langmuir′s experiments resulted in a set of techniques and infrastructures – a system of epidemic intelligence – that transformed the epidemic as an object of human art.

Serosurvey of antibody to highly pathogenic avian influenza (H5N1 ...

African Journals Online (AJOL)

Avian influenza is a disease of economic and public health importance that has been described in most domestic animals and humans. Highly pathogenic avian influenza H5N1 epidemic in Nigeria was observed in agro-ecological zones where pigs and chickens are raised in shared environment with chances of ...

[Epidemics and diseases during the Independence period in Mexico].

Science.gov (United States)

Viesca-Treviño, Carlos

2010-01-01

The epidemics and endemic diseases in Mexico were not a problem before the Independence period. Hunger was less than in the past. The 1806 Influenza epidemics had been forgotten. Measles was considered a benign illness. In 1810, there was an increase in the number of cases of black vomit in Veracruz. Sixty percent of 541 hospitalized patients die of the disease. In 1812, an outbreak of yellow fever spread from Veracruz to Jalapa accompanying the movement of troops and killing over 300 soldiers of the Castilla's Battalion. The appearance of petechial fever, maybe typhus marketed in 1813 the onset of the most important epidemics. The preceding was the indirect effect of war: diseases of prisons and military quarters which became overwhelming in times where the movements of troops and of important groups of populations along with crowing, loss homes, hunger and bad hygiene habits. There was also Influenza or "pestilent cold." Measures of detection and quarantine were taken. "Naranjate" mixed with tartaric cremor was used against fever. Fumigation with nitric acid and burners, where they incinerated gun powder were among the health protection policies. It is noteworthy the advance and relief provided by the introduction of smallpox vaccine, the only preventive mean useful against smallpox which was a breakthrough in public health.

Universal Influenza Vaccines, a Dream to Be Realized Soon

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Han Zhang

2014-04-01

Full Text Available Due to frequent viral antigenic change, current influenza vaccines need to be re-formulated annually to match the circulating strains for battling seasonal influenza epidemics. These vaccines are also ineffective in preventing occasional outbreaks of new influenza pandemic viruses. All these challenges call for the development of universal influenza vaccines capable of conferring broad cross-protection against multiple subtypes of influenza A viruses. Facilitated by the advancement in modern molecular biology, delicate antigen design becomes one of the most effective factors for fulfilling such goals. Conserved epitopes residing in virus surface proteins including influenza matrix protein 2 and the stalk domain of the hemagglutinin draw general interest for improved antigen design. The present review summarizes the recent progress in such endeavors and also covers the encouraging progress in integrated antigen/adjuvant delivery and controlled release technology that facilitate the development of an affordable universal influenza vaccine.

Numerous cerebral hemorrhages in a patient with influenza-associated encephalitis: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Ji Ye; Seong, Su Ok; Park, Noh Hyuck; Park, Chan Sup [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of)

2016-02-15

Influenza-associated encephalitis (IAE) is a complication of a common disease that is rare even during an epidemic. Awareness of magnetic resonance imaging features of IAE is important in treatment planning and prognosis estimation. Several reports have described necrotizing encephalopathy in children with influenza. However, few reports have described multifocal hemorrhages in both cerebral hemispheres in adults with concomitant infection with influenza A and B. Here, we describe a case of influenza A- and B-associated encephalitis accompanied by numerous cerebral hemorrhages.

Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review

Science.gov (United States)

Mateus, Ana LP; Otete, Harmony E; Beck, Charles R; Dolan, Gayle P; Nguyen-Van-Tam, Jonathan S

2014-01-01

Abstract Objective To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. Methods We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care databases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. Findings The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Conclusion Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus. PMID:25552771

Computational algebraic geometry of epidemic models

Science.gov (United States)

Rodríguez Vega, Martín.

2014-06-01

Computational Algebraic Geometry is applied to the analysis of various epidemic models for Schistosomiasis and Dengue, both, for the case without control measures and for the case where control measures are applied. The models were analyzed using the mathematical software Maple. Explicitly the analysis is performed using Groebner basis, Hilbert dimension and Hilbert polynomials. These computational tools are included automatically in Maple. Each of these models is represented by a system of ordinary differential equations, and for each model the basic reproductive number (R0) is calculated. The effects of the control measures are observed by the changes in the algebraic structure of R0, the changes in Groebner basis, the changes in Hilbert dimension, and the changes in Hilbert polynomials. It is hoped that the results obtained in this paper become of importance for designing control measures against the epidemic diseases described. For future researches it is proposed the use of algebraic epidemiology to analyze models for airborne and waterborne diseases.

Influenza Virus and Glycemic Variability in Diabetes: A Killer Combination?

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Katina D. Hulme

2017-05-01

Full Text Available Following the 2009 H1N1 influenza virus pandemic, numerous studies identified the striking link between diabetes mellitus and influenza disease severity. Typically, influenza virus is a self-limiting infection but in individuals who have a pre-existing chronic illness, such as diabetes mellitus, severe influenza can develop. Here, we discuss the latest clinical and experimental evidence for the role of diabetes in predisposing the host to severe influenza. We explore the possible mechanisms that underlie this synergy and highlight the, as yet, unexplored role that blood glucose oscillations may play in disease development. Diabetes is one of the world’s fastest growing chronic diseases and influenza virus represents a constant and pervasive threat to human health. It is therefore imperative that we understand how diabetes increases influenza severity in order to mitigate the burden of future influenza epidemics and pandemics.

Defining epidemics in computer simulation models: How do definitions influence conclusions?

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Carolyn Orbann

2017-06-01

Full Text Available Computer models have proven to be useful tools in studying epidemic disease in human populations. Such models are being used by a broader base of researchers, and it has become more important to ensure that descriptions of model construction and data analyses are clear and communicate important features of model structure. Papers describing computer models of infectious disease often lack a clear description of how the data are aggregated and whether or not non-epidemic runs are excluded from analyses. Given that there is no concrete quantitative definition of what constitutes an epidemic within the public health literature, each modeler must decide on a strategy for identifying epidemics during simulation runs. Here, an SEIR model was used to test the effects of how varying the cutoff for considering a run an epidemic changes potential interpretations of simulation outcomes. Varying the cutoff from 0% to 15% of the model population ever infected with the illness generated significant differences in numbers of dead and timing variables. These results are important for those who use models to form public health policy, in which questions of timing or implementation of interventions might be answered using findings from computer simulation models.

Evaluation of Epidemic Intelligence Systems Integrated in the Early Alerting and Reporting Project for the Detection of A/H5N1 Influenza Events

Science.gov (United States)

Barboza, Philippe; Vaillant, Laetitia; Mawudeku, Abla; Nelson, Noele P.; Hartley, David M.; Madoff, Lawrence C.; Linge, Jens P.; Collier, Nigel; Brownstein, John S.; Yangarber, Roman; Astagneau, Pascal; on behalf of the Early Alerting, Reporting Project of the Global Health Security Initiative

2013-01-01

The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI) Early Alerting and Reporting (EAR) project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7–13.8). This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users. PMID:23472077

Evaluation of epidemic intelligence systems integrated in the early alerting and reporting project for the detection of A/H5N1 influenza events.

Directory of Open Access Journals (Sweden)

Philippe Barboza

Full Text Available The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI Early Alerting and Reporting (EAR project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7-13.8. This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users.

Evaluation of epidemic intelligence systems integrated in the early alerting and reporting project for the detection of A/H5N1 influenza events.

Science.gov (United States)

Barboza, Philippe; Vaillant, Laetitia; Mawudeku, Abla; Nelson, Noele P; Hartley, David M; Madoff, Lawrence C; Linge, Jens P; Collier, Nigel; Brownstein, John S; Yangarber, Roman; Astagneau, Pascal

2013-01-01

The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI) Early Alerting and Reporting (EAR) project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7-13.8). This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users.

The spatial resolution of epidemic peaks.

Directory of Open Access Journals (Sweden)

Harriet L Mills

2014-04-01

Full Text Available The emergence of novel respiratory pathogens can challenge the capacity of key health care resources, such as intensive care units, that are constrained to serve only specific geographical populations. An ability to predict the magnitude and timing of peak incidence at the scale of a single large population would help to accurately assess the value of interventions designed to reduce that peak. However, current disease-dynamic theory does not provide a clear understanding of the relationship between: epidemic trajectories at the scale of interest (e.g. city; population mobility; and higher resolution spatial effects (e.g. transmission within small neighbourhoods. Here, we used a spatially-explicit stochastic meta-population model of arbitrary spatial resolution to determine the effect of resolution on model-derived epidemic trajectories. We simulated an influenza-like pathogen spreading across theoretical and actual population densities and varied our assumptions about mobility using Latin-Hypercube sampling. Even though, by design, cumulative attack rates were the same for all resolutions and mobilities, peak incidences were different. Clear thresholds existed for all tested populations, such that models with resolutions lower than the threshold substantially overestimated population-wide peak incidence. The effect of resolution was most important in populations which were of lower density and lower mobility. With the expectation of accurate spatial incidence datasets in the near future, our objective was to provide a framework for how to use these data correctly in a spatial meta-population model. Our results suggest that there is a fundamental spatial resolution for any pathogen-population pair. If underlying interactions between pathogens and spatially heterogeneous populations are represented at this resolution or higher, accurate predictions of peak incidence for city-scale epidemics are feasible.

Influenza infection in the intensive care unit: Four years after the 2009 pandemic.

Science.gov (United States)

Pérez-Carrasco, Marcos; Lagunes, Leonel; Antón, Andrés; Gattarello, Simone; Laborda, César; Pumarola, Tomás; Rello, Jordi

2016-03-01

The role of influenza viruses in severe acute respiratory infection (SARI) in Intensive Care Units (ICU) remains unknown. The post-pandemic influenza A(H1N1)pdm09 period, in particular, has been poorly studied. To identify influenza SARI patients in ICU, to assess the usefulness of the symptoms of influenza-like illness (ILI), and to compare the features of pandemic vs. post-pandemic influenza A(H1N1) pdm09 infection. A prospective observational study with SARI patients admitted to ICU during the first three post-pandemic seasons. Patient demographics, characteristics and outcomes were recorded. An influenza epidemic period (IEP) was defined as >100 cases/100,000 inhabitants per week. One hundred sixty-three patients were diagnosed with SARI. ILI was present in 65 (39.9%) patients. Influenza infection was documented in 41 patients, 27 (41.5%) ILI patients, and 14 (14.3%) non-ILI patients, 27 of them during an IEP. Influenza A viruses were mainly responsible. Only five patients had influenza B virus infection, which were non-ILI during an IEP. SARI overall mortality was 22.1%, and 15% in influenza infection patients. Pandemic and post-pandemic influenza infection patients shared similar clinical features. During influenza epidemic periods, influenza infection screening should be considered in all SARI patients. Influenza SARI was mainly caused by subtype A(H1N1)pdm09 and A(H3N2) in post-pandemic seasons, and no differences were observed in ILI and mortality rate compared with a pandemic season. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Transferring the Malaria Epidemic Prediction Model to Users in East ...

International Development Research Centre (IDRC) Digital Library (Canada)

Transferring the Malaria Epidemic Prediction Model to Users in East Africa. In the highlands of East Africa, epidemic malaria is an emerging climate-related hazard that urgently needs addressing. Malaria incidence increased by 337% during the 1987 epidemic in Rwanda. In Tanzania, Uganda and Kenya, malaria incidence ...

Discrete stochastic analogs of Erlang epidemic models.

Science.gov (United States)

Getz, Wayne M; Dougherty, Eric R

2018-12-01

Erlang differential equation models of epidemic processes provide more realistic disease-class transition dynamics from susceptible (S) to exposed (E) to infectious (I) and removed (R) categories than the ubiquitous SEIR model. The latter is itself is at one end of the spectrum of Erlang SE[Formula: see text]I[Formula: see text]R models with [Formula: see text] concatenated E compartments and [Formula: see text] concatenated I compartments. Discrete-time models, however, are computationally much simpler to simulate and fit to epidemic outbreak data than continuous-time differential equations, and are also much more readily extended to include demographic and other types of stochasticity. Here we formulate discrete-time deterministic analogs of the Erlang models, and their stochastic extension, based on a time-to-go distributional principle. Depending on which distributions are used (e.g. discretized Erlang, Gamma, Beta, or Uniform distributions), we demonstrate that our formulation represents both a discretization of Erlang epidemic models and generalizations thereof. We consider the challenges of fitting SE[Formula: see text]I[Formula: see text]R models and our discrete-time analog to data (the recent outbreak of Ebola in Liberia). We demonstrate that the latter performs much better than the former; although confining fits to strict SEIR formulations reduces the numerical challenges, but sacrifices best-fit likelihood scores by at least 7%.

Influenza pandemic planning guide

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-11-15

An influenza pandemic will have serious economic impacts on the natural gas industry due to absenteeism as well as downstream effects due to supply disruption.This guide was prepared to assist gas distribution companies in planning for an influenza epidemic. The guide aimed to minimize the risks that an influenza pandemic might pose to the health and safety of employees and the continuity of business operations. The guide discussed 5 critical aspects of emergency planning: (1) prevention and threat mitigation; (2) preparedness; (3) response; (4) business continuity; and (5) communication. The legal context of the emergency plans were discussed. The plans were also discussed to other essential infrastructure emergency response plans. Recommendations were presented for infection control, decentralization and access restriction. Outlines for pandemic response planning teams and training and exercise programs were provided. Issues related to alert, mobilization, and response procedures were also discussed. 10 refs., 3 tabs., 1 fig.

Influenza seasonality goes south in the Yucatan Peninsula: The case for a different influenza vaccine calendar in this Mexican region.

Science.gov (United States)

Ayora-Talavera, Guadalupe; Flores, Gerardo Montalvo-Zurbia; Gómez-Carballo, Jesus; González-Losa, Refugio; Conde-Ferraez, Laura; Puerto-Solís, Marylin; López-Martínez, Irma; Díaz-Quiñonez, Alberto; Barrera-Badillo, Gisela; Acuna-Soto, Rodolfo; Livinski, Alicia A; Alonso, Wladimir J

2017-08-24

While vaccination may be relatively straightforward for regions with a well-defined winter season, the situation is quite different for tropical regions. Influenza activity in tropical regions might be out of phase with the dynamics predicted for their hemispheric group thereby impacting the effectiveness of the immunization campaign. To investigate how the climatic diversity of Mexico hinders its existing influenza immunization strategy and to suggest that the hemispheric vaccine recommendations be tailored to the regional level in order to optimize vaccine effectiveness. We studied the seasonality of influenza throughoutMexico by modeling virological and mortality data.De-trended time series of each Mexican state were analyzed by Fourier decomposition to describe the amplitude and timing of annual influenza epidemic cycles and to compare with each the timing of the WHO's Northern and Southern Hemispheric vaccination schedule. The timings of the primary (major) peaks of both virological and mortality data for most Mexican states are well aligned with the Northern Hemisphere winter (December-February) and vaccine schedule. However, influenza peaks in September in the three states of the Yucatan Peninsula. Influenza-related mortality also peaks in September in Quintana Roo and Yucatan whereas it peaks in May in Campeche. As the current timing of vaccination in Mexico is between October and November, more than half of the annual influenza cases have already occurred in the Yucatan Peninsula states by the time the Northern Hemispheric vaccine is delivered and administered. The current Northern Hemispheric influenza calendar adopted for Mexico is not optimal for the Yucatan Peninsula states thereby likely reducing the effectiveness of the immunization of the population. We recommend that Mexico tailor its immunization strategy to better reflect its climatologic and epidemiological diversity and adopt the WHO Southern Hemisphere influenza vaccine and schedule for the

Early Outbreak of 2009 Influenza A (H1N1) in Mexico Prior to Identification of pH1N1 Virus

Science.gov (United States)

Hsieh, Ying-Hen; Ma, Stefan; Velasco Hernandez, Jorge X.; Lee, Vernon J.; Lim, Wei Yen

2011-01-01

Background In the aftermath of the global spread of 2009 influenza A (pH1N1) virus, still very little is known of the early stages of the outbreak in Mexico during the early months of the year, before the virus was identified. Methodology/Main Findings We fit a simple mathematical model, the Richards model, to the number of excess laboratory-confirmed influenza cases in Mexico and Mexico City during the first 15 weeks in 2009 over the average influenza case number of the previous five baseline years of 2004-2008 during the same period to ascertain the turning point (or the peak incidence) of a wave of early influenza infections, and to estimate the transmissibility of the virus during these early months in terms of its basic reproduction number. The results indicate that there may have been an early epidemic in Mexico City as well as in all of Mexico during February/March. Based on excess influenza cases, the estimated basic reproduction number R0 for the early outbreak was 1.59 (0.55 to 2.62) for Mexico City during weeks 5–9, and 1.25 (0.76, 1.74) for all of Mexico during weeks 5–14. Conclusions We established the existence of an early epidemic in Mexico City and in all of Mexico during February/March utilizing the routine influenza surveillance data, although the location of seeding is unknown. Moreover, estimates of R0 as well as the time of peak incidence (the turning point) for Mexico City and all of Mexico indicate that the early epidemic in Mexico City in February/March had been more transmissible (larger R0) and peaked earlier than the rest of the country. Our conclusion lends support to the possibility that the virus could have already spread to other continents prior to the identification of the virus and the reporting of lab-confirmed pH1N1 cases in North America in April. PMID:21909366

I costi dell’influenza in Italia

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C. Lucioni

2001-03-01

Full Text Available The influenza is an acute viral infection that strikes respiratory tract and its diffusion is characteristic of epidemic and pandemic reoccurence. Globally the influenza represents, for the entity of its social impact (measurable in terms of morbility, hospitalization and mortality, a heavy healt care problem. In Italy the estimated incidence is 10-15%: the influenza is the third death cause for infectiuos disease, after AIDS and tubercolosis. This study is based on the Studio 606, the first italian study that allow us to pass from the presumptive phase to the observational one. The Studio 606 has been projected and realized by the Società Italiana di Medicina Generale (SIMG, involving about 200 general practitioners (MMG in two sample region, Lombardia and Puglia. The study has been developed between December the 15th, 1998 and March the 15th, 1999. The influenza causes especially indirect costs: most of people affected with influenza doesn’t go to work for about five days and these absences create an average cost per capita of £558.000. This indirect cost represents 87% of total average cost of one single influenza event.

Effect of gargling with tea and ingredients of tea on the prevention of influenza infection: a meta-analysis

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Kazuki Ide

2016-05-01

Full Text Available Abstract Background Influenza viruses can spread easily from person to person, and annual influenza epidemics are serious public health issues worldwide. Non-pharmaceutical public health interventions could potentially be effective for combatting influenza epidemics, but combined interventions and/or interventions with greater effectiveness are needed. Experimental studies have reported that tea and its ingredients (especially catechins have antiviral activities. Although several clinical studies have investigated the use of tea or its ingredients to prevent influenza infections, the effect of gargling these substances has remained uncertain. Methods We conducted a meta-analysis of randomized controlled studies and prospective cohort studies to assess the effect of gargling with tea and its ingredients on the prevention of influenza infection. The published literature was searched using the Cochrane Library, PubMed/MEDLINE (1966 to September 2015, Web of Science (1981 to September 2015, and Ichu-shi Web (1983 to September 2015. The extracted studies were read by two reviewers independently, and their overall scientific quality was evaluated. Studies meeting our inclusion criteria were pooled using the Mantel-Haenszel method in a fixed effects model and were also analyzed in a random effects model. The qualities of the model fits were assessed using the Akaike information criterion (AIC and Bayesian information criterion (BIC. Results The literature search and review identified 5 studies that met the inclusion criteria for the meta-analysis (total number of participants, 1890; mean age range, 16–83 years. The participants who gargled with tea or its ingredients showed a lower risk of influenza infection than did participants who gargled with placebo/water or who did not gargle (fixed effects model, Mantel-Haenszel method: relative risk [RR] = 0.70, 95 % confidence interval [CI] = 0.54–0.89; random effects model: RR = 0.71, 95�

Effect of Weather Variability on Seasonal Influenza Among Different Age Groups in Queensland, Australia: A Bayesian Spatiotemporal Analysis.

Science.gov (United States)

Huang, Xiaodong; Mengersen, Kerrie; Milinovich, Gabriel; Hu, Wenbiao

2017-06-01

The effects of weather variability on seasonal influenza among different age groups remain unclear. The comparative study aims to explore the differences in the associations between weather variability and seasonal influenza, and growth rates of seasonal influenza epidemics among different age groups in Queensland, Australia. Three Bayesian spatiotemporal conditional autoregressive models were fitted at the postal area level to quantify the relationships between seasonal influenza and monthly minimum temperature (MIT), monthly vapor pressure, school calendar pattern, and Index of Relative Socio-Economic Advantage and Disadvantage for 3 age groups (Weather variability appears to be more influential on seasonal influenza transmission in younger (0-14) age groups. The growth rates of influenza at postal area level were relatively small for older (≥65) age groups in Queensland, Australia. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Modelling the dynamics of nonendemic epidemics

International Nuclear Information System (INIS)

Ramani, A.; Grammaticos, B.; Satsuma, J.

2009-01-01

We present two models for an epidemic where the individuals are infective over a fixed period of time and which never becomes endemic i.e., no infective individuals remain after the epidemic has run its course. The first model is based on a delay-difference scheme. We show that, as a function of the delay (which corresponds to the period of infectiveness) the percentage of non-infected population varies over a wide range. We present also a variant of our model where the recovery rate follows a Poisson law and obtain a discrete version of the SIR model. We estimate the percentage of non-infected population in the two models, show that they lead to almost the same values and present an explanation of this fact. The second model is based on the assumption that the infection is spread by carriers. Under the hypothesis that the carriers are relatively long-lived, and that the number of the infected ones is a relatively small fraction of the total population of potential carriers, we show that the model reduces to the same version of the discrete SIR obtained by our first model.

Clinical outcomes of seasonal influenza and pandemic influenza A (H1N1 in pediatric inpatients

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Budd Alicia

2010-10-01

Full Text Available Abstract Background In April 2009, a novel influenza A H1N1 (nH1N1 virus emerged and spread rapidly worldwide. News of the pandemic led to a heightened awareness of the consequences of influenza and generally resulted in enhanced infection control practices and strengthened vaccination efforts for both healthcare workers and the general population. Seasonal influenza (SI illness in the pediatric population has been previously shown to result in significant morbidity, mortality, and substantial hospital resource utilization. Although influenza pandemics have the possibility of resulting in considerable illness, we must not ignore the impact that we can experience annually with SI. Methods We compared the outcomes of pediatric patients ≤18 years of age at a large urban hospital with laboratory confirmed influenza and an influenza-like illness (ILI during the 2009 pandemic and two prior influenza seasons. The primary outcome measure was hospital length of stay (LOS. All variables potentially associated with LOS based on univariable analysis, previous studies, or hypothesized relationships were included in the regression models to ensure adjustment for their effects. Results There were 133 pediatric cases of nH1N1 admitted during 2009 and 133 cases of SI admitted during the prior 2 influenza seasons (2007-8 and 2008-9. Thirty-six percent of children with SI and 18% of children with nH1N1 had no preexisting medical conditions (p = 0.14. Children admitted with SI had 1.73 times longer adjusted LOS than children admitted for nH1N1 (95% CI 1.35 - 2.13. There was a trend towards more children with SI requiring mechanical ventilation compared with nH1N1 (16 vs.7, p = 0.08. Conclusions This study strengthens the growing body of evidence demonstrating that SI results in significant morbidity in the pediatric population. Pandemic H1N1 received considerable attention with strong media messages urging people to undergo vaccination and encouraging improved

Ultraviolet air disinfection for protection against influenza

International Nuclear Information System (INIS)

Riley, R.L.

1977-01-01

Three converging lines of evidence support the belief that it may be possible, under appropriate circumstances, to interrupt the airborne transmission of influenza by ultraviolet (UV) air disinfection. These lines of evidence are: (a) that influenza is airborne; (b) that UV irradiation of the upper air of a room can provide safe and effective disinfection of air in the lower part of the room; and (c) that epidemic spread of airborne viral infections in humans can be prevented if the population under consideration remains in the UV-protected environment

Modeling age-specific mortality for countries with generalized HIV epidemics.

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David J Sharrow

Full Text Available In a given population the age pattern of mortality is an important determinant of total number of deaths, age structure, and through effects on age structure, the number of births and thereby growth. Good mortality models exist for most populations except those experiencing generalized HIV epidemics and some developing country populations. The large number of deaths concentrated at very young and adult ages in HIV-affected populations produce a unique 'humped' age pattern of mortality that is not reproduced by any existing mortality models. Both burden of disease reporting and population projection methods require age-specific mortality rates to estimate numbers of deaths and produce plausible age structures. For countries with generalized HIV epidemics these estimates should take into account the future trajectory of HIV prevalence and its effects on age-specific mortality. In this paper we present a parsimonious model of age-specific mortality for countries with generalized HIV/AIDS epidemics.The model represents a vector of age-specific mortality rates as the weighted sum of three independent age-varying components. We derive the age-varying components from a Singular Value Decomposition of the matrix of age-specific mortality rate schedules. The weights are modeled as a function of HIV prevalence and one of three possible sets of inputs: life expectancy at birth, a measure of child mortality, or child mortality with a measure of adult mortality. We calibrate the model with 320 five-year life tables for each sex from the World Population Prospects 2010 revision that come from the 40 countries of the world that have and are experiencing a generalized HIV epidemic. Cross validation shows that the model is able to outperform several existing model life table systems.We present a flexible, parsimonious model of age-specific mortality for countries with generalized HIV epidemics. Combined with the outputs of existing epidemiological and

Risk factors for the introduction of high pathogenicity Avian Influenza virus into poultry farms during the epidemic in the Netherlands in 2003.

Science.gov (United States)

Thomas, M E; Bouma, A; Ekker, H M; Fonken, A J M; Stegeman, J A; Nielen, M

2005-06-10

An epidemic of high pathogenicity Avian Influenza (HPAI) occurred in the Netherlands in 2003. A census survey of 173 infected and 401 uninfected commercial poultry farms was carried out to identify factors associated with the introduction of the HPAI virus into poultry farms. Data on farm size, production characteristics, type of housing, presence of cattle and pigs were gathered by the National Inspection Service for Livestock and Meat from all farms included in this study. For each risk factor (RF) available for analysis, the Mantel-Haenszel odds ratio was calculated (stratified on farm size and housing type). We found an increased risk of HPAI virus introduction in layer finisher type poultry: OR = 2.05 (95% confidence interval, CI = 1.29-3.27). An explanation for this increased risk is the high number of contacts between these farms, especially via cardboard egg trays used for removal of eggs during the epidemic. Our analysis did not indicate significant differences between the infected and uninfected farms with regard to housing type, presence of cattle or pigs. Since layer finisher type farms are assumed to be at higher risk for HPAI virus introduction, more specific control measures might be applied in future outbreaks.

Outbreak of avian influenza H7N3 on a turkey farm in the Netherlands

NARCIS (Netherlands)

Velkers, F.C.; Bouma, A.; Matthijs, M.G.R.; Koch, G.; Westendorp, S.T.; Stegeman, J.A.

2006-01-01

This case report describes the course of an outbreak of avian influenza on a Dutch turkey farm. When clinical signs were observed their cause remained unclear. However, serum samples taken for the monitoring campaign launched during the epidemic of highly pathogenic avian influenza in 2003, showed

PREDICTION OF DENGUE FEVER EPIDEMIC SPREADING USING DYNAMICS TRANSMISSION VECTOR MODEL

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Retno Widyaningrum

2014-05-01

Full Text Available Increasing number of dengue cases in Surabaya shows that its city has high potential of dengue fever epidemic. Although some policies were designed by Surabaya Health Department, such as fogging and mosquito’s nest eradication, but these efforts still out of target because of inaccurate predictions. Ineffectiveness eradication of dengue fever epidemic is caused by lack of information and knowledge on environmental conditions in Surabaya. Developing spread and prediction system to minimize dengue fever epidemic is necessary to be conducted immediately. Spread and prediction system can improve eradication and prevention accuracy. The transmission dynamics vector simulation will be used as an approach to draw a complex system ofmosquito life cycle in which involve a lot offactors. Dynamics transmission model used to build model in mosquito model (oviposition rate and pre adult mosquito, infected and death cases in dengue fever. The model of mosquito and infected population can represent system. The output of this research is website of spread and prediction system of dengue fever epidemics to predict growth rate of Aedes Aegypti mosquito, infected, and death population because of dengue fever epidemics. The deviation of infected population is 0,519. The model of death cases in dengue fever is less precision with the deviation 1,229. Death cases model need improvement by adding some variables that influence to dengue fever death cases. Spread ofdengue fever prediction will help the government, health department to decide the best policies in minimizing the spread ofdengue fever epidemics.

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. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Influenza vaccine effectiveness assessment through sentinel virological data in three post-pandemic seasons

Science.gov (United States)

Torner, Núria; Martínez, Ana; Basile, Luca; Marcos, M Angeles; Antón, Andrés; Mar Mosquera, M; Isanta, Ricard; Cabezas, Carmen; Jané, Mireia; Domínguez, Angela; Program of Catalonia, the PIDIRAC Sentinel Surveillance

2014-01-01

Influenza vaccination aims at reducing the incidence of serious disease, complications and death among those with the most risk of severe influenza disease. Influenza vaccine effectiveness (VE) through sentinel surveillance data from the PIDIRAC program (Daily Acute Respiratory Infection Surveillance of Catalonia) during 2010–2011, 2011–2012, and 2012–2013 influenza seasons, with three different predominant circulating influenza virus (IV) types [A(H1N1)pdm09, A(H3N2) and B, respectively] was assessed. The total number of sentinel samples with known vaccination background collected during the study period was 3173, 14.7% of which had received the corresponding seasonal influenza vaccine. 1117 samples (35.2%) were positive for IV. A retrospective negative case control design was used to assess vaccine effectiveness (VE) for the entire period and for each epidemic influenza season. An overall VE of 58.1% (95% CI:46.8–67) was obtained. Differences in VE according to epidemic season were observed, being highest for the 2012–2013 season with predominance of IV type B (69.7% ;95% CI:51.5–81) and for the 2010–2011 season, with predominance of the A(H1N1)pdm09 influenza virus strain (67.2% ;95%CI:49.5–78.8) and lowest for the 2011–2012 season with A(H3N2) subtype predominance (34.2% ;95%CI:4.5–54.6). Influenza vaccination prevents a substantial number of influenza-associated illnesses. Although vaccines with increased effectiveness are needed and the search for a universal vaccine that is not subject to genetic modifications might increase VE, nowadays only the efforts to increase vaccination rates of high-risk population and healthcare personnel let reduce the burden of influenza and its complications. PMID:25483540

Risk-based input-output analysis of influenza epidemic consequences on interdependent workforce sectors.

Science.gov (United States)

Santos, Joost R; May, Larissa; Haimar, Amine El

2013-09-01

Outbreaks of contagious diseases underscore the ever-looming threat of new epidemics. Compared to other disasters that inflict physical damage to infrastructure systems, epidemics can have more devastating and prolonged impacts on the population. This article investigates the interdependent economic and productivity risks resulting from epidemic-induced workforce absenteeism. In particular, we develop a dynamic input-output model capable of generating sector-disaggregated economic losses based on different magnitudes of workforce disruptions. An ex post analysis of the 2009 H1N1 pandemic in the national capital region (NCR) reveals the distribution of consequences across different economic sectors. Consequences are categorized into two metrics: (i) economic loss, which measures the magnitude of monetary losses incurred in each sector, and (ii) inoperability, which measures the normalized monetary losses incurred in each sector relative to the total economic output of that sector. For a simulated mild pandemic scenario in NCR, two distinct rankings are generated using the economic loss and inoperability metrics. Results indicate that the majority of the critical sectors ranked according to the economic loss metric comprise of sectors that contribute the most to the NCR's gross domestic product (e.g., federal government enterprises). In contrast, the majority of the critical sectors generated by the inoperability metric include sectors that are involved with epidemic management (e.g., hospitals). Hence, prioritizing sectors for recovery necessitates consideration of the balance between economic loss, inoperability, and other objectives. Although applied specifically to the NCR, the proposed methodology can be customized for other regions. © 2012 Society for Risk Analysis.

Inter-Seasonal Influenza is Characterized by Extended Virus Transmission and Persistence

Science.gov (United States)

Patterson Ross, Zoe; Komadina, Naomi; Deng, Yi-Mo; Spirason, Natalie; Kelly, Heath A.; Sullivan, Sheena G.; Barr, Ian G.; Holmes, Edward C.

2015-01-01

The factors that determine the characteristic seasonality of influenza remain enigmatic. Current models predict that occurrences of influenza outside the normal surveillance season within a temperate region largely reflect the importation of viruses from the alternate hemisphere or from equatorial regions in Asia. To help reveal the drivers of seasonality we investigated the origins and evolution of influenza viruses sampled during inter-seasonal periods in Australia. To this end we conducted an expansive phylogenetic analysis of 9912, 3804, and 3941 hemagglutinnin (HA) sequences from influenza A/H1N1pdm, A/H3N2, and B, respectively, collected globally during the period 2009-2014. Of the 1475 viruses sampled from Australia, 396 (26.8% of Australian, or 2.2% of global set) were sampled outside the monitored temperate influenza surveillance season (1 May – 31 October). Notably, rather than simply reflecting short-lived importations of virus from global localities with higher influenza prevalence, we documented a variety of more complex inter-seasonal transmission patterns including “stragglers” from the preceding season and “heralds” of the forthcoming season, and which included viruses sampled from clearly temperate regions within Australia. We also provide evidence for the persistence of influenza B virus between epidemic seasons, in which transmission of a viral lineage begins in one season and continues throughout the inter-seasonal period into the following season. Strikingly, a disproportionately high number of inter-seasonal influenza transmission events occurred in tropical and subtropical regions of Australia, providing further evidence that climate plays an important role in shaping patterns of influenza seasonality. PMID:26107631

Influenza outbreak during Sydney World Youth Day 2008: the utility of laboratory testing and case definitions on mass gathering outbreak containment.

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Sebastiaan J van Hal

Full Text Available BACKGROUND: Influenza causes annual epidemics and often results in extensive outbreaks in closed communities. To minimize transmission, a range of interventions have been suggested. For these to be effective, an accurate and timely diagnosis of influenza is required. This is confirmed by a positive laboratory test result in an individual whose symptoms are consistent with a predefined clinical case definition. However, the utility of these clinical case definitions and laboratory testing in mass gathering outbreaks remains unknown. METHODS AND RESULTS: An influenza outbreak was identified during World Youth Day 2008 in Sydney. From the data collected on pilgrims presenting to a single clinic, a Markov model was developed and validated against the actual epidemic curve. Simulations were performed to examine the utility of different clinical case definitions and laboratory testing strategies for containment of influenza outbreaks. Clinical case definitions were found to have the greatest impact on averting further cases with no added benefit when combined with any laboratory test. Although nucleic acid testing (NAT demonstrated higher utility than indirect immunofluorescence antigen or on-site point-of-care testing, this effect was lost when laboratory NAT turnaround times was included. The main benefit of laboratory confirmation was limited to identification of true influenza cases amenable to interventions such as antiviral therapy. CONCLUSIONS: Continuous re-evaluation of case definitions and laboratory testing strategies are essential for effective management of influenza outbreaks during mass gatherings.

Uptake of the Influenza Vaccination in Pregnancy

LENUS (Irish Health Repository)

Crosby, DA

2016-09-01

Influenza is caused by a highly infectious RNA virus, which usually occurs in a seasonal pattern with epidemics in the winter months. The objective of this study was to determine the uptake of the influenza vaccine in a pregnant population and ascertain the reasons why some women did not receive it. A prospective cohort study was conducted over a two-week period in January 2016 in the National Maternity Hospital Dublin, a tertiary referral maternity hospital delivering over 9000 infants per year. There were 504 women studied over the 2-week period. Overall, 197(39.1%) women received the vaccine at a mean gestational age 20.9 weeks (SD 7.0). Given the increased rates of influenza in the community and the associated implications for mother and infant, it is important that pregnant women are educated regarding the risks of influenza in pregnancy and encourage this cohort to be vaccinated.

The prediction of epidemics through mathematical modeling.

Science.gov (United States)

Schaus, Catherine

2014-01-01

Mathematical models may be resorted to in an endeavor to predict the development of epidemics. The SIR model is one of the applications. Still too approximate, the use of statistics awaits more data in order to come closer to reality.

Evaluating neighborhood structures for modeling intercity diffusion of large-scale dengue epidemics.

Science.gov (United States)

Wen, Tzai-Hung; Hsu, Ching-Shun; Hu, Ming-Che

2018-05-03

Dengue fever is a vector-borne infectious disease that is transmitted by contact between vector mosquitoes and susceptible hosts. The literature has addressed the issue on quantifying the effect of individual mobility on dengue transmission. However, there are methodological concerns in the spatial regression model configuration for examining the effect of intercity-scale human mobility on dengue diffusion. The purposes of the study are to investigate the influence of neighborhood structures on intercity epidemic progression from pre-epidemic to epidemic periods and to compare definitions of different neighborhood structures for interpreting the spread of dengue epidemics. We proposed a framework for assessing the effect of model configurations on dengue incidence in 2014 and 2015, which were the most severe outbreaks in 70 years in Taiwan. Compared with the conventional model configuration in spatial regression analysis, our proposed model used a radiation model, which reflects population flow between townships, as a spatial weight to capture the structure of human mobility. The results of our model demonstrate better model fitting performance, indicating that the structure of human mobility has better explanatory power in dengue diffusion than the geometric structure of administration boundaries and geographic distance between centroids of cities. We also identified spatial-temporal hierarchy of dengue diffusion: dengue incidence would be influenced by its immediate neighboring townships during pre-epidemic and epidemic periods, and also with more distant neighbors (based on mobility) in pre-epidemic periods. Our findings suggest that the structure of population mobility could more reasonably capture urban-to-urban interactions, which implies that the hub cities could be a "bridge" for large-scale transmission and make townships that immediately connect to hub cities more vulnerable to dengue epidemics.

The ghost of pandemics past: revisiting two centuries of influenza in Sweden.

Science.gov (United States)

Holmberg, Martin

2017-09-01

Previous influenza pandemics are usually invoked in pandemic preparedness planning without a thorough analysis of the events surrounding them, what has been called the 'configuration' of epidemics. Historic pandemics are instead used to contrast them to the novelty of the coming imagined plague or as fear of a ghost-like repetition of the past. This view of pandemics is guided by a biomedical framework that is ahistorical and reductionist. The meaning of 'pandemic' influenza is in fact highly ambiguous in its partitioning of pandemic and seasonal influenza. The past 200 years of influenza epidemics in Sweden are examined with a special focus on key social structures-households, schools, transportations and the military. These are shown to have influenced the progression of influenza pandemics. Prevailing beliefs around influenza pandemics have also profoundly influenced intervention strategies. Measuring long-term trends in pandemic severity is problematic because pandemics are non-linear events where the conditions surrounding them constantly change. However, in a linearised view, the Spanish flu can be seen to represent a historical turning point and the H1N1 2009 pandemic not as an outlier, but following a 100-year trend of decreasing severity. Integrating seasonal and pandemic influenza, and adopting an ecosocial stance can deepen our understanding and bring the ghost-like pandemic past to life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Surveillance of low pathogenic avian influenza in layer chickens: risk factors, transmission and early detection

NARCIS (Netherlands)

Gonzales Rojas, J.L.

2012-01-01

Low pathogenic avian influenza virus (LPAIv) of H5 and H7 subtypes are able to mutate to highly pathogenic avian influenza virus (HPAIv), which are lethal for most poultry species, can cause large epidemics and are a serious threat to public health. Thus, circulation of these LPAIv in poultry is

The timing and targeting of treatment in influenza pandemics influences the emergence of resistance in structured populations.

Science.gov (United States)

Althouse, Benjamin M; Patterson-Lomba, Oscar; Goerg, Georg M; Hébert-Dufresne, Laurent

2013-01-01

Antiviral resistance in influenza is rampant and has the possibility of causing major morbidity and mortality. Previous models have identified treatment regimes to minimize total infections and keep resistance low. However, the bulk of these studies have ignored stochasticity and heterogeneous contact structures. Here we develop a network model of influenza transmission with treatment and resistance, and present both standard mean-field approximations as well as simulated dynamics. We find differences in the final epidemic sizes for identical transmission parameters (bistability) leading to different optimal treatment timing depending on the number initially infected. We also find, contrary to previous results, that treatment targeted by number of contacts per individual (node degree) gives rise to more resistance at lower levels of treatment than non-targeted treatment. Finally we highlight important differences between the two methods of analysis (mean-field versus stochastic simulations), and show where traditional mean-field approximations fail. Our results have important implications not only for the timing and distribution of influenza chemotherapy, but also for mathematical epidemiological modeling in general. Antiviral resistance in influenza may carry large consequences for pandemic mitigation efforts, and models ignoring contact heterogeneity and stochasticity may provide misleading policy recommendations.

Epidemic Survivability: Characterizing Networks Under Epidemic-like Failure Propagation Scenarios

DEFF Research Database (Denmark)

Manzano, Marc; Calle, Eusebi; Ripoll, Jordi

2013-01-01

Epidemics theory has been used in different contexts in order to describe the propagation of diseases, human interactions or natural phenomena. In computer science, virus spreading has been also characterized using epidemic models. Although in the past the use of epidemic models...... in telecommunication networks has not been extensively considered, nowadays, with the increasing computation capacity and complexity of operating systems of modern network devices (routers, switches, etc.), the study of possible epidemic-like failure scenarios must be taken into account. When epidemics occur......, such as in other multiple failure scenarios, identifying the level of vulnerability offered by a network is one of the main challenges. In this paper, we present epidemic survivability, a new network measure that describes the vulnerability of each node of a network under a specific epidemic intensity. Moreover...

Sentinel surveillance for influenza in Senegal, 1996-2009.

Science.gov (United States)

Niang, Mbayame Ndiaye; Dosseh, Annick; Ndiaye, Kader; Sagna, Monique; Gregory, Victoria; Goudiaby, Deborah; Hay, Alan; Diop, Ousmane M

2012-12-15

Data on influenza in tropical and resource-limited countries are scarce. In this study we present results from 14 years of influenza surveillance in Senegal, one of the few tropical countries in Africa from which longitudinal data are available. From 1996 to 2009, we collected respiratory specimens from outpatients presenting with influenza-like illness at 13 facilities in order to investigate the epidemiology of seasonal influenza and the characteristics of the circulating influenza viruses. Specimens were tested for influenza using viral isolation and/or reverse-transcription polymerase chain reaction (RT-PCR). From 1996 to 2009, specimens were obtained from 9176 patients; 1233 (13%) were influenza-positive by virus isolation and/or RT-PCR. Among positive samples, 958 (77%) were influenza A, 268 (22%) influenza B, and 7 (1%) influenza type C; of influenza A viruses, 619 (65%) were A(H3) and 339 (35%) A(H1), of which 13 (1%) were identified as H1N2. The proportion positive was similar for children 55 years (9%). Although influenza A(H1), A(H3), and B all circulated during most years, influenza A(H3N2) predominated during 9 of the 14 years. Influenza activity consistently peaked during the rainy season (July-September). Phylogenetic analysis showed that viruses circulating in Senegal were similar to contemporary viruses circulating elsewhere in the world. Our data confirm that influenza is prevalent in Senegal, occurs in seasonal epidemics, and contributes to the burden of respiratory diseases in all age groups.

Effectiveness and Cost-Benefit of an Influenza Vaccination Program for Health Care Workers

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Annalee Yassi

1991-01-01

Full Text Available This study retrospectively reviewed the effectiveness of a vaccination program for hospital workers in a large tertiary care hospital, quantified influenza-induced absenteeism, and examined the factors determining the costs and benefits of this program. Absenteeism among high risk hospital workers was increased by 35% (P=0.001 during the virulent influenza epidemic of 1987–88. Benefits, measured as the value of sick time avoided, compared with costs, including materials, occupational nursing staff time, employee time during vaccination, and time lost due to adverse reactions, revealed a net benefit of $39.23 per vaccinated employee. Sensitivity analyses highlighted vaccine efficacy and absenteeism due to influenza and adverse reactions to vaccination as the most important factors; with time lost due to adverse reactions as much as 0.013 days per vaccinated employee and a vaccine efficacy of 70%, net positive benefits could be achieved if influenza-induced absenteeism is 0.5% or greater of paid employee time during the epidemic season. The results suggested that the net cost-benefit of a hospital employee vaccination program to decrease both employee morbidity and nosocomial influenza among patients, would be increased by active promotion of the vaccination program, especially for employees in high risk areas.

Disparities in spread and control of influenza in slums of Delhi: findings from an agent-based modelling study.

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Adiga, Abhijin; Chu, Shuyu; Eubank, Stephen; Kuhlman, Christopher J; Lewis, Bryan; Marathe, Achla; Marathe, Madhav; Nordberg, Eric K; Swarup, Samarth; Vullikanti, Anil; Wilson, Mandy L

2018-01-21

This research studies the role of slums in the spread and control of infectious diseases in the National Capital Territory of India, Delhi, using detailed social contact networks of its residents. We use an agent-based model to study the spread of influenza in Delhi through person-to-person contact. Two different networks are used: one in which slum and non-slum regions are treated the same, and the other in which 298 slum zones are identified. In the second network, slum-specific demographics and activities are assigned to the individuals whose homes reside inside these zones. The main effects of integrating slums are that the network has more home-related contacts due to larger family sizes and more outside contacts due to more daily activities outside home. Various vaccination and social distancing interventions are applied to control the spread of influenza. Simulation-based results show that when slum attributes are ignored, the effectiveness of vaccination can be overestimated by 30%-55%, in terms of reducing the peak number of infections and the size of the epidemic, and in delaying the time to peak infection. The slum population sustains greater infection rates under all intervention scenarios in the network that treats slums differently. Vaccination strategy performs better than social distancing strategies in slums. Unique characteristics of slums play a significant role in the spread of infectious diseases. Modelling slums and estimating their impact on epidemics will help policy makers and regulators more accurately prioritise allocation of scarce medical resources and implement public health policies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Pandemic (H1N1 2009 influenza community transmission was established in one Australian state when the virus was first identified in North America.

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Heath A Kelly

Full Text Available BACKGROUND: In mid-June 2009 the State of Victoria in Australia appeared to have the highest notification rate of pandemic (H1N1 2009 influenza in the world. We hypothesise that this was because community transmission of pandemic influenza was already well established in Victoria at the time testing for the novel virus commenced. In contrast, this was not true for the pandemic in other parts of Australia, including Western Australia (WA. METHODS: We used data from detailed case follow-up of patients with confirmed infection in Victoria and WA to demonstrate the difference in the pandemic curve in two Australian states on opposite sides of the continent. We modelled the pandemic in both states, using a susceptible-infected-removed model with Bayesian inference accounting for imported cases. RESULTS: Epidemic transmission occurred earlier in Victoria and later in WA. Only 5% of the first 100 Victorian cases were not locally acquired and three of these were brothers in one family. By contrast, 53% of the first 102 cases in WA were associated with importation from Victoria. Using plausible model input data, estimation of the effective reproductive number for the Victorian epidemic required us to invoke an earlier date for commencement of transmission to explain the observed data. This was not required in modelling the epidemic in WA. CONCLUSION: Strong circumstantial evidence, supported by modelling, suggests community transmission of pandemic influenza was well established in Victoria, but not in WA, at the time testing for the novel virus commenced in Australia. The virus is likely to have entered Victoria and already become established around the time it was first identified in the US and Mexico.

Trivalent inactivated influenza vaccine effective against influenza A(H3N2) variant viruses in children during the 2014/15 season, Japan

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Sugaya, Norio; Shinjoh, Masayoshi; Kawakami, Chiharu; Yamaguchi, Yoshio; Yoshida, Makoto; Baba, Hiroaki; Ishikawa, Mayumi; Kono, Mio; Sekiguchi, Shinichiro; Kimiya, Takahisa; Mitamura, Keiko; Fujino, Motoko; Komiyama, Osamu; Yoshida, Naoko; Tsunematsu, Kenichiro; Narabayashi, Atsushi; Nakata, Yuji; Sato, Akihiro; Taguchi, Nobuhiko; Fujita, Hisayo; Toki, Machiko; Myokai, Michiko; Ookawara, Ichiro; Takahashi, Takao

2016-01-01

The 2014/15 influenza season in Japan was characterised by predominant influenza A(H3N2) activity; 99% of influenza A viruses detected were A(H3N2). Subclade 3C.2a viruses were the major epidemic A(H3N2) viruses, and were genetically distinct from A/New York/39/2012(H3N2) of 2014/15 vaccine strain in Japan, which was classified as clade 3C.1. We assessed vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children aged 6 months to 15 years by test-negative case–control design based on influenza rapid diagnostic test. Between November 2014 and March 2015, a total of 3,752 children were enrolled: 1,633 tested positive for influenza A and 42 for influenza B, and 2,077 tested negative. Adjusted VE was 38% (95% confidence intervals (CI): 28 to 46) against influenza virus infection overall, 37% (95% CI: 27 to 45) against influenza A, and 47% (95% CI: -2 to 73) against influenza B. However, IIV was not statistically significantly effective against influenza A in infants aged 6 to 11 months or adolescents aged 13 to 15 years. VE in preventing hospitalisation for influenza A infection was 55% (95% CI: 42 to 64). Trivalent IIV that included A/New York/39/2012(H3N2) was effective against drifted influenza A(H3N2) virus, although vaccine mismatch resulted in low VE. PMID:27784529

Burden of medically attended influenza infection and cases averted by vaccination — United States, 2013/14 through 2015/16 influenza seasons

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Jackson, Michael L.; Phillips, C. Hallie; Benoit, Joyce; Jackson, Lisa A.; Gaglani, Manjusha; Murthy, Kempapura; McLean, Huong Q.; Belongia, Edward A.; Malosh, Ryan; Zimmerman, Richard; Flannery, Brendan

2018-01-01

Background In addition to preventing hospitalizations and deaths due to influenza, influenza vaccination programs can reduce the burden of outpatient visits for influenza. We estimated the incidence of medically-attended influenza at three geographically diverse sites in the United States, and the cases averted by vaccination, for the 2013/14 through 2015/16 influenza seasons. Methods We defined surveillance populations at three sites from the United States Influenza Vaccine Effectiveness Network. Among these populations, we identified outpatient visits laboratory-confirmed influenza via active surveillance, and identified all outpatient visits for acute respiratory illness from healthcare databases. We extrapolated the total number of outpatient visits for influenza from the proportion of surveillance visits with a positive influenza test. We combined estimates of incidence, vaccine coverage, and vaccine effectiveness to estimate outpatient visits averted by vaccination. Results Across the three sites and seasons, incidence of medically attended influenza ranged from 14 to 54 per 1,000 population. Incidence was highest in children aged 6 months to 9 years (33 to 70 per 1,000) and lowest in adults aged 18-49 years (21 to 27 per 1,000). Cases averted ranged from 9 per 1,000 vaccinees (Washington, 2014/15) to 28 per 1,000 (Wisconsin, 2013/14). Discussion Seasonal influenza epidemics cause a considerable burden of outpatient medical visits. The United States influenza vaccination program has caused meaningful reductions in outpatient visits for influenza, even in years when the vaccine is not well-matched to the dominant circulating influenza strain. PMID:29249545

Animal Models for Influenza Viruses: Implications for Universal Vaccine Development

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Irina Margine

2014-10-01

Full Text Available Influenza virus infections are a significant cause of morbidity and mortality in the human population. Depending on the virulence of the influenza virus strain, as well as the immunological status of the infected individual, the severity of the respiratory disease may range from sub-clinical or mild symptoms to severe pneumonia that can sometimes lead to death. Vaccines remain the primary public health measure in reducing the influenza burden. Though the first influenza vaccine preparation was licensed more than 60 years ago, current research efforts seek to develop novel vaccination strategies with improved immunogenicity, effectiveness, and breadth of protection. Animal models of influenza have been essential in facilitating studies aimed at understanding viral factors that affect pathogenesis and contribute to disease or transmission. Among others, mice, ferrets, pigs, and nonhuman primates have been used to study influenza virus infection in vivo, as well as to do pre-clinical testing of novel vaccine approaches. Here we discuss and compare the unique advantages and limitations of each model.

Mechanistic movement models to understand epidemic spread.

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Fofana, Abdou Moutalab; Hurford, Amy

2017-05-05

An overlooked aspect of disease ecology is considering how and why animals come into contact with one and other resulting in disease transmission. Mathematical models of disease spread frequently assume mass-action transmission, justified by stating that susceptible and infectious hosts mix readily, and foregoing any detailed description of host movement. Numerous recent studies have recorded, analysed and modelled animal movement. These movement models describe how animals move with respect to resources, conspecifics and previous movement directions and have been used to understand the conditions for the occurrence and the spread of infectious diseases when hosts perform a type of movement. Here, we summarize the effect of the different types of movement on the threshold conditions for disease spread. We identify gaps in the literature and suggest several promising directions for future research. The mechanistic inclusion of movement in epidemic models may be beneficial for the following two reasons. Firstly, the estimation of the transmission coefficient in an epidemic model is possible because animal movement data can be used to estimate the rate of contacts between conspecifics. Secondly, unsuccessful transmission events, where a susceptible host contacts an infectious host but does not become infected can be quantified. Following an outbreak, this enables disease ecologists to identify 'near misses' and to explore possible alternative epidemic outcomes given shifts in ecological or immunological parameters.This article is part of the themed issue 'Opening the black box: re-examining the ecology and evolution of parasite transmission'. © 2017 The Author(s).

Assessing the ecotoxicologic hazards of a pandemic influenza medical response.

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Singer, Andrew C; Colizza, Vittoria; Schmitt, Heike; Andrews, Johanna; Balcan, Duygu; Huang, Wei E; Keller, Virginie D J; Vespignani, Alessandro; Williams, Richard J

2011-08-01

The global public health community has closely monitored the unfolding of the 2009 H1N1 influenza pandemic to best mitigate its impact on society. However, little attention has been given to the impact of this response on the environment. Antivirals and antibiotics prescribed to treat influenza are excreted into wastewater in a biologically active form, which presents a new and potentially significant ecotoxicologic challenge to microorganisms responsible for wastewater nutrient removal in wastewater treatment plants (WWTPs) and receiving rivers. We assessed the ecotoxicologic risks of a pandemic influenza medical response. To evaluate this risk, we coupled a global spatially structured epidemic model that simulates the quantities of antivirals and antibiotics used during an influenza pandemic of varying severity and a water quality model applied to the Thames catchment to determine predicted environmental concentrations. An additional model was then used to assess the effects of antibiotics on microorganisms in WWTPs and rivers. Consistent with expectations, our model projected a mild pandemic to exhibit a negligible ecotoxicologic hazard. In a moderate and severe pandemic, we projected WWTP toxicity to vary between 0-14% and 5-32% potentially affected fraction (PAF), respectively, and river toxicity to vary between 0-14% and 0-30% PAF, respectively, where PAF is the fraction of microbial species predicted to be growth inhibited (lower and upper 95% reference range). The current medical response to pandemic influenza might result in the discharge of insufficiently treated wastewater into receiving rivers, thereby increasing the risk of eutrophication and contamination of drinking water abstraction points. Widespread drugs in the environment could hasten the generation of drug resistance. Our results highlight the need for empirical data on the effects of antibiotics and antiviral medications on WWTPs and freshwater ecotoxicity.

Stochastic epidemic-type model with enhanced connectivity: exact solution

International Nuclear Information System (INIS)

Williams, H T; Mazilu, I; Mazilu, D A

2012-01-01

We present an exact analytical solution to a one-dimensional model of the susceptible–infected–recovered (SIR) epidemic type, with infection rates dependent on nearest-neighbor occupations. We use a quantum mechanical approach, transforming the master equation via a quantum spin operator formulation. We calculate exactly the time-dependent density of infected, recovered and susceptible populations for random initial conditions. Our results compare well with those of previous work, validating the model as a useful tool for additional and extended studies in this important area. Our model also provides exact solutions for the n-point correlation functions, and can be extended to more complex epidemic-type models

A Weighted Configuration Model and Inhomogeneous Epidemics

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Britton, Tom; Deijfen, Maria; Liljeros, Fredrik

2011-12-01

A random graph model with prescribed degree distribution and degree dependent edge weights is introduced. Each vertex is independently equipped with a random number of half-edges and each half-edge is assigned an integer valued weight according to a distribution that is allowed to depend on the degree of its vertex. Half-edges with the same weight are then paired randomly to create edges. An expression for the threshold for the appearance of a giant component in the resulting graph is derived using results on multi-type branching processes. The same technique also gives an expression for the basic reproduction number for an epidemic on the graph where the probability that a certain edge is used for transmission is a function of the edge weight (reflecting how closely `connected' the corresponding vertices are). It is demonstrated that, if vertices with large degree tend to have large (small) weights on their edges and if the transmission probability increases with the edge weight, then it is easier (harder) for the epidemic to take off compared to a randomized epidemic with the same degree and weight distribution. A recipe for calculating the probability of a large outbreak in the epidemic and the size of such an outbreak is also given. Finally, the model is fitted to three empirical weighted networks of importance for the spread of contagious diseases and it is shown that R 0 can be substantially over- or underestimated if the correlation between degree and weight is not taken into account.

A simple and rapid characterization of influenza virus isolates by monoclonal antibodies in radioimmunoassay

International Nuclear Information System (INIS)

Kostolansky, F.; Styk, B.; Russ, G.

1986-01-01

Radioimmunoassay is described with infectious allantoic fluid directly bound to solid phase, suitable for the detection and further characterization of influenza virus isolates. This simple and rapid method was applied for the description of isolates obtained from different regions of Czechoslovakia during the influenza epidemic in 1983. The results confirmed that all 13 examined isolates represented influenza A viruses possessing H3 subtype haemagglutinin very similar to haemagglutinin of influenza viruses A/Bangkok/1/79 (H3N2), A/Belgium/2/81 (H3N2) and A/Philippines/2/82 (H3N2). (author)

The threshold of a stochastic delayed SIR epidemic model with vaccination

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Liu, Qun; Jiang, Daqing

2016-11-01

In this paper, we study the threshold dynamics of a stochastic delayed SIR epidemic model with vaccination. We obtain sufficient conditions for extinction and persistence in the mean of the epidemic. The threshold between persistence in the mean and extinction of the stochastic system is also obtained. Compared with the corresponding deterministic model, the threshold affected by the white noise is smaller than the basic reproduction number Rbar0 of the deterministic system. Results show that time delay has important effects on the persistence and extinction of the epidemic.

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

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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.

Challenges and Strategies of Laboratory Diagnosis for Newly Emerging Influenza Viruses in Taiwan: A Decade after SARS

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Jih-Hui Lin

2015-01-01

Full Text Available Since the first case of severe acute respiratory syndrome (SARS in Taiwan was identified in March 2003, viral respiratory infections, in particular the influenza virus, have become a national public health concern. Taiwan would face a serious threat of public health problems if another SARS epidemic overlapped with a flu outbreak. After SARS, the Taiwan Centers for Disease Control accelerated and strengthened domestic research on influenza and expanded the exchange of information with international counterparts. The capacity of influenza A to cross species barriers presents a potential threat to human health. Given the mutations of avian flu viruses such as H7N9, H6N1, and H10N8, all countries, including Taiwan, must equip themselves to face a possible epidemic or pandemic. Such preparedness requires global collaboration.

Reverse Genetics Approaches for the Development of Influenza Vaccines

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Nogales, Aitor; Martínez-Sobrido, Luis

2016-01-01

Influenza viruses cause annual seasonal epidemics and occasional pandemics of human respiratory disease. Influenza virus infections represent a serious public health and economic problem, which are most effectively prevented through vaccination. However, influenza viruses undergo continual antigenic variation, which requires either the annual reformulation of seasonal influenza vaccines or the rapid generation of vaccines against potential pandemic virus strains. The segmented nature of influenza virus allows for the reassortment between two or more viruses within a co-infected cell, and this characteristic has also been harnessed in the laboratory to generate reassortant viruses for their use as either inactivated or live-attenuated influenza vaccines. With the implementation of plasmid-based reverse genetics techniques, it is now possible to engineer recombinant influenza viruses entirely from full-length complementary DNA copies of the viral genome by transfection of susceptible cells. These reverse genetics systems have provided investigators with novel and powerful approaches to answer important questions about the biology of influenza viruses, including the function of viral proteins, their interaction with cellular host factors and the mechanisms of influenza virus transmission and pathogenesis. In addition, reverse genetics techniques have allowed the generation of recombinant influenza viruses, providing a powerful technology to develop both inactivated and live-attenuated influenza vaccines. In this review, we will summarize the current knowledge of state-of-the-art, plasmid-based, influenza reverse genetics approaches and their implementation to provide rapid, convenient, safe and more effective influenza inactivated or live-attenuated vaccines. PMID:28025504

Nonlinear model of epidemic spreading in a complex social network.

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Kosiński, Robert A; Grabowski, A

2007-10-01

The epidemic spreading in a human society is a complex process, which can be described on the basis of a nonlinear mathematical model. In such an approach the complex and hierarchical structure of social network (which has implications for the spreading of pathogens and can be treated as a complex network), can be taken into account. In our model each individual has one of the four permitted states: susceptible, infected, infective, unsusceptible or dead. This refers to the SEIR model used in epidemiology. The state of an individual changes in time, depending on the previous state and the interactions with other individuals. The description of the interpersonal contacts is based on the experimental observations of the social relations in the community. It includes spatial localization of the individuals and hierarchical structure of interpersonal interactions. Numerical simulations were performed for different types of epidemics, giving the progress of a spreading process and typical relationships (e.g. range of epidemic in time, the epidemic curve). The spreading process has a complex and spatially chaotic character. The time dependence of the number of infective individuals shows the nonlinear character of the spreading process. We investigate the influence of the preventive vaccinations on the spreading process. In particular, for a critical value of preventively vaccinated individuals the percolation threshold is observed and the epidemic is suppressed.

Outbreak of avian influenza H7N3 on a turkey farm in the Netherlands

OpenAIRE

Velkers, F.C.; Bouma, A.; Matthijs, M.G.R.; Koch, G.; Westendorp, S.T.; Stegeman, J.A.

2006-01-01

This case report describes the course of an outbreak of avian influenza on a Dutch turkey farm. When clinical signs were observed their cause remained unclear. However, serum samples taken for the monitoring campaign launched during the epidemic of highly pathogenic avian influenza in 2003, showed that all the remaining turkeys were seropositive against an H7 strain of avian influenza virus, and the virus was subsequently isolated from stored carcases. The results of a reverse-transcriptase P...

The threshold of a stochastic delayed SIR epidemic model with temporary immunity

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Liu, Qun; Chen, Qingmei; Jiang, Daqing

2016-05-01

This paper is concerned with the asymptotic properties of a stochastic delayed SIR epidemic model with temporary immunity. Sufficient conditions for extinction and persistence in the mean of the epidemic are established. The threshold between persistence in the mean and extinction of the epidemic is obtained. Compared with the corresponding deterministic model, the threshold affected by the white noise is smaller than the basic reproduction number R0 of the deterministic system.

Free-grazing ducks and highly pathogenic avian influenza, Thailand

NARCIS (Netherlands)

Gilbert, Marius; Chaitaweesup, P.; Parakamawongsa, T.; Premashthira, S.; Tiensin, T.; Kalpravidh, W.; Wagner, H.; Slingenbergh, J.

Thailand has recently had 3 epidemic waves of highly pathogenic avian influenza (HPAI); virus was again detected in July 2005. Risk factors need to be identified to better understand disease ecology and assist HPAI surveillance and detection. This study analyzed the spatial distribution of HPAI

Influenza A and B viruses in the population of Vojvodina, Serbia

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Radovanov J.

2014-01-01

Full Text Available At present, two influenza A viruses, H1N1pdm09 and H3N2, along with influenza B virus co-circulate in the human population, causing endemic and seasonal epidemic acute febrile respiratory infections, sometimes with life-threatening complications. Detection of influenza viruses in nasopharyngeal swab samples was done by real-time RT-PCR. There were 60.2% (53/88 positive samples in 2010/11, 63.4% (52/82 in 2011/12, and 49.9% (184/369 in 2012/13. Among the positive patients, influenza A viruses were predominant during the first two seasons, while influenza B type was more active during 2012/13. Subtyping of influenza A positive samples revealed the presence of A (H1N1pdm09 in 2010/11, A (H3N2 in 2011/12, while in 2012/13, both subtypes were detected. The highest seroprevalence against influenza A was in the age-group 30-64, and against influenza B in adults aged 30-64 and >65. [Projekat Ministarstva nauke Republike Srbije, br. TR31084

Travelling Wave Solutions in Multigroup Age-Structured Epidemic Models

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Ducrot, Arnaut; Magal, Pierre; Ruan, Shigui

2010-01-01

Age-structured epidemic models have been used to describe either the age of individuals or the age of infection of certain diseases and to determine how these characteristics affect the outcomes and consequences of epidemiological processes. Most results on age-structured epidemic models focus on the existence, uniqueness, and convergence to disease equilibria of solutions. In this paper we investigate the existence of travelling wave solutions in a deterministic age-structured model describing the circulation of a disease within a population of multigroups. Individuals of each group are able to move with a random walk which is modelled by the classical Fickian diffusion and are classified into two subclasses, susceptible and infective. A susceptible individual in a given group can be crisscross infected by direct contact with infective individuals of possibly any group. This process of transmission can depend upon the age of the disease of infected individuals. The goal of this paper is to provide sufficient conditions that ensure the existence of travelling wave solutions for the age-structured epidemic model. The case of two population groups is numerically investigated which applies to the crisscross transmission of feline immunodeficiency virus (FIV) and some sexual transmission diseases.

Using the ferret as an animal model for investigating influenza antiviral effectiveness

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Ding Yuan Oh

2016-02-01

Full Text Available The concern of the emergence of a pandemic influenza virus has sparked an increased effort towards the development and testing of novel influenza antivirals. Central to this is the animal model of influenza infection, which has played an important role in understanding treatment effectiveness and the effect of antivirals on host immune responses. Among the different animal models of influenza, ferrets can be considered the most suitable for antiviral studies as they display most of the human-like symptoms following influenza infections, they can be infected with human influenza virus without prior viral adaptation and have the ability to transmit influenza virus efficiently between one another. However, an accurate assessment of the effectiveness of an antiviral treatment in ferrets is dependent on three major experimental considerations encompassing firstly, the volume and titre of virus, and the route of viral inoculation. Secondly, the route and dose of drug administration, and lastly, the different methods used to assess clinical symptoms, viral shedding kinetics and host immune responses in the ferrets. A good understanding of these areas is necessary to achieve data that can accurately inform the human use of influenza antivirals. In this review, we discuss the current progress and the challenges faced in these three major areas when using the ferret model to measure influenza antiviral effectiveness.

Incorporation of membrane-bound, mammalian-derived immunomodulatory proteins into influenza whole virus vaccines boosts immunogenicity and protection against lethal challenge

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Roberts Paul C

2009-04-01

Full Text Available Abstract Background Influenza epidemics continue to cause morbidity and mortality within the human population despite widespread vaccination efforts. This, along with the ominous threat of an avian influenza pandemic (H5N1, demonstrates the need for a much improved, more sophisticated influenza vaccine. We have developed an in vitro model system for producing a membrane-bound Cytokine-bearing Influenza Vaccine (CYT-IVAC. Numerous cytokines are involved in directing both innate and adaptive immunity and it is our goal to utilize the properties of individual cytokines and other immunomodulatory proteins to create a more immunogenic vaccine. Results We have evaluated the immunogenicity of inactivated cytokine-bearing influenza vaccines using a mouse model of lethal influenza virus challenge. CYT-IVACs were produced by stably transfecting MDCK cell lines with mouse-derived cytokines (GM-CSF, IL-2 and IL-4 fused to the membrane-anchoring domain of the viral hemagglutinin. Influenza virus replication in these cell lines resulted in the uptake of the bioactive membrane-bound cytokines during virus budding and release. In vivo efficacy studies revealed that a single low dose of IL-2 or IL-4-bearing CYT-IVAC is superior at providing protection against lethal influenza challenge in a mouse model and provides a more balanced Th1/Th2 humoral immune response, similar to live virus infections. Conclusion We have validated the protective efficacy of CYT-IVACs in a mammalian model of influenza virus infection. This technology has broad applications in current influenza virus vaccine development and may prove particularly useful in boosting immune responses in the elderly, where current vaccines are minimally effective.

Matrix protein 2 of influenza A virus blocks autophagosome fusion with lysosomes

DEFF Research Database (Denmark)

Gannagé, Monique; Dormann, Dorothee; Albrecht, Randy

2009-01-01

Influenza A virus is an important human pathogen causing significant morbidity and mortality every year and threatening the human population with epidemics and pandemics. Therefore, it is important to understand the biology of this virus to develop strategies to control its pathogenicity. Here, we...... demonstrate that influenza A virus inhibits macroautophagy, a cellular process known to be manipulated by diverse pathogens. Influenza A virus infection causes accumulation of autophagosomes by blocking their fusion with lysosomes, and one viral protein, matrix protein 2, is necessary and sufficient...... for this inhibition of autophagosome degradation. Macroautophagy inhibition by matrix protein 2 compromises survival of influenza virus-infected cells but does not influence viral replication. We propose that influenza A virus, which also encodes proapoptotic proteins, is able to determine the death of its host cell...

Using extreme value theory approaches to forecast the probability of outbreak of highly pathogenic influenza in Zhejiang, China.

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Jiangpeng Chen

Full Text Available Influenza is a contagious disease with high transmissibility to spread around the world with considerable morbidity and mortality and presents an enormous burden on worldwide public health. Few mathematical models can be used because influenza incidence data are generally not normally distributed. We developed a mathematical model using Extreme Value Theory (EVT to forecast the probability of outbreak of highly pathogenic influenza.The incidence data of highly pathogenic influenza in Zhejiang province from April 2009 to November 2013 were retrieved from the website of Health and Family Planning Commission of Zhejiang Province. MATLAB "VIEM" toolbox was used to analyze data and modelling. In the present work, we used the Peak Over Threshold (POT model, assuming the frequency as a Poisson process and the intensity to be Pareto distributed, to characterize the temporal variability of the long-term extreme incidence of highly pathogenic influenza in Zhejiang, China.The skewness and kurtosis of the incidence of highly pathogenic influenza in Zhejiang between April 2009 and November 2013 were 4.49 and 21.12, which indicated a "fat tail" distribution. A QQ plot and a mean excess plot were used to further validate the features of the distribution. After determining the threshold, we modeled the extremes and estimated the shape parameter and scale parameter by the maximum likelihood method. The results showed that months in which the incidence of highly pathogenic influenza is about 4462/2286/1311/487 are predicted to occur once every five/three/two/one year, respectively.Despite the simplicity, the present study successfully offers the sound modeling strategy and a methodological avenue to implement forecasting of an epidemic in the midst of its course.

History of Swine influenza viruses in Asia.

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Zhu, Huachen; Webby, Richard; Lam, Tommy T Y; Smith, David K; Peiris, Joseph S M; Guan, Yi

2013-01-01

The pig is one of the main hosts of influenza A viruses and plays important roles in shaping the current influenza ecology. The occurrence of the 2009 H1N1 pandemic influenza virus demonstrated that pigs could independently facilitate the genesis of a pandemic influenza strain. Genetic analyses revealed that this virus was derived by reassortment between at least two parent swine influenza viruses (SIV), from the northern American triple reassortant H1N2 (TR) and European avian-like H1N1 (EA) lineages. The movement of live pigs between different continents and subsequent virus establishment are preconditions for such a reassortment event to occur. Asia, especially China, has the largest human and pig populations in the world, and seems to be the only region frequently importing pigs from other continents. Virological surveillance revealed that not only classical swine H1N1 (CS), and human-origin H3N2 viruses circulated, but all of the EA, TR and their reassortant variants were introduced into and co-circulated in pigs in this region. Understanding the long-term evolution and history of SIV in Asia would provide insights into the emergence of influenza viruses with epidemic potential in swine and humans.

Theoretical basis to measure the impact of short-lasting control of an infectious disease on the epidemic peak

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Omori Ryosuke

2011-01-01

Full Text Available Abstract Background While many pandemic preparedness plans have promoted disease control effort to lower and delay an epidemic peak, analytical methods for determining the required control effort and making statistical inferences have yet to be sought. As a first step to address this issue, we present a theoretical basis on which to assess the impact of an early intervention on the epidemic peak, employing a simple epidemic model. Methods We focus on estimating the impact of an early control effort (e.g. unsuccessful containment, assuming that the transmission rate abruptly increases when control is discontinued. We provide analytical expressions for magnitude and time of the epidemic peak, employing approximate logistic and logarithmic-form solutions for the latter. Empirical influenza data (H1N1-2009 in Japan are analyzed to estimate the effect of the summer holiday period in lowering and delaying the peak in 2009. Results Our model estimates that the epidemic peak of the 2009 pandemic was delayed for 21 days due to summer holiday. Decline in peak appears to be a nonlinear function of control-associated reduction in the reproduction number. Peak delay is shown to critically depend on the fraction of initially immune individuals. Conclusions The proposed modeling approaches offer methodological avenues to assess empirical data and to objectively estimate required control effort to lower and delay an epidemic peak. Analytical findings support a critical need to conduct population-wide serological survey as a prior requirement for estimating the time of peak.

Analysis of Economic Burden of Seasonal Influenza: An Actuarial Based Conceptual Model

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S. S. N. Perera

2017-01-01

Full Text Available Analysing the economic burden of the seasonal influenza is highly essential due to the large number of outbreaks in recent years. Mathematical and actuarial models can be considered as management tools to understand the dynamical behavior, predict the risk, and compute it. This study is an attempt to develop conceptual model to investigate the economic burden due to seasonal influenza. The compartment SIS (susceptible-infected-susceptible model is used to capture the dynamical behavior of influenza. Considering the current investment and future medical care expenditure as premium payment and benefit (claim, respectively, the insurance and actuarial based conceptual model is proposed to model the present economic burden due to the spread of influenza. Simulation is carried out to demonstrate the variation of the present economic burden with respect to model parameters. The sensitivity of the present economic burden is studied with respect to the risk of disease spread. The basic reproduction is used to identify the risk of disease spread. Impact of the seasonality is studied by introducing the seasonally varying infection rate. The proposed model provides theoretical background to investigate the economic burden of seasonal influenza.

Pandemic influenza--including a risk assessment of H5N1.

Science.gov (United States)

Taubenberger, J K; Morens, D M

2009-04-01

Influenza pandemics and epidemics have apparently occurred since at least the Middle Ages. When pandemics appear, 50% or more of an affected population can be infected in a single year, and the number of deaths caused by influenza can dramatically exceed what is normally expected. Since 1500, there appear to have been 13 or more influenza pandemics. In the past 120 years there were undoubted pandemics in 1889, 1918, 1957, 1968, and 1977. Although most experts believe we will face another influenza pandemic, it is impossible to predict when it will appear, where it will originate, or how severe it will be. Nor is there agreement about the subtype of influenza virus most likely to cause the next pandemic. The continuing spread of H5N1 highly pathogenic avian influenza viruses has heightened interest in pandemic prediction. Despite uncertainties in the historical record of the pre-virology era, study of previous pandemics may help guide future pandemic planning and lead to a better understanding of the complex ecobiology underlying the formation of pandemic strains of influenza A viruses.

A mathematical model of avian influenza with half-saturated incidence.

Science.gov (United States)

Chong, Nyuk Sian; Tchuenche, Jean Michel; Smith, Robert J

2014-03-01

The widespread impact of avian influenza viruses not only poses risks to birds, but also to humans. The viruses spread from birds to humans and from human to human In addition, mutation in the primary strain will increase the infectiousness of avian influenza. We developed a mathematical model of avian influenza for both bird and human populations. The effect of half-saturated incidence on transmission dynamics of the disease is investigated. The half-saturation constants determine the levels at which birds and humans contract avian influenza. To prevent the spread of avian influenza, the associated half-saturation constants must be increased, especially the half-saturation constant H m for humans with mutant strain. The quantity H m plays an essential role in determining the basic reproduction number of this model. Furthermore, by decreasing the rate β m at which human-to-human mutant influenza is contracted, an outbreak can be controlled more effectively. To combat the outbreak, we propose both pharmaceutical (vaccination) and non-pharmaceutical (personal protection and isolation) control methods to reduce the transmission of avian influenza. Vaccination and personal protection will decrease β m, while isolation will increase H m. Numerical simulations demonstrate that all proposed control strategies will lead to disease eradication; however, if we only employ vaccination, it will require slightly longer to eradicate the disease than only applying non-pharmaceutical or a combination of pharmaceutical and non-pharmaceutical control methods. In conclusion, it is important to adopt a combination of control methods to fight an avian influenza outbreak.

Seroprevalence survey of H9N2 avian influenza virus in backyard chickens around the Caspian Sea in Iran

OpenAIRE

Hadipour,MM

2010-01-01

Since 1998, an epidemic of avian influenza occurred in the Iranian poultry industry. The identified agent presented low pathogenicity, and was subtyped as an H9N2 avian influenza virus. Backyard chickens can play an important role in the epidemiology of H9N2 avian influenza virus infection. Close contact of backyard chickens with migratory birds, especially with aquatic birds, as well as neighboring poultry farms, may pose the risk of transmitting avian influenza virus, but little is known ab...

Steady States in SIRS Epidemical Model of Mobile Individuals

International Nuclear Information System (INIS)

Zhang Duanming; He Minhua; Yu Xiaoling; Pan Guijun; Sun Hongzhang; Su Xiangying; Sun Fan; Yin Yanping; Li Rui; Liu Dan

2006-01-01

We consider an epidemical model within socially interacting mobile individuals to study the behaviors of steady states of epidemic propagation in 2D networks. Using mean-field approximation and large scale simulations, we recover the usual epidemic behavior with critical thresholds δ c and p c below which infectious disease dies out. For the population density δ far above δ c , it is found that there is linear relationship between contact rate λ and the population density δ in the main. At the same time, the result obtained from mean-field approximation is compared with our numerical result, and it is found that these two results are similar by and large but not completely the same.

Steady States in SIRS Epidemical Model of Mobile Individuals

Institute of Scientific and Technical Information of China (English)

ZHANG Duan-Ming; LIU Dan; HE Min-Hua; YU Xiao-Ling; PAN Gui-Jun; SUN Hong-Zhang; SU Xiang-Ying; SUN Fan; YIN Yan-Ping; LI Rui

2006-01-01

We consider an epidemical model within socially interacting mobile individuals to study the behaviors of steady statesof epidemic propagation in 2D networks. Using mean-field approximation and large scale simulations, we recover the usual epidemic behavior with critical thresholds δc and pc below which infectious disease dies out. For the population density δ far above δc, it is found that there is linear relationship between contact rate λ and the population density δ in the main. At the same time, the result obtained from mean-field approximation is compared with our numerical result, and it is found that these two results are similar by and large but not completely the same.

Antiviral resistance and the control of pandemic influenza.

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Marc Lipsitch

2007-01-01

Full Text Available 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.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.The benefits of antiviral drug use to control an influenza pandemic may be reduced, although not completely offset, by drug resistance in the virus. Therefore, the risk of resistance

Multi-Omics Studies towards Novel Modulators of Influenza A Virus–Host Interaction

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Sandra Söderholm

2016-09-01

Full Text Available Human influenza A viruses (IAVs cause global pandemics and epidemics. These viruses evolve rapidly, making current treatment options ineffective. To identify novel modulators of IAV–host interactions, we re-analyzed our recent transcriptomics, metabolomics, proteomics, phosphoproteomics, and genomics/virtual ligand screening data. We identified 713 potential modulators targeting 199 cellular and two viral proteins. Anti-influenza activity for 48 of them has been reported previously, whereas the antiviral efficacy of the 665 remains unknown. Studying anti-influenza efficacy and immuno/neuro-modulating properties of these compounds and their combinations as well as potential viral and host resistance to them may lead to the discovery of novel modulators of IAV–host interactions, which might be more effective than the currently available anti-influenza therapeutics.

Quantification of bird-to-bird and bird-to-human infections during 2013 novel H7N9 avian influenza outbreak in China.

Science.gov (United States)

Hsieh, Ying-Hen; Wu, Jianhong; Fang, Jian; Yang, Yong; Lou, Jie

2014-01-01

From February to May, 2013, 132 human avian influenza H7N9 cases were identified in China resulting in 37 deaths. We developed a novel, simple and effective compartmental modeling framework for transmissions among (wild and domestic) birds as well as from birds to human, to infer important epidemiological quantifiers, such as basic reproduction number for bird epidemic, bird-to-human infection rate and turning points of the epidemics, for the epidemic via human H7N9 case onset data and to acquire useful information regarding the bird-to-human transmission dynamics. Estimated basic reproduction number for infections among birds is 4.10 and the mean daily number of human infections per infected bird is 3.16*10-5 [3.08*10-5, 3.23*10-5]. The turning point of 2013 H7N9 epidemic is pinpointed at April 16 for bird infections and at April 9 for bird-to-human transmissions. Our result reveals very low level of bird-to-human infections, thus indicating minimal risk of widespread bird-to-human infections of H7N9 virus during the outbreak. Moreover, the turning point of the human epidemic, pinpointed at shortly after the implementation of full-scale control and intervention measures initiated in early April, further highlights the impact of timely actions on ending the outbreak. This is the first study where both the bird and human components of an avian influenza epidemic can be quantified using only the human case data.

Characterizing the reproduction number of epidemics with early subexponential growth dynamics.

Science.gov (United States)

Chowell, Gerardo; Viboud, Cécile; Simonsen, Lone; Moghadas, Seyed M

2016-10-01

Early estimates of the transmission potential of emerging and re-emerging infections are increasingly used to inform public health authorities on the level of risk posed by outbreaks. Existing methods to estimate the reproduction number generally assume exponential growth in case incidence in the first few disease generations, before susceptible depletion sets in. In reality, outbreaks can display subexponential (i.e. polynomial) growth in the first few disease generations, owing to clustering in contact patterns, spatial effects, inhomogeneous mixing, reactive behaviour changes or other mechanisms. Here, we introduce the generalized growth model to characterize the early growth profile of outbreaks and estimate the effective reproduction number, with no need for explicit assumptions about the shape of epidemic growth. We demonstrate this phenomenological approach using analytical results and simulations from mechanistic models, and provide validation against a range of empirical disease datasets. Our results suggest that subexponential growth in the early phase of an epidemic is the rule rather the exception. Mechanistic simulations show that slight modifications to the classical susceptible-infectious-removed model result in subexponential growth, and in turn a rapid decline in the reproduction number within three to five disease generations. For empirical outbreaks, the generalized-growth model consistently outperforms the exponential model for a variety of directly and indirectly transmitted diseases datasets (pandemic influenza, measles, smallpox, bubonic plague, cholera, foot-and-mouth disease, HIV/AIDS and Ebola) with model estimates supporting subexponential growth dynamics. The rapid decline in effective reproduction number predicted by analytical results and observed in real and synthetic datasets within three to five disease generations contrasts with the expectation of invariant reproduction number in epidemics obeying exponential growth. The

Characterizing the reproduction number of epidemics with early subexponential growth dynamics

Science.gov (United States)

Viboud, Cécile; Simonsen, Lone; Moghadas, Seyed M.

2016-01-01

Early estimates of the transmission potential of emerging and re-emerging infections are increasingly used to inform public health authorities on the level of risk posed by outbreaks. Existing methods to estimate the reproduction number generally assume exponential growth in case incidence in the first few disease generations, before susceptible depletion sets in. In reality, outbreaks can display subexponential (i.e. polynomial) growth in the first few disease generations, owing to clustering in contact patterns, spatial effects, inhomogeneous mixing, reactive behaviour changes or other mechanisms. Here, we introduce the generalized growth model to characterize the early growth profile of outbreaks and estimate the effective reproduction number, with no need for explicit assumptions about the shape of epidemic growth. We demonstrate this phenomenological approach using analytical results and simulations from mechanistic models, and provide validation against a range of empirical disease datasets. Our results suggest that subexponential growth in the early phase of an epidemic is the rule rather the exception. Mechanistic simulations show that slight modifications to the classical susceptible–infectious–removed model result in subexponential growth, and in turn a rapid decline in the reproduction number within three to five disease generations. For empirical outbreaks, the generalized-growth model consistently outperforms the exponential model for a variety of directly and indirectly transmitted diseases datasets (pandemic influenza, measles, smallpox, bubonic plague, cholera, foot-and-mouth disease, HIV/AIDS and Ebola) with model estimates supporting subexponential growth dynamics. The rapid decline in effective reproduction number predicted by analytical results and observed in real and synthetic datasets within three to five disease generations contrasts with the expectation of invariant reproduction number in epidemics obeying exponential growth. The

A primer on stochastic epidemic models: Formulation, numerical simulation, and analysis

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Linda J.S. Allen

2017-05-01

Full Text Available Some mathematical methods for formulation and numerical simulation of stochastic epidemic models are presented. Specifically, models are formulated for continuous-time Markov chains and stochastic differential equations. Some well-known examples are used for illustration such as an SIR epidemic model and a host-vector malaria model. Analytical methods for approximating the probability of a disease outbreak are also discussed. Keywords: Branching process, Continuous-time Markov chain, Minor outbreak, Stochastic differential equation, 2000 MSC: 60H10, 60J28, 92D30

A stochastic modeling of recurrent measles epidemic | Kassem ...

African Journals Online (AJOL)

A simple stochastic mathematical model is developed and investigated for the dynamics of measles epidemic. The model, which is a multi-dimensional diffusion process, includes susceptible individuals, latent (exposed), infected and removed individuals. Stochastic effects are assumed to arise in the process of infection of ...

Homology modelling and docking studies on Neuraminidase enzyme as a natural product target for combating influenza

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Nisha Singh

2017-10-01

Full Text Available Influenza remains to be dreadful with yearly epidemics and sudden pandemic outbreaks causing significant mortality, even in nations with the most advanced health care systems. Thus, there has been a long-standing interest to develop effective and safe antiviral agents to treat infected individuals. Attempt to identify suitable molecular targets as antiviral compounds have focused recently on the influenza virus neuraminidase (NA, a key enzyme in viral replication [1]. In this research, virtual screening was done on a total of 600 natural compounds from 22 ethno medicinal Indian herbs for activity against neuraminidase enzyme exploiting representative protein conformations selected from molecular dynamics simulations. Neuraminidase enzyme sequences from different existing strains available on National Center of Biotechnology Information [2] (NCBI protein database were aligned using Clustal W [3] and CLC workbench 10 [4] to find the conserved residues. Neuraminidase protein sequence from H1N1 strain available on NCBI was used to structure 3D target model predicted against dataset from Protein data bank using modeller [5]. The target model was validated on different parameter at SAVES Server [6]. Using this target model a pharmacophore model was developed using ligand based strategy exploiting the three known inhibitors. The docking parameters were validated by redocking Zanamivir to its co-complex 2009 H1N1 NA crystal structure (PDB ID: 3TI5 generating best pose with a RMSD value of 0.7543 A°. This model was then used for in silico analysis of a library of natural compounds from 22 ethno medicinal Indian herbs known to have antiviral activity taken downloaded from PubChem database and selected on the basis of drug likeliness. All the compounds were docked in the binding pocket of neuraminidase. Top compounds having binding affinity better than or comparable to the control drug Zanamivir were selected and analyzed for their ADME and toxicity

Model-based evaluation of highly and low pathogenic avian influenza dynamics in wild birds.

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Viviane Hénaux

Full Text Available There is growing interest in avian influenza (AI epidemiology to predict disease risk in wild and domestic birds, and prevent transmission to humans. However, understanding the epidemic dynamics of highly pathogenic (HPAI viruses remains challenging because they have rarely been detected in wild birds. We used modeling to integrate available scientific information from laboratory and field studies, evaluate AI dynamics in individual hosts and waterfowl populations, and identify key areas for future research. We developed a Susceptible-Exposed-Infectious-Recovered (SEIR model and used published laboratory challenge studies to estimate epidemiological parameters (rate of infection, latency period, recovery and mortality rates, considering the importance of age classes, and virus pathogenicity. Infectious contact leads to infection and virus shedding within 1-2 days, followed by relatively slower period for recovery or mortality. We found a shorter infectious period for HPAI than low pathogenic (LP AI, which may explain that HPAI has been much harder to detect than LPAI during surveillance programs. Our model predicted a rapid LPAI epidemic curve, with a median duration of infection of 50-60 days and no fatalities. In contrast, HPAI dynamics had lower prevalence and higher mortality, especially in young birds. Based on field data from LPAI studies, our model suggests to increase surveillance for HPAI in post-breeding areas, because the presence of immunologically naïve young birds is predicted to cause higher HPAI prevalence and bird losses during this season. Our results indicate a better understanding of the transmission, infection, and immunity-related processes is required to refine predictions of AI risk and spread, improve surveillance for HPAI in wild birds, and develop disease control strategies to reduce potential transmission to domestic birds and/or humans.

Model-based evaluation of highly and low pathogenic avian influenza dynamics in wild birds

Science.gov (United States)

Hénaux, Viviane; Samuel, Michael D.; Bunck, Christine M.

2010-01-01

There is growing interest in avian influenza (AI) epidemiology to predict disease risk in wild and domestic birds, and prevent transmission to humans. However, understanding the epidemic dynamics of highly pathogenic (HPAI) viruses remains challenging because they have rarely been detected in wild birds. We used modeling to integrate available scientific information from laboratory and field studies, evaluate AI dynamics in individual hosts and waterfowl populations, and identify key areas for future research. We developed a Susceptible-Exposed-Infectious-Recovered (SEIR) model and used published laboratory challenge studies to estimate epidemiological parameters (rate of infection, latency period, recovery and mortality rates), considering the importance of age classes, and virus pathogenicity. Infectious contact leads to infection and virus shedding within 1–2 days, followed by relatively slower period for recovery or mortality. We found a shorter infectious period for HPAI than low pathogenic (LP) AI, which may explain that HPAI has been much harder to detect than LPAI during surveillance programs. Our model predicted a rapid LPAI epidemic curve, with a median duration of infection of 50–60 days and no fatalities. In contrast, HPAI dynamics had lower prevalence and higher mortality, especially in young birds. Based on field data from LPAI studies, our model suggests to increase surveillance for HPAI in post-breeding areas, because the presence of immunologically naïve young birds is predicted to cause higher HPAI prevalence and bird losses during this season. Our results indicate a better understanding of the transmission, infection, and immunity-related processes is required to refine predictions of AI risk and spread, improve surveillance for HPAI in wild birds, and develop disease control strategies to reduce potential transmission to domestic birds and/or humans.

A comparative analysis of influenza vaccination programs.

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Shweta Bansal

2006-10-01

Full Text Available BACKGROUND: The threat of avian influenza and the 2004-2005 influenza vaccine supply shortage in the United States have sparked a debate about optimal vaccination strategies to reduce the burden of morbidity and mortality caused by the influenza virus. METHODS AND FINDINGS: We present a comparative analysis of two classes of suggested vaccination strategies: mortality-based strategies that target high-risk populations and morbidity-based strategies that target high-prevalence populations. Applying the methods of contact network epidemiology to a model of disease transmission in a large urban population, we assume that vaccine supplies are limited and then evaluate the efficacy of these strategies across a wide range of viral transmission rates and for two different age-specific mortality distributions. We find that the optimal strategy depends critically on the viral transmission level (reproductive rate of the virus: morbidity-based strategies outperform mortality-based strategies for moderately transmissible strains, while the reverse is true for highly transmissible strains. These results hold for a range of mortality rates reported for prior influenza epidemics and pandemics. Furthermore, we show that vaccination delays and multiple introductions of disease into the community have a more detrimental impact on morbidity-based strategies than mortality-based strategies. CONCLUSIONS: If public health officials have reasonable estimates of the viral transmission rate and the frequency of new introductions into the community prior to an outbreak, then these methods can guide the design of optimal vaccination priorities. When such information is unreliable or not available, as is often the case, this study recommends mortality-based vaccination priorities.

Classical Swine Fever and Avian Influenza epidemcis: Lessons learned

NARCIS (Netherlands)

Elbers, A.R.; Loeffen, W.L.A.; Koch, G.

2012-01-01

This publication is based on a talk which was held in the course of the spring symposium „Impfen statt Keulen“ of the Akademie für Tiergesundheit (AfT) 2011 in Wiesbaden-Naurod. Experience with recent large-scale epidemics of Classical Swine Fever and Avian Influenza – among others in the

Pandemic influenza – including a risk assessment of H5N1

Science.gov (United States)

Taubenberger, J.K.; Morens, D.M.

2009-01-01

Summary Influenza pandemics and epidemics have apparently occurred since at least the Middle Ages. When pandemics appear, 50% or more of an affected population can be infected in a single year, and the number of deaths caused by influenza can dramatically exceed what is normally expected. Since 1500, there appear to have been 13 or more influenza pandemics. In the past 120 years there were undoubted pandemics in 1889, 1918, 1957, 1968, and 1977. Although most experts believe we will face another influenza pandemic, it is impossible to predict when it will appear, where it will originate, or how severe it will be. Nor is there agreement about the subtype of influenza virus most likely to cause the next pandemic. The continuing spread of H5N1 highly pathogenic avian influenza viruses has heightened interest in pandemic prediction. Despite uncertainties in the historical record of the pre-virology era, study of previous pandemics may help guide future pandemic planning and lead to a better understanding of the complex ecobiology underlying the formation of pandemic strains of influenza A viruses. PMID:19618626

Epidemiologic parameters and evaluation of control measure for 2009 novel influenza a (H1N1 in Xiamen, Fujian Province, China

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Shen Jinyu

2012-01-01

Full Text Available Abstract Background Containment of influenza A H1N1 virus spread was implemented successfully in Xiamen, with large-scale inoculation to reduce morbidity. To identify beneficial elements and to guide decision-making in epidemic containment, we analyzed the epidemiologic parameters and evaluated the control measures. Method We determined various parameters from laboratory-confirmed cases, including incubation period, duration of illness and reproductive number (R0, and evaluated the control measures. Results There were1414 cases with dates of onset between June 14, 2009 and March 22, 2010. The incidence was 56.79/100,000, and mortality was 0.12/100,000. The incidence during the community epidemic phase was 6.23 times higher than in the containment phase. A total of 296,888 subjects were inoculated with domestic influenza H1N1 virus cleavage vaccine. An epidemic curve showed that vaccination in students cut the peak incidence of illness significantly. Men (relative risk (RR = 1.30, 95% confidence interval (CI: 1.17-1.45 and persons aged 0-14 years were at greater risk of infection. The incidence increased with younger age (χ2 = 950.675, p = ∞. Morbidity was lower in urban than in rural areas (RR = 0.56, 95%CI: 0.50-0.62. The median incubation time was 2 days, median duration of symptoms was 7 days, and the within-school reproductive number was 1.35. Conclusion Our analysis indicated that the characteristics of this novel influenza virus were similar to those of seasonal influenza. The principle of "interception of imported cases" applied at Xiamen ports, and vaccination of students effectively limited the spread of the influenza pandemic and reduced the epidemic peak.

Modeling the dynamics of backyard chicken flows in traditional trade networks in Thailand: implications for surveillance and control of avian influenza.

Science.gov (United States)

Wiratsudakul, Anuwat; Paul, Mathilde Cécile; Bicout, Dominique Joseph; Tiensin, Thanawat; Triampo, Wannapong; Chalvet-Monfray, Karine

2014-06-01

In Southeast Asia, traditional poultry marketing chains have been threatened by epidemics caused by the highly pathogenic avian influenza H5N1 (HPAI H5N1) virus. In Thailand, the trade of live backyard chickens is based on the activities of traders buying chickens from villages and supplying urban markets with chicken meat. This study aims to quantify the flows of chickens traded during a 1-year period in a province of Thailand. A compartmental stochastic dynamic model was constructed to illustrate trade flows of live chickens from villages to slaughterhouses. Live poultry movements present important temporal variations with increased activities during the 15 days preceding the Chinese New Year and, to a lesser extent, other festivals (Qingming Festival, Thai New Year, Hungry Ghost Festival, and International New Year). The average distance of poultry movements ranges from 4 to 25 km, defining a spatial scale for the risk of avian influenza that spread through traditional poultry marketing chains. Some characteristics of traditional poultry networks in Thailand, such as overlapping chicken supply zones, may facilitate disease diffusion over longer distances through combined expansion and relocation processes. This information may be of use in tailoring avian influenza and other emerging infectious poultry disease surveillance and control programs provided that the cost-effectiveness of such scenarios is also evaluated in further studies.

Bird flu, influenza and 1918: the case for mutant Avian tuberculosis.

Science.gov (United States)

Broxmeyer, Lawrence

2006-01-01

Influenza is Italian for "influence", Latin: influentia. It used to be thought that the disease was caused by a bad influence from the heavens. Influenza was called a virus long, long before it was proven to be one. In 2005, an article in the New England Journal of Medicine estimated that a recurrence of the 1918 influenza epidemic could kill between 180 million and 360 million people worldwide. A large part of the current bird-flu hysteria is fostered by a distrust among the lay and scientific community regarding the actual state of our knowledge regarding the bird flu or H5N1 and the killer "Influenza" Pandemic of 1918 that it is compared to. And this distrust is not completely unfounded. Traditionally, "flu" does not kill. Experts, including Peter Palese of the Mount School of Medicine in Manhattan, remind us that even in 1992, millions in China already had antibodies to H5N1, meaning that they had contracted it and that their immune system had little trouble fending it off. Dr. Andrew Noymer and Michel Garenne, UC Berkely demographers, reported in 2000 convincing statistics showing that undetected tuberculosis may have been the real killer in the 1918 flu epidemic. Aware of recent attempts to isolate the "Influenza virus" on human cadavers and their specimens, Noymer and Garenne summed that: "Frustratingly, these findings have not answered the question why the 1918 virus was so virulent, nor do they offer an explanation for the unusual age profile of deaths". Bird flu would certainly be diagnosed in the hospital today as Acute Respiratory Distress Syndrome (ARDS). Roger and others favor suspecting tuberculosis in all cases of acute respiratory failure of unknown origin. By 1918, it could be said, in so far as tuberculosis was concerned, that the world was a supersaturated sponge ready to ignite and that among its most vulnerable parts was the very Midwest where the 1918 unknown pandemic began. It is theorized that the lethal pig epidemic that began in Kansas

A Multiyear Model of Influenza Vaccination in the United States.

Science.gov (United States)

Kamis, Arnold; Zhang, Yuji; Kamis, Tamara

2017-07-28

Vaccinating adults against influenza remains a challenge in the United States. Using data from the Centers for Disease Control and Prevention, we present a model for predicting who receives influenza vaccination in the United States between 2012 and 2014, inclusive. The logistic regression model contains nine predictors: age, pneumococcal vaccination, time since last checkup, highest education level attained, employment, health care coverage, number of personal doctors, smoker status, and annual household income. The model, which classifies correctly 67 percent of the data in 2013, is consistent with models tested on the 2012 and 2014 datasets. Thus, we have a multiyear model to explain and predict influenza vaccination in the United States. The results indicate room for improvement in vaccination rates. We discuss how cognitive biases may underlie reluctance to obtain vaccination. We argue that targeted communications addressing cognitive biases could be useful for effective framing of vaccination messages, thus increasing the vaccination rate. Finally, we discuss limitations of the current study and questions for future research.

Influenza and other respiratory viruses detected by influenza-like illness surveillance in Leyte Island, the Philippines, 2010-2013.

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Hirono Otomaru

Full Text Available This study aimed to determine the role of influenza-like illness (ILI surveillance conducted on Leyte Island, the Philippines, including involvement of other respiratory viruses, from 2010 to 2013. ILI surveillance was conducted from January 2010 to March 2013 with 3 sentinel sites located in Tacloban city, Palo and Tanauan of Leyte Island. ILI was defined as fever ≥38°C or feverish feeling and either cough or running nose in a patient of any age. Influenza virus and other 5 respiratory viruses were searched. A total of 5,550 ILI cases visited the 3 sites and specimens were collected from 2,031 (36.6% cases. Among the cases sampled, 1,637 (75.6% were children aged <5 years. 874 (43.0% cases were positive for at least one of the respiratory viruses tested. Influenza virus and respiratory syncytial virus (RSV were predominantly detected (both were 25.7% followed by human rhinovirus (HRV (17.5%. The age distributions were significantly different between those who were positive for influenza, HRV, and RSV. ILI cases were reported throughout the year and influenza virus was co-detected with those viruses on approximately half of the weeks of study period (RSV in 60.5% and HRV 47.4%. In terms of clinical manifestations, only the rates of headache and sore throat were significantly higher in influenza positive cases than cases positive to other viruses. In conclusion, syndromic ILI surveillance in this area is difficult to detect the start of influenza epidemic without laboratory confirmation which requires huge resources. Age was an important factor that affected positive rates of influenza and other respiratory viruses. Involvement of older age children may be useful to detect influenza more effectively.

Simulating individual-based models of epidemics in hierarchical networks

NARCIS (Netherlands)

Quax, R.; Bader, D.A.; Sloot, P.M.A.

2009-01-01

Current mathematical modeling methods for the spreading of infectious diseases are too simplified and do not scale well. We present the Simulator of Epidemic Evolution in Complex Networks (SEECN), an efficient simulator of detailed individual-based models by parameterizing separate dynamics

Dynamic malware containment under an epidemic model with alert

Science.gov (United States)

Zhang, Tianrui; Yang, Lu-Xing; Yang, Xiaofan; Wu, Yingbo; Tang, Yuan Yan

2017-03-01

Alerting at the early stage of malware invasion turns out to be an important complement to malware detection and elimination. This paper addresses the issue of how to dynamically contain the prevalence of malware at a lower cost, provided alerting is feasible. A controlled epidemic model with alert is established, and an optimal control problem based on the epidemic model is formulated. The optimality system for the optimal control problem is derived. The structure of an optimal control for the proposed optimal control problem is characterized under some conditions. Numerical examples show that the cost-efficiency of an optimal control strategy can be enhanced by adjusting the upper and lower bounds on admissible controls.

The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies.

Science.gov (United States)

Jackson, Charlotte; Mangtani, Punam; Hawker, Jeremy; Olowokure, Babatunde; Vynnycky, Emilia

2014-01-01

School closure is a potential intervention during an influenza pandemic and has been investigated in many modelling studies. To systematically review the effects of school closure on influenza outbreaks as predicted by simulation studies. We searched Medline and Embase for relevant modelling studies published by the end of October 2012, and handsearched key journals. We summarised the predicted effects of school closure on the peak and cumulative attack rates and the duration of the epidemic. We investigated how these predictions depended on the basic reproduction number, the timing and duration of closure and the assumed effects of school closures on contact patterns. School closures were usually predicted to be most effective if they caused large reductions in contact, if transmissibility was low (e.g. a basic reproduction number 90% reductions or even increases under certain assumptions). This partly reflected differences in model assumptions, such as those regarding population contact patterns. Simulation studies suggest that school closure can be a useful control measure during an influenza pandemic, particularly for reducing peak demand on health services. However, it is difficult to accurately quantify the likely benefits. Further studies of the effects of reactive school closures on contact patterns are needed to improve the accuracy of model predictions.

Real-time numerical forecast of global epidemic spreading: case study of 2009 A/H1N1pdm

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Tizzoni Michele

2012-12-01

Full Text Available Abstract Background Mathematical and computational models for infectious diseases are increasingly used to support public-health decisions; however, their reliability is currently under debate. Real-time forecasts of epidemic spread using data-driven models have been hindered by the technical challenges posed by parameter estimation and validation. Data gathered for the 2009 H1N1 influenza crisis represent an unprecedented opportunity to validate real-time model predictions and define the main success criteria for different approaches. Methods We used the Global Epidemic and Mobility Model to generate stochastic simulations of epidemic spread worldwide, yielding (among other measures the incidence and seeding events at a daily resolution for 3,362 subpopulations in 220 countries. Using a Monte Carlo Maximum Likelihood analysis, the model provided an estimate of the seasonal transmission potential during the early phase of the H1N1 pandemic and generated ensemble forecasts for the activity peaks in the northern hemisphere in the fall/winter wave. These results were validated against the real-life surveillance data collected in 48 countries, and their robustness assessed by focusing on 1 the peak timing of the pandemic; 2 the level of spatial resolution allowed by the model; and 3 the clinical attack rate and the effectiveness of the vaccine. In addition, we studied the effect of data incompleteness on the prediction reliability. Results Real-time predictions of the peak timing are found to be in good agreement with the empirical data, showing strong robustness to data that may not be accessible in real time (such as pre-exposure immunity and adherence to vaccination campaigns, but that affect the predictions for the attack rates. The timing and spatial unfolding of the pandemic are critically sensitive to the level of mobility data integrated into the model. Conclusions Our results show that large-scale models can be used to provide valuable real

Epidemic Intelligence. Langmuir and the Birth of Disease Surveillance

OpenAIRE

Lyle Fearnley

2010-01-01

In the wake of the SARS and influenza epidemics of the past decade, one public health solution has become a refrain: surveillance systems for detection of disease outbreaks. This paper is an effort to understand how disease surveillance for outbreak detection gained such paramount rationality in contemporary public health. The epidemiologist Alexander Langmuir is well known as the creator of modern disease surveillance. But less well known is how he imagined disease surveillance as one part o...

Memory T Cells Generated by Prior Exposure to Influenza Cross React with the Novel H7N9 Influenza Virus and Confer Protective Heterosubtypic Immunity

Science.gov (United States)

McMaster, Sean R.; Gabbard, Jon D.; Koutsonanos, Dimitris G.; Compans, Richard W.; Tripp, Ralph A.; Tompkins, S. Mark; Kohlmeier, Jacob E.

2015-01-01

Influenza virus is a source of significant health and economic burden from yearly epidemics and sporadic pandemics. Given the potential for the emerging H7N9 influenza virus to cause severe respiratory infections and the lack of exposure to H7 and N9 influenza viruses in the human population, we aimed to quantify the H7N9 cross-reactive memory T cell reservoir in humans and mice previously exposed to common circulating influenza viruses. We identified significant cross-reactive T cell populations in humans and mice; we also found that cross-reactive memory T cells afforded heterosubtypic protection by reducing morbidity and mortality upon lethal H7N9 challenge. In context with our observation that PR8-primed mice have limited humoral cross-reactivity with H7N9, our data suggest protection from H7N9 challenge is indeed mediated by cross-reactive T cell populations established upon previous priming with another influenza virus. Thus, pre-existing cross-reactive memory T cells may limit disease severity in the event of an H7N9 influenza virus pandemic. PMID:25671696

Memory T cells generated by prior exposure to influenza cross react with the novel H7N9 influenza virus and confer protective heterosubtypic immunity.

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Sean R McMaster

Full Text Available Influenza virus is a source of significant health and economic burden from yearly epidemics and sporadic pandemics. Given the potential for the emerging H7N9 influenza virus to cause severe respiratory infections and the lack of exposure to H7 and N9 influenza viruses in the human population, we aimed to quantify the H7N9 cross-reactive memory T cell reservoir in humans and mice previously exposed to common circulating influenza viruses. We identified significant cross-reactive T cell populations in humans and mice; we also found that cross-reactive memory T cells afforded heterosubtypic protection by reducing morbidity and mortality upon lethal H7N9 challenge. In context with our observation that PR8-primed mice have limited humoral cross-reactivity with H7N9, our data suggest protection from H7N9 challenge is indeed mediated by cross-reactive T cell populations established upon previous priming with another influenza virus. Thus, pre-existing cross-reactive memory T cells may limit disease severity in the event of an H7N9 influenza virus pandemic.

Measuring Cellular Immunity to Influenza: Methods of Detection, Applications and Challenges

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Lynda Coughlan

2015-04-01

Full Text Available Influenza A virus is a respiratory pathogen which causes both seasonal epidemics and occasional pandemics; infection continues to be a significant cause of mortality worldwide. Current influenza vaccines principally stimulate humoral immune responses that are largely directed towards the variant surface antigens of influenza. Vaccination can result in an effective, albeit strain-specific antibody response and there is a need for vaccines that can provide superior, long-lasting immunity to influenza. Vaccination approaches targeting conserved viral antigens have the potential to provide broadly cross-reactive, heterosubtypic immunity to diverse influenza viruses. However, the field lacks consensus on the correlates of protection for cellular immunity in reducing severe influenza infection, transmission or disease outcome. Furthermore, unlike serological methods such as the standardized haemagglutination inhibition assay, there remains a large degree of variation in both the types of assays and method of reporting cellular outputs. T-cell directed immunity has long been known to play a role in ameliorating the severity and/or duration of influenza infection, but the precise phenotype, magnitude and longevity of the requisite protective response is unclear. In order to progress the development of universal influenza vaccines, it is critical to standardize assays across sites to facilitate direct comparisons between clinical trials.

The SIS Model of Epidemic Spreading in a Hierarchical Social Network

International Nuclear Information System (INIS)

Grabowski, A.; Kosinski, R.A.

2005-01-01

The phenomenon of epidemic spreading in a population with a hierarchical structure of interpersonal interactions is described and investigated numerically. The SIS model with temporal immunity to a disease and a time of incubation is used. In our model spatial localization of individuals belonging to different social groups, effectiveness of different interpersonal interactions and the mobility of a contemporary community are taken into account. The structure of interpersonal connections is based on a scale-free network. The influence of the structure of the social network on typical relations characterizing the spreading process, like a range of epidemic and epidemic curves, is discussed. The probability that endemic state occurs is also calculated. Surprisingly it occurs, that less contagious diseases has greater chance to survive. The influence of preventive vaccinations on the spreading process is investigated and critical range of vaccinations that is sufficient for the suppression of an epidemic is calculated. Our results of numerical calculations are compared with the solutions of the master equation for the spreading process, and good agreement is found. (author)

[Global public health: international health is tested to its limits by the human influenza A epidemic].

Science.gov (United States)

Franco-Giraldo, Alvaro; Alvarez-Dardet, Carlos

2009-06-01

This article comes from the intense international pressure that follows a near-catastrophy, such as the human influenza A H1N1 epidemic, and the limited resources for confronting such events. The analysis covers prevailing 20th century trends in the international public health arena and the change-induced challenges brought on by globalization, the transition set in motion by what has been deemed the "new" international public health and an ever-increasing focus on global health, in the context of an international scenario of shifting risks and opportunities and a growing number of multinational players. Global public health is defined as a public right, based on a new appreciation of the public, a new paradigm centered on human rights, and altruistic philosophy, politics, and ethics that undergird the changes in international public health on at least three fronts: redefining its theoretical foundation, improving world health, and renewing the international public health system, all of which is the byproduct of a new form of governance. A new world health system, directed by new global public institutions, would aim to make public health a global public right and face a variety of staggering challenges, such as working on public policy management on a global scale, renewing and democratizing the current global governing structure, and conquering the limits and weaknesses witnessed by international health.

Mathematics of epidemics on networks from exact to approximate models

CERN Document Server

Kiss, István Z; Simon, Péter L

2017-01-01

This textbook provides an exciting new addition to the area of network science featuring a stronger and more methodical link of models to their mathematical origin and explains how these relate to each other with special focus on epidemic spread on networks. The content of the book is at the interface of graph theory, stochastic processes and dynamical systems. The authors set out to make a significant contribution to closing the gap between model development and the supporting mathematics. This is done by: Summarising and presenting the state-of-the-art in modeling epidemics on networks with results and readily usable models signposted throughout the book; Presenting different mathematical approaches to formulate exact and solvable models; Identifying the concrete links between approximate models and their rigorous mathematical representation; Presenting a model hierarchy and clearly highlighting the links between model assumptions and model complexity; Providing a reference source for advanced undergraduate...

Possible impact of global warming on the evolution of hemagglutinins from influenza a viruses.

Science.gov (United States)

Yan, Shaomin; Wu, Guang

2011-02-01

To determine if global warming has an impact on the evolution of hemagglutinins from influenza A viruses, because both global warming and influenza pandemics/epidemics threaten the world. 4 706 hemagglutinins from influenza A viruses sampled from 1956 to 2009 were converted to a time-series to show their evolutionary process and compared with the global, northern hemisphere and southern hemisphere temperatures, to determine if their trends run in similar or opposite directions. Point-to-point comparisons between temperature and quantified hemagglutinins were performed for all species and for the major prevailing species. The comparisons show that the trends for both hemagglutinin evolution and temperature change run in a similar direction. Global warming has a consistent and progressive impact on the hemagglutinin evolution of influenza A viruses.

Avian influenza overview September–November 2017

DEFF Research Database (Denmark)

Brown, Ian; Kuiken, Thijs; Mulatti, Paolo

2017-01-01

Between 1 September and 15 November 2017, 48 A(H5N8) highly pathogenic avian influenza (HPAI) outbreaks in poultry holdings and 9 H5 HPAI wild bird events were reported within Europe. A second epidemic HPAI A(H5N8) wave started in Italy on the third week of July and is still ongoing on 15November...... to focus in order to achieve the most effective testing of dead birds for detection of H5 HPAI viruses. Monitoring the avian influenza situation in other continents revealed the same risks as in the previous report (October 2016-August 2017): the recent human case of HPAI A(H5N6) in China underlines...... the continuing threat of this avian influenza virus to human health and possible introduction via migratory wild birds into Europe. Close monitoring is required of the situation in Africa with regards to HPAI of the subtypes A(H5N1) and A(H5N8), given the rapidity of the evolution and the uncertainty...

Is sunspot activity a factor in influenza pandemics?

Science.gov (United States)

Qu, Jiangwen

2016-09-01

The 2009 AH1N1 pandemic became a global health concern, although fortunately, its worst anticipated effects were not realised. While the origins of such outbreaks remain poorly understood, it is very important to identify the precipitating factors in their emergence so that future pandemics can be detected as quickly as possible. Methords: Descriptive epidemiology was used to analyse the association between influenza pandemics and possible pandemics and relative number of sunspots. Non-conditional logistic regression was performed to analyse the statistical association between sunspot extremes and influenza pandemics to within plus or minus 1 year. Almost all recorded influenza/possible pandemics have occurred in time frames corresponding to sunspot extremes, or +/- 1 year within such extremes. These periods were identified as important risk factors in both possible and confirmed influenza pandemics (odds ratio: 3.87; 95% confidence interval: 1.08 to 13.85). Extremes of sunspot activity to within plus or minus 1 year may precipitate influenza pandemics. Mechanisms of epidemic initiation and early spread are discussed including primary causation by externally derived viral variants (from space via cometary dust). Efforts to construct a comprehensive early warning system for potential influenza and other viral pandemics that include analysis of sunspot activity and stratospheric sampling for viral variants should be supported. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Influenza seasonality in Madagascar: the mysterious African free-runner.

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Alonso, Wladimir Jimenez; Guillebaud, Julia; Viboud, Cecile; Razanajatovo, Norosoa Harline; Orelle, Arnaud; Zhou, Steven Zhixiang; Randrianasolo, Laurence; Heraud, Jean-Michel

2015-05-01

The seasonal drivers of influenza activity remain debated in tropical settings where epidemics are not clearly phased. Antananarivo is a particularly interesting case study because it is in Madagascar, an island situated in the tropics and with quantifiable connectivity levels to other countries. We aimed at disentangling the role of environmental forcing and population fluxes on influenza seasonality in Madagascar. We compiled weekly counts of laboratory-confirmed influenza-positive specimens for the period 2002 to 2012 collected in Antananarivo, with data available from sub-Saharan countries and countries contributing most foreign travelers to Madagascar. Daily climate indicators were compiled for the study period. Overall, influenza activity detected in Antananarivo predated that identified in temperate Northern Hemisphere locations. This activity presented poor temporal matching with viral activity in other countries from the African continent or countries highly connected to Madagascar excepted for A(H1N1)pdm09. Influenza detection in Antananarivo was not associated with travel activity and, although it was positively correlated with all climatic variables studied, such association was weak. The timing of influenza activity in Antananarivo is irregular, is not driven by climate, and does not align with that of countries in geographic proximity or highly connected to Madagascar. This work opens fresh questions regarding the drivers of influenza seasonality globally particularly in mid-latitude and less-connected regions to tailor vaccine strategies locally. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Statins in influenza: time for a controlled clinical study.

Science.gov (United States)

Carrillo-Esper, Raúl

2009-01-01

Mexico recently experienced the impact of an influenza epidemic. This outbreak, the H1N1 strain, affected a large number of citizens and caused panic, economic instability and increased health care costs to the federal government and public and private institutions. Influenza outbreaks are periodic. They may or may not be seasonal, and severity of the disease is linked to host immunity and to the virus strain. In the event of a pandemic as happened in 1918, it is estimated that approximately 175-350 million people may die, and health systems would face a catastrophic situation due to the insufficiency of antivirals and vaccines, as well as affecting hospital infrastructure.

Recalibrating disease parameters for increasing realism in modeling epidemics in closed settings

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Livio Bioglio

2016-11-01

Full Text Available Abstract Background The homogeneous mixing assumption is widely adopted in epidemic modelling for its parsimony and represents the building block of more complex approaches, including very detailed agent-based models. The latter assume homogeneous mixing within schools, workplaces and households, mostly for the lack of detailed information on human contact behaviour within these settings. The recent data availability on high-resolution face-to-face interactions makes it now possible to assess the goodness of this simplified scheme in reproducing relevant aspects of the infection dynamics. Methods We consider empirical contact networks gathered in different contexts, as well as synthetic data obtained through realistic models of contacts in structured populations. We perform stochastic spreading simulations on these contact networks and in populations of the same size under a homogeneous mixing hypothesis. We adjust the epidemiological parameters of the latter in order to fit the prevalence curve of the contact epidemic model. We quantify the agreement by comparing epidemic peak times, peak values, and epidemic sizes. Results Good approximations of the peak times and peak values are obtained with the homogeneous mixing approach, with a median relative difference smaller than 20 % in all cases investigated. Accuracy in reproducing the peak time depends on the setting under study, while for the peak value it is independent of the setting. Recalibration is found to be linear in the epidemic parameters used in the contact data simulations, showing changes across empirical settings but robustness across groups and population sizes. Conclusions An adequate rescaling of the epidemiological parameters can yield a good agreement between the epidemic curves obtained with a real contact network and a homogeneous mixing approach in a population of the same size. The use of such recalibrated homogeneous mixing approximations would enhance the accuracy and

Recalibrating disease parameters for increasing realism in modeling epidemics in closed settings.

Science.gov (United States)

Bioglio, Livio; Génois, Mathieu; Vestergaard, Christian L; Poletto, Chiara; Barrat, Alain; Colizza, Vittoria

2016-11-14

The homogeneous mixing assumption is widely adopted in epidemic modelling for its parsimony and represents the building block of more complex approaches, including very detailed agent-based models. The latter assume homogeneous mixing within schools, workplaces and households, mostly for the lack of detailed information on human contact behaviour within these settings. The recent data availability on high-resolution face-to-face interactions makes it now possible to assess the goodness of this simplified scheme in reproducing relevant aspects of the infection dynamics. We consider empirical contact networks gathered in different contexts, as well as synthetic data obtained through realistic models of contacts in structured populations. We perform stochastic spreading simulations on these contact networks and in populations of the same size under a homogeneous mixing hypothesis. We adjust the epidemiological parameters of the latter in order to fit the prevalence curve of the contact epidemic model. We quantify the agreement by comparing epidemic peak times, peak values, and epidemic sizes. Good approximations of the peak times and peak values are obtained with the homogeneous mixing approach, with a median relative difference smaller than 20 % in all cases investigated. Accuracy in reproducing the peak time depends on the setting under study, while for the peak value it is independent of the setting. Recalibration is found to be linear in the epidemic parameters used in the contact data simulations, showing changes across empirical settings but robustness across groups and population sizes. An adequate rescaling of the epidemiological parameters can yield a good agreement between the epidemic curves obtained with a real contact network and a homogeneous mixing approach in a population of the same size. The use of such recalibrated homogeneous mixing approximations would enhance the accuracy and realism of agent-based simulations and limit the intrinsic biases of

Time and dose-dependent risk of pneumococcal pneumonia following influenza: a model for within-host interaction between influenza and Streptococcus pneumoniae

OpenAIRE

Shrestha, Sourya; Foxman, Betsy; Dawid, Suzanne; Aiello, Allison E.; Davis, Brian M.; Berus, Joshua; Rohani, Pejman

2013-01-01

A significant fraction of seasonal and in particular pandemic influenza deaths are attributed to secondary bacterial infections. In animal models, influenza virus predisposes hosts to severe infection with both Streptococcus pneumoniae and Staphylococcus aureus. Despite its importance, the mechanistic nature of the interaction between influenza and pneumococci, its dependence on the timing and sequence of infections as well as the clinical and epidemiological consequences remain unclear. We e...

Lessons from the epidemiological surveillance program, during the influenza A (H1N1 virus epidemic, in a reference university hospital of Southeastern Brazil Lições aprendidas pelo programa de vigilância epidemiológica, durante a epidemia pelo vírus da influenza A (H1N1, em um hospital universitário na região sudeste do Brasil

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Maria Luiza Moretti

2011-08-01

Full Text Available INTRODUCTION: The case definition of influenza-like illness (ILI is a powerful epidemiological tool during influenza epidemics. METHODS: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature > 38ºC in period 1, and the definition of severe acute respiratory infection (ARS (coughing + temperature > 38ºC and dyspnoea in period 2. RESULTS: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50% than in children (21.6% ( p INTRODUÇÃO: A definição de síndrome gripal é uma ferramenta epidemiológica importante durante epidemias de influenza. MÉTODOS: Foi conduzido estudo de coorte prospectivo para avaliar o impacto das definições de síndrome gripal (SG e doença respiratória aguda grave (DRAG como ferramenta de vigilância epidemiológica, em adultos e crianças, durante a epidemia de influenza A H1N1. Os pacientes foram incluídos se tivessem coleta de secreção respiratória alta testada por PCR real time para o vírus da influenza. Os dados clínicos e epidemiológicos foram estudados comparando-se dois períodos: período 1: SG (tosse + temperatura > 38ºC, e período 2: DRAG (tosse + temperatura > 38 e dispnéia. RESULTADOS: Foram incluídos 366 adultos e 147 crianças, em um total de 243 casos de SG e 270 DRAG. A confirmação laboratorial de influenza em adultos (50% foi significativamente maior do que em crianças (21,6% (p < 0,0001 e a definição de SG foi mais confirmatória de infecção por influenza (53% do que DRAG (24,4% (p < 0,0001. Adultos referiam mais calafrios e mialgias do que as

No serological evidence that harbour porpoises are additional hosts of influenza B viruses.

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Rogier Bodewes

Full Text Available Influenza A and B viruses circulate among humans causing epidemics almost annually. While various hosts for influenza A viruses exist, influenza B viruses have been detected only in humans and seals. However, recurrent infections of seals in Dutch coastal waters with influenza B viruses that are antigenetically distinct from influenza B viruses circulating among humans suggest that influenza B viruses have been introduced into this seal population by another, non-human, host. Harbour porpoises (Phocoena phocoena are sympatric with seals in these waters and are also occasionally in close contact with humans after stranding and subsequent rehabilitation. In addition, virus attachment studies demonstrated that influenza B viruses can bind to cells of the respiratory tract of these animals. Therefore, we hypothesized that harbour porpoises might be a reservoir of influenza B viruses. In the present study, an unique set of serum samples from 79 harbour porpoises, stranded alive on the Dutch coast between 2003 and 2013, was tested for the presence of antibodies against influenza B viruses by use of the hemagglutination inhibition test and for antibodies against influenza A viruses by use of a competitive influenza A nucleoprotein ELISA. No antibodies were detected against either virus, suggesting that influenza A and B virus infections of harbour porpoises in Dutch coastal waters are not common, which was supported by statistical analysis of the dataset.

Novel framework for assessing epidemiologic effects of influenza epidemics and pandemics.

Science.gov (United States)

Reed, Carrie; Biggerstaff, Matthew; Finelli, Lyn; Koonin, Lisa M; Beauvais, Denise; Uzicanin, Amra; Plummer, Andrew; Bresee, Joe; Redd, Stephen C; Jernigan, Daniel B

2013-01-01

The effects of influenza on a population are attributable to the clinical severity of illness and the number of persons infected, which can vary greatly between seasons or pandemics. To create a systematic framework for assessing the public health effects of an emerging pandemic, we reviewed data from past influenza seasons and pandemics to characterize severity and transmissibility (based on ranges of these measures in the United States) and outlined a formal assessment of the potential effects of a novel virus. The assessment was divided into 2 periods. Because early in a pandemic, measurement of severity and transmissibility is uncertain, we used a broad dichotomous scale in the initial assessment to divide the range of historic values. In the refined assessment, as more data became available, we categorized those values more precisely. By organizing and prioritizing data collection, this approach may inform an evidence-based assessment of pandemic effects and guide decision making.

The threshold of a stochastic SIQS epidemic model

Science.gov (United States)

Zhang, Xiao-Bing; Huo, Hai-Feng; Xiang, Hong; Shi, Qihong; Li, Dungang

2017-09-01

In this paper, we present the threshold of a stochastic SIQS epidemic model which determines the extinction and persistence of the disease. Furthermore, we find that noise can suppress the disease outbreak. Numerical simulations are also carried out to confirm the analytical results.

La influenza, un problema vigente de salud pública Influenza, an existing public health problem

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Juan García-García

2006-06-01

particular, during winter months and having an elevated effect on public health worldwide. The disease has high morbidity rates for people of all ages and particularly high mortality rates for children, adults over 60 years old, patients with chronic illnesses and pregnant women. Prevention control strategies include vaccination using inactivated, subunit or genetically modified virus vaccines. Influenza in humans is caused by two subtypes of influenza virus A and one of influenza virus B. The influenza virus A that affects humans mutates easily, thereby often causing new antigenic variants of each subtype to emerge, requiring the inclusion of such variants in annual vaccines in order to assure proper immunization of the population. The influenza pandemic refers to the introduction and later worldwide spread of a new influenza virus in the human population, which occurs sporadically. Due to the lack of immunity in humans against the new virus, serious epidemics can be provoked resulting in high morbidity and mortality rates. Historically, influenza pandemics are a result of the transmission of the virus from birds to humans, or the transfer of such genes to seasonal influenza. Wild waterfowl -both migratory and shore birds- carry a large diversity of influenza virus subtypes, which are eventually transmitted to domestic birds. Some of those viruses cross the species barrier and infect mammals, including humans. The adaptation process of the avian virus to mammal hosts requires time. Therefore, the presentation of these cases can take several years. Since December 2003, in several Southeast Asian countries a large proportion of domestic birds have been affected by an avian influenza epidemic (subtype H5N1. By Februrary 2006, the epidemic had already affected countries in Europe and Africa, having a significant economic impact on commercial poultry due to the more than 180 million birds that were sacrificed. Some strains of this avian influenza virus have directly, although

A final size relation for epidemic models of vector-transmitted diseases

OpenAIRE

Fred Brauer

2017-01-01

We formulate and analyze an age of infection model for epidemics of diseases transmitted by a vector, including the possibility of direct transmission as well. We show how to determine a basic reproduction number. While there is no explicit final size relation as for diseases transmitted directly, we are able to obtain estimates for the final size of the epidemic.

Modelling the innate immune response against avian influenza virus in chicken

NARCIS (Netherlands)

Hagenaars, T.J.; Fischer, E.A.J.; Jansen, C.A.; Rebel, J.M.J.; Spekreijse, D.; Vervelde, L.; Backer, J.A.; Jong, de M.C.M.; Koets, A.P.

2016-01-01

At present there is limited understanding of the host immune response to (low pathogenic) avian influenza virus infections in poultry. Here we develop a mathematical model for the innate immune response to avian influenza virus in chicken lung, describing the dynamics of viral load,

Two profitless delays for an SEIRS epidemic disease model with vertical transmission and pulse vaccination

International Nuclear Information System (INIS)

Meng Xinzhu; Jiao Jianjun; Chen Lansun

2009-01-01

Since the investigation of impulsive delay differential equations is beginning, the literature on delay epidemic models with pulse vaccination is not extensive. In this paper, we propose a new SEIRS epidemic disease model with two profitless delays and vertical transmission, and analyze the dynamics behaviors of the model under pulse vaccination. Using the discrete dynamical system determined by the stroboscopic map, we obtain a 'infection-free' periodic solution, further, show that the 'infection-free' periodic solution is globally attractive when some parameters of the model are under appropriate conditions. Using a new modeling method, we obtain sufficient condition for the permanence of the epidemic model with pulse vaccination. We show that time delays, pulse vaccination and vertical transmission can bring different effects on the dynamics behaviors of the model by numerical analysis. Our results also show the delays are 'profitless'. In this paper, the main feature is to introduce two discrete time delays, vertical transmission and impulse into SEIRS epidemic model and to give pulse vaccination strategies.

Intranasal vaccination promotes detrimental Th17-mediated immunity against influenza infection.

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Asher Maroof

2014-01-01

Full Text Available Influenza disease is a global health issue that causes significant morbidity and mortality through seasonal epidemics. Currently, inactivated influenza virus vaccines given intramuscularly or live attenuated influenza virus vaccines administered intranasally are the only approved options for vaccination against influenza virus in humans. We evaluated the efficacy of a synthetic toll-like receptor 4 agonist CRX-601 as an adjuvant for enhancing vaccine-induced protection against influenza infection. Intranasal administration of CRX-601 adjuvant combined with detergent split-influenza antigen (A/Uruguay/716/2007 (H3N2 generated strong local and systemic immunity against co-administered influenza antigens while exhibiting high efficacy against two heterotypic influenza challenges. Intranasal vaccination with CRX-601 adjuvanted vaccines promoted antigen-specific IgG and IgA antibody responses and the generation of polyfunctional antigen-specific Th17 cells (CD4(+IL-17A(+TNFα(+. Following challenge with influenza virus, vaccinated mice transiently exhibited increased weight loss and morbidity during early stages of disease but eventually controlled infection. This disease exacerbation following influenza infection in vaccinated mice was dependent on both the route of vaccination and the addition of the adjuvant. Neutralization of IL-17A confirmed a detrimental role for this cytokine during influenza infection. The expansion of vaccine-primed Th17 cells during influenza infection was also accompanied by an augmented lung neutrophilic response, which was partially responsible for mediating the increased morbidity. This discovery is of significance in the field of vaccinology, as it highlights the importance of both route of vaccination and adjuvant selection in vaccine development.

Global stability of a susceptible-infected-susceptible epidemic model on networks with individual awareness

International Nuclear Information System (INIS)

Li Ke-Zan; Xu Zhong-Pu; Zhu Guang-Hu; Ding Yong

2014-01-01

Recent research results indicate that individual awareness can play an important influence on epidemic spreading in networks. By local stability analysis, a significant conclusion is that the embedded awareness in an epidemic network can increase its epidemic threshold. In this paper, by using limit theory and dynamical system theory, we further give global stability analysis of a susceptible-infected-susceptible (SIS) epidemic model on networks with awareness. Results show that the obtained epidemic threshold is also a global stability condition for its endemic equilibrium, which implies the embedded awareness can enhance the epidemic threshold globally. Some numerical examples are presented to verify the theoretical results. (interdisciplinary physics and related areas of science and technology)

Pharmaceutical interventions for mitigating an influenza pandemic: modeling the risks and health-economic impacts.

Science.gov (United States)

Postma, Maarten J; Milne, George; Nelson, E Anthony S; Pyenson, Bruce; Basili, Marcello; Coker, Richard; Oxford, John; Garrison, Louis P

2010-12-01

Model-based analyses built on burden-of-disease and cost-effectiveness theory predict that pharmaceutical interventions may efficiently mitigate both the epidemiologic and economic impact of an influenza pandemic. Pharmaceutical interventions typically encompass the application of (pre)pandemic influenza vaccines, other vaccines (notably pneumococcal), antiviral treatments and other drug treatment (e.g., antibiotics to target potential complications of influenza). However, these models may be too limited to capture the full macro-economic impact of pandemic influenza. The aim of this article is to summarize current health-economic modeling approaches to recognize the strengths and weaknesses of these approaches, and to compare these with more recently proposed alternative methods. We conclude that it is useful, particularly for policy and planning purposes, to extend modeling concepts through the application of alternative approaches, including insurers' risk theories, human capital approaches and sectoral and full macro-economic modeling. This article builds on a roundtable meeting of the Pandemic Influenza Economic Impact Group that was held in Boston, MA, USA, in December 2008.

School-based influenza vaccination: parents' perspectives.

Directory of Open Access Journals (Sweden)

Candace Lind

Full Text Available School-age children are important drivers of annual influenza epidemics yet influenza vaccination coverage of this population is low despite universal publicly funded influenza vaccination in Alberta, Canada. Immunizing children at school may potentially increase vaccine uptake. As parents are a key stakeholder group for such a program, it is important to consider their concerns.We explored parents' perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools, and obtained suggestions for structuring such a program.Forty-eight parents of children aged 5-18 years participated in 9 focus groups. Participants lived in urban areas of the Alberta Health Services Calgary Zone.Three major themes emerged: Advantages of school-based influenza vaccination (SBIV, Disadvantages of SBIV, and Implications for program design & delivery. Advantages were perceived to occur for different populations: children (e.g. emotional support, families (e.g. convenience, the community (e.g. benefits for school and multicultural communities, the health sector (e.g. reductions in costs due to burden of illness and to society at large (e.g. indirect conduit of information about health services, building structure for pandemic preparedness, building healthy lifestyles. Disadvantages, however, might also occur for children (e.g. older children less likely to be immunized, families (e.g. communication challenges, perceived loss of parental control over information, choices and decisions and the education sector (loss of instructional time. Nine second-level themes emerged within the major theme of Implications for program design & delivery: program goals/objectives, consent process, stakeholder consultation, age-appropriate program, education, communication, logistics, immunizing agent, and clinic process.Parents perceived advantages and disadvantages to delivering annual seasonal

Modelling the Innate Immune Response against Avian Influenza Virus in Chicken

NARCIS (Netherlands)

Hagenaars, T J; Fischer, E A J; Jansen, C A; Rebel, J M J; Spekreijse, D; Vervelde, L; Backer, J A; de Jong, M.C.M.; Koets, A P

2016-01-01

At present there is limited understanding of the host immune response to (low pathogenic) avian influenza virus infections in poultry. Here we develop a mathematical model for the innate immune response to avian influenza virus in chicken lung, describing the dynamics of viral load, interferon-α, -β

Evaluating the combined effectiveness of influenza control strategies and human preventive behavior.

Directory of Open Access Journals (Sweden)

Liang Mao

Full Text Available Control strategies enforced by health agencies are a major type of practice to contain influenza outbreaks. Another type of practice is the voluntary preventive behavior of individuals, such as receiving vaccination, taking antiviral drugs, and wearing face masks. These two types of practices take effects concurrently in influenza containment, but little attention has been paid to their combined effectiveness. This article estimates this combined effectiveness using established simulation models in the urbanized area of Buffalo, NY, USA. Three control strategies are investigated, including: Targeted Antiviral Prophylaxis (TAP, workplace/school closure, community travel restriction, as well as the combination of the three. All control strategies are simulated with and without regard to individual preventive behavior, and the resulting effectiveness are compared. The simulation outcomes suggest that weaker control strategies could suffice to contain influenza epidemics, because individuals voluntarily adopt preventive behavior, rendering these weaker strategies more effective than would otherwise have been expected. The preventive behavior of individuals could save medical resources for control strategies and avoid unnecessary socio-economic interruptions. This research adds a human behavioral dimension into the simulation of control strategies and offers new insights into disease containment. Health policy makers are recommended to review current control strategies and comprehend preventive behavior patterns of local populations before making decisions on influenza containment.

Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts.

Science.gov (United States)

Okusaga, Olaoluwa; Yolken, Robert H; Langenberg, Patricia; Lapidus, Manana; Arling, Timothy A; Dickerson, Faith B; Scrandis, Debra A; Severance, Emily; Cabassa, Johanna A; Balis, Theodora; Postolache, Teodor T

2011-04-01

Anecdotal reports of mood disorder following infection with common respiratory viruses with neurotropic potential have been in existence since the last century. Nevertheless, systematic studies on the association between these viruses and mood disorders are lacking. Influenza A, B and coronavirus antibody titers were measured in 257 subjects with recurrent unipolar and bipolar disorder and healthy controls, by SCID. Pearson's χ² tests and logistic regression models were used to analyze associations between seropositivity for coronaviruses, influenza A and B viruses and the following: a) history of recurrent mood disorders b) having attempted suicide in the past c) uni- vs. bi-polarity and d) presence of psychotic symptoms during mood episodes. Seropositivity for influenza A (p=0.004), B (pmood disorders but not with the specific diagnosis of unipolar or bipolar depression. Seropositivity for influenza B was significantly associated with a history of suicide attempt (p=0.001) and history of psychotic symptoms (p=0.005). The design was cross-sectional. Socioeconomic factors, inflammatory markers, and axis II psychopathology were not assessed. The association of seropositivity for influenza and coronaviruses with a history of mood disorders, and influenza B with suicidal behavior require replication in larger longitudinal samples. The need for these studies is additionally supported by the high incidence of these viral infections, the high prevalence of mood disorders, and resilience of suicide epidemics. Copyright © 2010 Elsevier B.V. All rights reserved.

Gradual changes in the age distribution of excess deaths in the years following the 1918 influenza pandemic in Copenhagen

DEFF Research Database (Denmark)

Saglanmak, Neslihan; Andreasen, Viggo; Simonsen, Lone

2011-01-01

implications for pandemic preparedness. In the present paper, we analyse the age patterns of influenza-related excess mortality in the decades before and after the 1918 pandemic, using detailed historic surveillance data from Copenhagen. Methods: Weekly age-specific rates of respiratory mortality and influenza...... in the recrudescent pandemic wave of 1919–1920 may suggest the emergence of an early influenza A/H1N1 drift variant. Subsequent drift events may have been associated with the particularly severe 1928–1929 epidemic in Denmark and elsewhere....

The application of GIS and RS for epidemics: a case study of the spread of highly pathogenic avian influenza in China in 2004-2005

Science.gov (United States)

Zhong, Shaobo; Lan, Guiwen; Zhu, Haiguo; Wen, Renqiang; Zhao, Qiansheng; Huang, Quanyi

2008-12-01

Because of their inherent advantages, Geographic Information System (GIS) and Remote Sensing (RS) are extremely useful for dealing with geographically referenced information. In the study of epidemics, most data are geographically referenced, which makes GIS and RS the perfect even necessary tools for processing, analysis, representation of epidemic data. Comprehensively considering the data requirements in the study of highly pathogenic avian influenza (HPAI) coupled with the quality of the existing remotely sensed data in terms of the resolution of space, time and spectra, the data sensed by MODIS are chosen and the relevant methods and procedures of data processing from RS and GIS for some environmental factors are proposed. Through using spatial analysis functions and Exploratory Spatial Data Analysis (ESDA) of GIS, some results of relationship between HPAI occurrences and these potential factors are presented. The role played by bird migration is also preliminarily illustrated with some operations such as visualization, overlapping etc. provided by GIS. Through the work of this paper, we conclude: Firstly, the migration of birds causes the spread of HPAI all over the country in 2004-2005. Secondly, the migration of birds is the reason why the spread of HPAI is perturbed. That is, for some classic communicable diseases, their spread exhibits obvious spatial diffusion process. However, the spread of HPAI breaks this general rule. We think leap diffusion and time lag are the probable reasons for this kind of phenomena. Potential distribution of HPAI viruses (corresponding to the distribution of flyways and putative risk sources) is not completely consistent with the occurrences of HPAI. For this phenomenon, we think, in addition to the flyways of birds, all kinds of geographical, climatic factors also have important effect on the occurrences of HPAI. Through the case study of HPAI, we can see that GIS and RS can play very important roles in the study of epidemics.

The neuropsychiatric aspects of influenza/swine flu: A selective review

Directory of Open Access Journals (Sweden)

Narayana Manjunatha

2011-01-01

Full Text Available The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu pandemic is believed to be the legacy of the influenza pandemic (1918-19. The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine ′PUBMED′ to search for published articles with different MeSH terms using Boolean operator (AND. Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson′s disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

Molecular characterization of influenza viruses circulating in Northern Italy during two seasons (2005/2006 and 2006/2007) of low influenza activity.

Science.gov (United States)

Pariani, Elena; Amendola, Antonella; Zappa, Alessandra; Bianchi, Silvia; Colzani, Daniela; Anselmi, Giovanni; Zanetti, Alessandro; Tanzi, Elisabetta

2008-11-01

The influenza activity and circulation of influenza viruses in Lombardy (the most populous Italian region) were observed during two consecutive seasons (2005/2006 and 2006/2007) characterized by low influenza activity by the Italian Influenza Surveillance Network. The molecular characteristics of circulating viruses were analyzed to evaluate the introduction of new variants and emergence of vaccine-escape viruses. In both seasons, the epidemic in Lombardy was sustained almost exclusively by influenza A viruses, accounting for 80.5% and 93.6% of total detections, respectively, and the co-circulation of A/H3 viruses belonging to distinct phylogenetic groups was observed. The A/H1N1 viruses isolated during the 2005/2006 season were closely related to A/New Caledonia/20/99, while the hemagglutinin (HA) sequences of the A/H1N1 viruses from the 2006/2007 season exhibited a greater diversity. These viruses were A/Solomon Islands/3/2006-like and showed several variants. All B isolates were similar to B/Malaysia/2506/2004 belonging to the B/Victoria/2/87-lineage. Influenza B virus was the dominant virus in Europe in the 2005/2006 season and accounted for the 20% of total detections in Lombardy. Overall, the viruses studied presented heterogeneity in their HA sequences suggesting the circulation of a miscellaneous set of variants during the two seasons notwithstanding the medium-low activity of influenza. The importance of virological surveillance of influenza viruses is recognized widely and the molecular characterization of the viruses, especially in vaccinated subjects, is of particular importance to evaluate the introduction and circulation of new variants. 2008 Wiley-Liss, Inc.

Principles underlying rational design of live attenuated influenza vaccines

Science.gov (United States)

Jang, Yo Han

2012-01-01

Despite recent innovative advances in molecular virology and the developments of vaccines, influenza virus remains a serious burden for human health. Vaccination has been considered a primary countermeasure for prevention of influenza infection. Live attenuated influenza vaccines (LAIVs) are particularly attracting attention as an effective strategy due to several advantages over inactivated vaccines. Cold-adaptation, as a classical means for attenuating viral virulence, has been successfully used for generating safe and effective donor strains of LAIVs against seasonal epidemics and occasional pandemics. Recently, the advent of reverse genetics technique expedited a variety of rational strategies to broaden the pool of LAIVs. Considering the breadth of antigenic diversity of influenza virus, the pool of LAIVs is likely to equip us with better options for controlling influenza pandemics. With a brief reflection on classical attenuating strategies used at the initial stage of development of LAIVs, especially on the principles underlying the development of cold-adapted LAIVs, we further discuss and outline other attenuation strategies especially with respect to the rationales for attenuation, and their practicality for mass production. Finally, we propose important considerations for a rational vaccine design, which will provide us with practical guidelines for improving the safety and effectiveness of LAIVs. PMID:23596576

Halting HIV/AIDS with avatars and havatars: a virtual world approach to modelling epidemics

Directory of Open Access Journals (Sweden)

Smith? Robert J

2009-11-01

Full Text Available Abstract Background A major deficit of all approaches to epidemic modelling to date has been the need to approximate or guess at human behaviour in disease-transmission-related contexts. Avatars are generally human-like figures in virtual computer worlds controlled by human individuals. Methods We introduce the concept of a "havatar", which is a (human, avatar pairing. Evidence is mounting that this pairing behaves in virtual contexts much like the human in the pairing might behave in analogous real-world contexts. Results We propose that studies of havatars, in a virtual world, may give a realistic approximation of human behaviour in real-world contexts. If the virtual world approximates the real world in relevant details (geography, transportation, etc., virtual epidemics in that world could accurately simulate real-world epidemics. Havatar modelling of epidemics therefore offers a complementary tool for tackling how best to halt epidemics, including perhaps HIV/AIDS, since sexual behaviour is a significant component of some virtual worlds, such as Second Life. Conclusion Havatars place the control parameters of an epidemic in the hands of each individual. By providing tools that everyone can understand and use, we could democratise epidemiology.

Triple-reassortant swine influenza A (H1) in humans in the United States, 2005-2009.

Science.gov (United States)

Shinde, Vivek; Bridges, Carolyn B; Uyeki, Timothy M; Shu, Bo; Balish, Amanda; Xu, Xiyan; Lindstrom, Stephen; Gubareva, Larisa V; Deyde, Varough; Garten, Rebecca J; Harris, Meghan; Gerber, Susan; Vagasky, Susan; Smith, Forrest; Pascoe, Neal; Martin, Karen; Dufficy, Deborah; Ritger, Kathy; Conover, Craig; Quinlisk, Patricia; Klimov, Alexander; Bresee, Joseph S; Finelli, Lyn

2009-06-18

Triple-reassortant swine influenza A (H1) viruses--containing genes from avian, human, and swine influenza viruses--emerged and became enzootic among pig herds in North America during the late 1990s. We report the clinical features of the first 11 sporadic cases of infection of humans with triple-reassortant swine influenza A (H1) viruses reported to the Centers for Disease Control and Prevention, occurring from December 2005 through February 2009, until just before the current epidemic of swine-origin influenza A (H1N1) among humans. These data were obtained from routine national influenza surveillance reports and from joint case investigations by public and animal health agencies. The median age of the 11 patients was 10 years (range, 16 months to 48 years), and 4 had underlying health conditions. Nine of the patients had had exposure to pigs, five through direct contact and four through visits to a location where pigs were present but without contact. In another patient, human-to-human transmission was suspected. The range of the incubation period, from the last known exposure to the onset of symptoms, was 3 to 9 days. Among the 10 patients with known clinical symptoms, symptoms included fever (in 90%), cough (in 100%), headache (in 60%), and diarrhea (in 30%). Complete blood counts were available for four patients, revealing leukopenia in two, lymphopenia in one, and thrombocytopenia in another. Four patients were hospitalized, two of whom underwent invasive mechanical ventilation. Four patients received oseltamivir, and all 11 recovered from their illness. From December 2005 until just before the current human epidemic of swine-origin influenza viruses, there was sporadic infection with triple-reassortant swine influenza A (H1) viruses in persons with exposure to pigs in the United States. Although all the patients recovered, severe illness of the lower respiratory tract and unusual influenza signs such as diarrhea were observed in some patients, including

Clinical Profile of Suspected and Confirmed H1N1 Influenza Infection in Patients admitted at a Tertiary Care Teaching Hospital

Directory of Open Access Journals (Sweden)

Basavaraju Jayadeva

2015-11-01

Full Text Available Introduction: This study aimed to evaluate the clinical profile and outcomes of adult patients screened and diagnosed with H1N1 influenza infection at a tertiary care hospital in India. Materials and Methods: This retrospective  study was conducted on all adult patients suspected of H1N1 influenza admitted at a teaching hospital during the epidemic period of January-March 2015. Patients were screened and classified into three categories of A, B, and C based on international guidelines. Home confinement was recommended for patients in category A, and subjects in category B received treatment with Oseltamivir capsules. In addition, patients in category C received inpatient treatment with oseltamivir capsules. Results: In total, 695 patients were screened for H1N1 influenza infection during the epidemic, out of whom 380 patients (54.6% were in category A, 264 (37.9% were in category B, and 51 (7.3% were in category C. Throat swabs were collected and examined for 192 ( 27.6% patients, and 59 ( 8.4% cases were positive for H1N1 infection. Conclusion: According to the results of this study, close vigilance over the symptoms of patients infected with H1N1 influenza is more important than treatment and screening of suspicious cases during the epidemics of this infection. This is a retrospective cross sectional study. Hence, there were no comparative controls. The limitation of this study is,  thus the lack of control.

Heroin epidemics, treatment and ODE modelling.

Science.gov (United States)

White, Emma; Comiskey, Catherine

2007-07-01

The UN [United Nations Office on Drugs and Crime (UNODC): World Drug Report, 2005, vol. 1: Analysis. UNODC, 2005.], EU [European Monitoring Centre for Drugs and Drug Addiction (EMCDDA): Annual Report, 2005.http://annualreport.emcdda.eu.int/en/home-en.html.] and WHO [World Health Organisation (WHO): Biregional Strategy for Harm Reduction, 2005-2009. HIV and Injecting Drug Use. WHO, 2005.] have consistently highlighted in recent years the ongoing and persistent nature of opiate and particularly heroin use on a global scale. While this is a global phenomenon, authors have emphasised the significant impact such an epidemic has on individual lives and on society. National prevalence studies have indicated the scale of the problem, but the drug-using career, typically consisting of initiation, habitual use, a treatment-relapse cycle and eventual recovery, is not well understood. This paper presents one of the first ODE models of opiate addiction, based on the principles of mathematical epidemiology. The aim of this model is to identify parameters of interest for further study, with a view to informing and assisting policy-makers in targeting prevention and treatment resources for maximum effectiveness. An epidemic threshold value, R(0), is proposed for the drug-using career. Sensitivity analysis is performed on R(0) and it is then used to examine the stability of the system. A condition under which a backward bifurcation may exist is found, as are conditions that permit the existence of one or more endemic equilibria. A key result arising from this model is that prevention is indeed better than cure.

Hop-by-HopWorm Propagation with Carryover Epidemic Model in Mobile Sensor Networks

Directory of Open Access Journals (Sweden)

Jun-Won Ho

2015-10-01

Full Text Available In the internet, a worm is usually propagated in a random multi-hop contact manner. However, the attacker will not likely select this random multi-hop propagation approach in a mobile sensor network. This is because multi-hop worm route paths to random vulnerable targets can be often breached due to node mobility, leading to failure of fast worm spread under this strategy. Therefore, an appropriate propagation strategy is needed for mobile sensor worms. To meet this need, we discuss a hop-by-hop worm propagation model in mobile sensor networks. In a hop-by-hop worm propagation model, benign nodes are infected by worm in neighbor-to-neighbor spread manner. Since worm infection occurs in hop-by-hop contact, it is not substantially affected by a route breach incurred by node mobility. We also propose the carryover epidemic model to deal with the worm infection quota deficiency that might occur when employing an epidemic model in a mobile sensor network. We analyze worm infection capability under the carryover epidemic model. Moreover, we simulate hop-by-hop worm propagation with carryover epidemic model by using an ns-2 simulator. The simulation results demonstrate that infection quota carryovers are seldom observed where a node’s maximum speed is no less than 20 m/s.

A chaotic model for the epidemic of Ebola virus disease in West Africa (2013-2016)

Science.gov (United States)

Mangiarotti, Sylvain; Peyre, Marisa; Huc, Mireille

2016-11-01

An epidemic of Ebola Virus Disease (EVD) broke out in Guinea in December 2013. It was only identified in March 2014 while it had already spread out in Liberia and Sierra Leone. The spill over of the disease became uncontrollable and the epidemic could not be stopped before 2016. The time evolution of this epidemic is revisited here with the global modeling technique which was designed to obtain the deterministic models from single time series. A generalized formulation of this technique for multivariate time series is introduced. It is applied to the epidemic of EVD in West Africa focusing on the period between March 2014 and January 2015, that is, before any detected signs of weakening. Data gathered by the World Health Organization, based on the official publications of the Ministries of Health of the three main countries involved in this epidemic, are considered in our analysis. Two observed time series are used: the daily numbers of infections and deaths. A four-dimensional model producing a very complex dynamical behavior is obtained. The model is tested in order to investigate its skills and drawbacks. Our global analysis clearly helps to distinguish three main stages during the epidemic. A characterization of the obtained attractor is also performed. In particular, the topology of the chaotic attractor is analyzed and a skeleton is obtained for its structure.

Structured Modeling and Analysis of Stochastic Epidemics with Immigration and Demographic Effects.

Science.gov (United States)

Baumann, Hendrik; Sandmann, Werner

2016-01-01

Stochastic epidemics with open populations of variable population sizes are considered where due to immigration and demographic effects the epidemic does not eventually die out forever. The underlying stochastic processes are ergodic multi-dimensional continuous-time Markov chains that possess unique equilibrium probability distributions. Modeling these epidemics as level-dependent quasi-birth-and-death processes enables efficient computations of the equilibrium distributions by matrix-analytic methods. Numerical examples for specific parameter sets are provided, which demonstrates that this approach is particularly well-suited for studying the impact of varying rates for immigration, births, deaths, infection, recovery from infection, and loss of immunity.

Influenza surveillance in Europe. Comparing intensity levels calculated using the Moving Epidemic Method.

LENUS (Irish Health Repository)

Vega, Tomás

2015-05-30

Although influenza-like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge.

Effectiveness of influenza vaccine against laboratory-confirmed influenza, in the late 2011–2012 season in Spain, among population targeted for vaccination

Science.gov (United States)

2013-01-01

Background In Spain, the influenza vaccine effectiveness (VE) was estimated in the last three seasons using the observational study cycEVA conducted in the frame of the existing Spanish Influenza Sentinel Surveillance System. The objective of the study was to estimate influenza vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza-like illness (ILI) among the target groups for vaccination in Spain in the 2011–2012 season. We also studied influenza VE in the early (weeks 52/2011-7/2012) and late (weeks 8-14/2012) phases of the epidemic and according to time since vaccination. Methods Medically attended patients with ILI were systematically swabbed to collect information on exposure, laboratory outcome and confounding factors. Patients belonging to target groups for vaccination and who were swabbed 4 months, respectively, since vaccination. A decrease in VE with time since vaccination was only observed in individuals aged ≥ 65 years. Regarding the phase of the season, decreasing point estimates were only observed in the early phase, whereas very low or null estimates were obtained in the late phase for the shortest time interval. Conclusions The 2011–2012 influenza vaccine showed a low-to-moderate protective effect against medically attended, laboratory-confirmed influenza in the target groups for vaccination, in a late season and with a limited match between the vaccine and circulating strains. The suggested decrease in influenza VE with time since vaccination was mostly observed in the elderly population. The decreasing protective effect of the vaccine in the late part of the season could be related to waning vaccine protection because no viral changes were identified throughout the season. PMID:24053661

Contemporary Avian Influenza A Virus Subtype H1, H6, H7, H10, and H15 Hemagglutinin Genes Encode a Mammalian Virulence Factor Similar to the 1918 Pandemic Virus H1 Hemagglutinin

OpenAIRE

Qi, Li; Pujanauski, Lindsey M.; Davis, A. Sally; Schwartzman, Louis M.; Chertow, Daniel S.; Baxter, David; Scherler, Kelsey; Hartshorn, Kevan L.; Slemons, Richard D.; Walters, Kathie-Anne; Kash, John C.; Taubenberger, Jeffery K.

2014-01-01

ABSTRACT Zoonotic avian influenza virus infections may lead to epidemics or pandemics. The 1918 pandemic influenza virus has an avian influenza virus-like genome, and its H1 hemagglutinin was identified as a key mammalian virulence factor. A chimeric 1918 virus expressing a contemporary avian H1 hemagglutinin, however, displayed murine pathogenicity indistinguishable from that of the 1918 virus. Here, isogenic chimeric avian influenza viruses were constructed on an avian influenza virus backb...

Integrated Detection and Prediction of Influenza Activity for Real-Time Surveillance: Algorithm Design.

Science.gov (United States)

Spreco, Armin; Eriksson, Olle; Dahlström, Örjan; Cowling, Benjamin John; Timpka, Toomas

2017-06-15

Influenza is a viral respiratory disease capable of causing epidemics that represent a threat to communities worldwide. The rapidly growing availability of electronic "big data" from diagnostic and prediagnostic sources in health care and public health settings permits advance of a new generation of methods for local detection and prediction of winter influenza seasons and influenza pandemics. The aim of this study was to present a method for integrated detection and prediction of influenza virus activity in local settings using electronically available surveillance data and to evaluate its performance by retrospective application on authentic data from a Swedish county. An integrated detection and prediction method was formally defined based on a design rationale for influenza detection and prediction methods adapted for local surveillance. The novel method was retrospectively applied on data from the winter influenza season 2008-09 in a Swedish county (population 445,000). Outcome data represented individuals who met a clinical case definition for influenza (based on International Classification of Diseases version 10 [ICD-10] codes) from an electronic health data repository. Information from calls to a telenursing service in the county was used as syndromic data source. The novel integrated detection and prediction method is based on nonmechanistic statistical models and is designed for integration in local health information systems. The method is divided into separate modules for detection and prediction of local influenza virus activity. The function of the detection module is to alert for an upcoming period of increased load of influenza cases on local health care (using influenza-diagnosis data), whereas the function of the prediction module is to predict the timing of the activity peak (using syndromic data) and its intensity (using influenza-diagnosis data). For detection modeling, exponential regression was used based on the assumption that the beginning

Defining the sizes of airborne particles that mediate influenza transmission in ferrets.

Science.gov (United States)

Zhou, Jie; Wei, Jianjian; Choy, Ka-Tim; Sia, Sin Fun; Rowlands, Dewi K; Yu, Dan; Wu, Chung-Yi; Lindsley, William G; Cowling, Benjamin J; McDevitt, James; Peiris, Malik; Li, Yuguo; Yen, Hui-Ling

2018-03-06

Epidemics and pandemics of influenza are characterized by rapid global spread mediated by non-mutually exclusive transmission modes. The relative significance between contact, droplet, and airborne transmission is yet to be defined, a knowledge gap for implementing evidence-based infection control measures. We devised a transmission chamber that separates virus-laden particles by size and determined the particle sizes mediating transmission of influenza among ferrets through the air. Ferret-to-ferret transmission was mediated by airborne particles larger than 1.5 µm, consistent with the quantity and size of virus-laden particles released by the donors. Onward transmission by donors was most efficient before fever onset and may continue for 5 days after inoculation. Multiple virus gene segments enhanced the transmissibility of a swine influenza virus among ferrets by increasing the release of virus-laden particles into the air. We provide direct experimental evidence of influenza transmission via droplets and fine droplet nuclei, albeit at different efficiency. Copyright © 2018 the Author(s). Published by PNAS.

Avian influenza trasnmission risks: analysis of biosecuritiy measures and contact structure in Dutch poultry farming

NARCIS (Netherlands)

Ssematimba, A.; Hagenaars, T.H.J.; Wit, de J.J.; Ruiterkamp, F.; Fabri, T.H.F.; Stegeman, J.A.; Jong, de M.C.M.

2013-01-01

In the 2003 epidemic of highly pathogenic avian influenza in Dutch poultry, between-farm virus transmission continued for considerable time despite control measures. Gaining more insight into the mechanisms of this spread is necessary for the possible development of better control strategies. We

77 FR 41985 - Use of Influenza Disease Models To Quantitatively Evaluate the Benefits and Risks of Vaccines: A...

Science.gov (United States)

2012-07-17

... models to generate quantitative estimates of the benefits and risks of influenza vaccination. The public...] Use of Influenza Disease Models To Quantitatively Evaluate the Benefits and Risks of Vaccines: A... Influenza Disease Models to Quantitatively Evaluate the Benefits and Risks of Vaccines: A Technical Workshop...

Antibody Contributes to Heterosubtypic Immunity In the Cotton Rat Model of Influenza

Science.gov (United States)

2010-09-29

H1N2 swine influenza virus in pigs previously infected with H1N1 and/or H3N2 subtypes. Vaccine 21: 1375–1381. Wei, C.J., J.C. Boyington, P.M...contributes to heterosubtypic protection against influenza A-induced tachypnea in cotton rats" Name of Candidate: r. Timothy M. Straight Doctor of...Heterosubtypic Immunity In the Cotton Rat Model of Influenza " is appropriately acknowledged and, beyond brief excerpts, is with the permission of the

Agent-based financial dynamics model from stochastic interacting epidemic system and complexity analysis

International Nuclear Information System (INIS)

Lu, Yunfan; Wang, Jun; Niu, Hongli

2015-01-01

An agent-based financial stock price model is developed and investigated by a stochastic interacting epidemic system, which is one of the statistical physics systems and has been used to model the spread of an epidemic or a forest fire. Numerical and statistical analysis are performed on the simulated returns of the proposed financial model. Complexity properties of the financial time series are explored by calculating the correlation dimension and using the modified multiscale entropy method. In order to verify the rationality of the financial model, the real stock market indexes, Shanghai Composite Index and Shenzhen Component Index, are studied in comparison with the simulation data of the proposed model for the different infectiousness parameters. The empirical research reveals that this financial model can reproduce some important features of the real stock markets. - Highlights: • A new agent-based financial price model is developed by stochastic interacting epidemic system. • The structure of the proposed model allows to simulate the financial dynamics. • Correlation dimension and MMSE are applied to complexity analysis of financial time series. • Empirical results show the rationality of the proposed financial model

Agent-based financial dynamics model from stochastic interacting epidemic system and complexity analysis

Energy Technology Data Exchange (ETDEWEB)

Lu, Yunfan, E-mail: yunfanlu@yeah.net; Wang, Jun; Niu, Hongli

2015-06-12

An agent-based financial stock price model is developed and investigated by a stochastic interacting epidemic system, which is one of the statistical physics systems and has been used to model the spread of an epidemic or a forest fire. Numerical and statistical analysis are performed on the simulated returns of the proposed financial model. Complexity properties of the financial time series are explored by calculating the correlation dimension and using the modified multiscale entropy method. In order to verify the rationality of the financial model, the real stock market indexes, Shanghai Composite Index and Shenzhen Component Index, are studied in comparison with the simulation data of the proposed model for the different infectiousness parameters. The empirical research reveals that this financial model can reproduce some important features of the real stock markets. - Highlights: • A new agent-based financial price model is developed by stochastic interacting epidemic system. • The structure of the proposed model allows to simulate the financial dynamics. • Correlation dimension and MMSE are applied to complexity analysis of financial time series. • Empirical results show the rationality of the proposed financial model.

Epidemics spread in heterogeneous populations

Science.gov (United States)

Capała, Karol; Dybiec, Bartłomiej

2017-05-01

Individuals building populations are subject to variability. This variability affects progress of epidemic outbreaks, because individuals tend to be more or less resistant. Individuals also differ with respect to their recovery rate. Here, properties of the SIR model in inhomogeneous populations are studied. It is shown that a small change in model's parameters, e.g. recovery or infection rate, can substantially change properties of final states which is especially well-visible in distributions of the epidemic size. In addition to the epidemic size and radii distributions, the paper explores first passage time properties of epidemic outbreaks.

Low dimensional chaotic models for the plague epidemic in Bombay (1896–1911)

International Nuclear Information System (INIS)

Mangiarotti, Sylvain

2015-01-01

A plague epidemic broke out in Bombay in 1896 and became endemic. From 1905 to 1911, the epidemic was closely monitored by an Advisory Committee appointed to investigate the causes of the disease in any way. An impressive quantity of information was gathered, analyzed and published. Published data include records of the number of people who died from plague, and of the two main populations of rodents which were infected by plague in Bombay city. In the present paper, these data are revisited using a global modeling technique. This technique is applied to both single and multivariate observational time series. Several models are obtained for which a chaotic behavior can be observed. Obtaining such models proves that the dynamics of plague can be approximated by low-dimensional deterministic systems that can produce chaos. The multivariate models give a strong argument for interactive couplings between the epidemic and the epizootics of the two main species of rat. An interpretation of this coupling is given.

Real time bayesian estimation of the epidemic potential of emerging infectious diseases.

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Luís M A Bettencourt

Full Text Available BACKGROUND: Fast changes in human demographics worldwide, coupled with increased mobility, and modified land uses make the threat of emerging infectious diseases increasingly important. Currently there is worldwide alert for H5N1 avian influenza becoming as transmissible in humans as seasonal influenza, and potentially causing a pandemic of unprecedented proportions. Here we show how epidemiological surveillance data for emerging infectious diseases can be interpreted in real time to assess changes in transmissibility with quantified uncertainty, and to perform running time predictions of new cases and guide logistics allocations. METHODOLOGY/PRINCIPAL FINDINGS: We develop an extension of standard epidemiological models, appropriate for emerging infectious diseases, that describes the probabilistic progression of case numbers due to the concurrent effects of (incipient human transmission and multiple introductions from a reservoir. The model is cast in terms of surveillance observables and immediately suggests a simple graphical estimation procedure for the effective reproductive number R (mean number of cases generated by an infectious individual of standard epidemics. For emerging infectious diseases, which typically show large relative case number fluctuations over time, we develop a bayesian scheme for real time estimation of the probability distribution of the effective reproduction number and show how to use such inferences to formulate significance tests on future epidemiological observations. CONCLUSIONS/SIGNIFICANCE: Violations of these significance tests define statistical anomalies that may signal changes in the epidemiology of emerging diseases and should trigger further field investigation. We apply the methodology to case data from World Health Organization reports to place bounds on the current transmissibility of H5N1 influenza in humans and establish a statistical basis for monitoring its evolution in real time.

Trends of influenza B during the 2010-2016 seasons in 2 regions of north and south Italy: The impact of the vaccine mismatch on influenza immunisation strategy.

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Orsi, Andrea; Colomba, Giuseppina Maria Elena; Pojero, Fanny; Calamusa, Giuseppe; Alicino, Cristiano; Trucchi, Cecilia; Canepa, Paola; Ansaldi, Filippo; Vitale, Francesco; Tramuto, Fabio

2018-03-04

Influenza A and B viruses are responsible for respiratory infections, representing globally seasonal threats to human health. The 2 viral types often co-circulate and influenza B plays an important role in the spread of infection. A 6-year retrospective surveillance study was conducted between 2010 and 2016 in 2 large administrative regions of Italy, located in the north (Liguria) and in the south (Sicily) of the country, to describe the burden and epidemiology of both B/Victoria and B/Yamagata lineages in different healthcare settings. Influenza B viruses were detected in 5 of 6 seasonal outbreaks, exceeding influenza A during the season 2012-2013. Most of influenza B infections were found in children aged ≤ 14 y and significant differences were observed in the age-groups infected by the different lineages. B/Victoria strains prevailed in younger population than B/Yamagata, but also were more frequently found in the community setting. Conversely, B/Yamagata viruses were prevalent among hospitalized cases suggesting their potential role in the development of more severe disease. The relative proportions of viral lineages varied from year to year, resulting in different lineage-level mismatch for the B component of trivalent influenza vaccine. Our findings confirmed the need for continuous virological surveillance of seasonal epidemics and bring attention to the adoption of universal influenza immunization program in the childhood. The use of tetravalent vaccine formulations may be useful to improve the prevention and control of the influenza burden in general population.

Cloned defective interfering influenza virus protects ferrets from pandemic 2009 influenza A virus and allows protective immunity to be established.

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Nigel J Dimmock

Full Text Available Influenza A viruses are a major cause of morbidity and mortality in the human population, causing epidemics in the winter, and occasional worldwide pandemics. In addition there are periodic outbreaks in domestic poultry, horses, pigs, dogs, and cats. Infections of domestic birds can be fatal for the birds and their human contacts. Control in man operates through vaccines and antivirals, but both have their limitations. In the search for an alternative treatment we have focussed on defective interfering (DI influenza A virus. Such a DI virus is superficially indistinguishable from a normal virus but has a large deletion in one of the eight RNAs that make up the viral genome. Antiviral activity resides in the deleted RNA. We have cloned one such highly active DI RNA derived from segment 1 (244 DI virus and shown earlier that intranasal administration protects mice from lethal disease caused by a number of different influenza A viruses. A more cogent model of human influenza is the ferret. Here we found that intranasal treatment with a single dose of 2 or 0.2 µg 244 RNA delivered as A/PR/8/34 virus particles protected ferrets from disease caused by pandemic virus A/California/04/09 (A/Cal; H1N1. Specifically, 244 DI virus significantly reduced fever, weight loss, respiratory symptoms, and infectious load. 244 DI RNA, the active principle, was amplified in nasal washes following infection with A/Cal, consistent with its amelioration of clinical disease. Animals that were treated with 244 DI RNA cleared infectious and DI viruses without delay. Despite the attenuation of infection and disease by DI virus, ferrets formed high levels of A/Cal-specific serum haemagglutination-inhibiting antibodies and were solidly immune to rechallenge with A/Cal. Together with earlier data from mouse studies, we conclude that 244 DI virus is a highly effective antiviral with activity potentially against all influenza A subtypes.

Epidemics in adaptive networks with community structure

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Shaw, Leah; Tunc, Ilker

2010-03-01

Models for epidemic spread on static social networks do not account for changes in individuals' social interactions. Recent studies of adaptive networks have modeled avoidance behavior, as non-infected individuals try to avoid contact with infectives. Such models have not generally included realistic social structure. Here we study epidemic spread on an adaptive network with community structure. We model the effect of heterogeneous communities on infection levels and epidemic extinction. We also show how an epidemic can alter the community structure.

Bayesian conditional-independence modeling of the AIDS epidemic in England and Wales

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Gilks, Walter R.; De Angelis, Daniela; Day, Nicholas E.

We describe the use of conditional-independence modeling, Bayesian inference and Markov chain Monte Carlo, to model and project the HIV-AIDS epidemic in homosexual/bisexual males in England and Wales. Complexity in this analysis arises through selectively missing data, indirectly observed underlying processes, and measurement error. Our emphasis is on presentation and discussion of the concepts, not on the technicalities of this analysis, which can be found elsewhere [D. De Angelis, W.R. Gilks, N.E. Day, Bayesian projection of the the acquired immune deficiency syndrome epidemic (with discussion), Applied Statistics, in press].

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

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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

[Influenza surveillance in nine consecutive seasons, 2003-2012: results from National Influenza Reference Laboratory, Istanbul Faculty Of Medicine, Turkey].

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Akçay Ciblak, Meral; Kanturvardar Tütenyurd, Melis; Asar, Serkan; Tulunoğlu, Merve; Fındıkçı, Nurcihan; Badur, Selim

2012-10-01

Influenza is a public health problem that affects 5-20% of the world population annually causing high morbidity and mortality especially in risk groups. In addition to determining prevention and treatment strategies with vaccines and antivirals, surveillance data plays an important role in combat against influenza. Surveillance provides valuable data on characteristics of influenza activity, on types, sub-types, antigenic properties and antiviral resistance profile of circulating viruses in a given region. The first influenza surveillance was initiated as a pilot study in 2003 by now named National Influenza Reference Laboratory, Istanbul Faculty of Medicine. Surveillance was launched at national level by Ministry of Health in 2004 and two National Influenza Laboratories, one in Istanbul and the other in Ankara, have been conducting surveillance in Turkey. Surveillance data obtained for nine consecutive years, 2003-2012, by National Influenza Reference Laboratory in Istanbul Faculty of Medicine have been summarized in this report. During 2003-2012 influenza surveillance seasons, a total of 11.077 nasal swabs collected in viral transport medium were sent to the National Influenza Reference Laboratory, Istanbul for analysis. Immun-capture ELISA followed by MDCK cell culture was used for detection of influenza viruses before 2009 and real-time RT-PCR was used thereafter. Antigenic characterizations were done by hemagglutination inhibition assay with the reactives supplied by World Health Organization. Analysis of the results showed that influenza B viruses have entered the circulation in 2005-2006 seasons, and have contributed to the epidemics at increasing rates every year except in the 2009 pandemic season. Influenza B Victoria and Yamagata lineages were cocirculating for two seasons. For other seasons either lineage was in circulation. Antigenic characterization revealed that circulating B viruses matched the vaccine composition either partially or totally for only

Stochastic inequalities and applications to dynamics analysis of a novel SIVS epidemic model with jumps

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Xiaona Leng

2017-06-01

Full Text Available Abstract This paper proposes a new nonlinear stochastic SIVS epidemic model with double epidemic hypothesis and Lévy jumps. The main purpose of this paper is to investigate the threshold dynamics of the stochastic SIVS epidemic model. By using the technique of a series of stochastic inequalities, we obtain sufficient conditions for the persistence in mean and extinction of the stochastic system and the threshold which governs the extinction and the spread of the epidemic diseases. Finally, this paper describes the results of numerical simulations investigating the dynamical effects of stochastic disturbance. Our results significantly improve and generalize the corresponding results in recent literatures. The developed theoretical methods and stochastic inequalities technique can be used to investigate the high-dimensional nonlinear stochastic differential systems.

Structured Modeling and Analysis of Stochastic Epidemics with Immigration and Demographic Effects.

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Hendrik Baumann

Full Text Available Stochastic epidemics with open populations of variable population sizes are considered where due to immigration and demographic effects the epidemic does not eventually die out forever. The underlying stochastic processes are ergodic multi-dimensional continuous-time Markov chains that possess unique equilibrium probability distributions. Modeling these epidemics as level-dependent quasi-birth-and-death processes enables efficient computations of the equilibrium distributions by matrix-analytic methods. Numerical examples for specific parameter sets are provided, which demonstrates that this approach is particularly well-suited for studying the impact of varying rates for immigration, births, deaths, infection, recovery from infection, and loss of immunity.

Trends in global warming and evolution of matrix protein 2 family from influenza A virus.

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Yan, Shao-Min; Wu, Guang

2009-12-01

The global warming is an important factor affecting the biological evolution, and the influenza is an important disease that threatens humans with possible epidemics or pandemics. In this study, we attempted to analyze the trends in global warming and evolution of matrix protein 2 family from influenza A virus, because this protein is a target of anti-flu drug, and its mutation would have significant effect on the resistance to anti-flu drugs. The evolution of matrix protein 2 of influenza A virus from 1959 to 2008 was defined using the unpredictable portion of amino-acid pair predictability. Then the trend in this evolution was compared with the trend in the global temperature, the temperature in north and south hemispheres, and the temperature in influenza A virus sampling site, and species carrying influenza A virus. The results showed the similar trends in global warming and in evolution of M2 proteins although we could not correlate them at this stage of study. The study suggested the potential impact of global warming on the evolution of proteins from influenza A virus.

Effects of closing and reopening live poultry markets on the epidemic of human infection with avian influenza A virus

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Lu, Jian; Liu, Wendong; Xia, Rui; Dai, Qigang; Bao, Changjun; Tang, Fenyang; Zhu, yefei; Wang, Qiao

2015-01-01

Abstract Live poultry markets (LPMs) are crucial places for human infection of influenza A (H7N9 virus). In Yangtze River Delta, LPMs were closed after the outbreak of human infection with avian influenza A (H7N9) virus, and then reopened when no case was found. Our purpose was to quantify the effect of LPMs? operations in this region on the transmission of influenza A (H7N9) virus. We obtained information about dates of symptom onset and locations for all human influenza A (H7N9) cases repor...

Investigation of influenza in migrating birds, the primordial reservoir and transmitters of influenza in Brazil Investigação de influenza em aves migratórias, principal reservatório e transporte de influenza no Brasil

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Adélia Hiroko Nagamori Kawamoto

2005-03-01

Full Text Available Birds are the most important reservoirs of the influenza virus. Its maintenance in its natural hosts, including man, allows the influenza virus to reassorts its strains. The recent report of an avian influenza A (H5N1 virus in humans, was in a child with fatal respiratory illness in China, 1997. The current study was conducted to elucidate the transportation of the influenza by birds that migrate, annually, through the both Northern and Southern hemispheres, with special attention paid to the Vireo olivaceus [Juruviara(BR or Red-eyed vireo(USA] species, which travels from the USA to Brazil, and vice versa, and the Elaenia mesoleuca [Tuque(BR or (USA] species that flies over the entire Southern Hemisphere. There are two species of birds, which breed and migrate in São Paulo State, Brazil, and which were demonstrated to carry Influenza virus, were selected. The viral particles isolated were observed by electron microscopy. The influenza virus was detected by the House Duplex/PCR and Gloria molecular biology tests. The results demonstrated that the Elaenia mesoleuca and Vireo olivaceus bird species are carrying the Influenza virus whilst crossing both the Northern and Southern hemispheres. To understand the role that these migrating birds may play in epidemic influenza, in Brazil, characterization of avian influenza subtypes will be done.Os mais importantes reservatórios do vírus influenza são os pássaros. A manutenção do vírus influenza em hospedeiros naturais, inclusive o homem, permite que esse vírus realize rearranjos entre as suas cepas. O recente relato de uma cepa influenza aviária A(H5N1, em humanos, se deu em uma criança com doença respiratória fatal, na China em 1977. O presente estudo foi conduzido para elucidar o transporte da influenza por pássaros que migram, anualmente, através de ambos hemisférios o do Norte e do Sul, com especial atenção voltada à espécies Vireo olivaceo [Juruviara(BR e Red-eyed vireo(USA] que

[Burden of influenza virus type B and mismatch with the flu vaccine in Spain].

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Eiros-Bouza, Jose Ma; Pérez-Rubio, Alberto

2015-02-01

Since the 80s two lineages of type B viruses are co - circulating in the world. Antigenic differences between them are important and it leads to lack of cross-reactivity. The impact on the burden of disease due to influenza B virus, poor foresight in estimating which of the two lineages of B viruses circulate in the season, and the consequent lack of immunity in case of including the wrong strain make that the availability of the quadrivalent vaccine is very useful. The aim of this paper is to analyze the past influenza seasons in Spain to assess the burden of disease, divergence between the vaccine strain and the circulating B and viral characteristics associated with type B in each seasonal epidemic. Review of all reports issued by the Influenza Surveillance System in Spain since the 2003-2004 season to 2012-2013. Over the past influenza seasons, although type A was present mostly, circulation of influenza B virus in each season was observed, even being co - dominant in some of them. In a high number of seasons the divergence between the vaccine strain and the circulating strain lineage has been observed The protective effect of influenza vaccine has varied depending on the type / subtype of influenza virus studied. The vaccine effectiveness against influenza infection by influenza B virus has varied greatly depending on the season analyzed.

On the modeling of epidemics under the influence of risk perception

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De Lillo, S.; Fioriti, G.; Prioriello, M.L.

2017-01-01

An epidemic spreading model is presented in the framework of the kinetic theory of active particles. The model is characterized by the influence of risk perception which can reduce the diffusion of infection. The evolution of the system is modeled through nonlinear interactions, whose output is

Influenza A (H1N1)pnd09 Vaccination of Pregnant Women and Immunological Consequences for Their Offspring

DEFF Research Database (Denmark)

Bischoff, Anne Louise

2013-01-01

against H1N1pnd09 according to the EMEA criteria with a HI titre of 40 or greater. Women receiving the non-adjuvanted vaccine had significantly fewer local reactions but similar rates of systemic reactions as women receiving the adjuvanted vaccine. There were no reports of serious adverse events in any......Pregnant women experience increased influenza related morbidity and mortality during seasonal influenza epidemics, and even graver outcomes during influenza pandemics. Thus, even though the huge amount of data on clinical efficacy and effectiveness of influenza vaccine in pregnant women......, there is limited information on the details of the immunological responses to influenza immunization in pregnant versus non-pregnant. We had the unique opportunity to study the H1N1pnd09 vaccination of pregnant and non-pregnant women in our unselected, prospective, clinical pregnancy-cohort: the Copenhagen...

A spatially explicit model for the future progression of the current Haiti cholera epidemic

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Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Rodriguez-Iturbe, I.; Rinaldo, A.

2011-12-01

As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to July 2011, climb to 385,000 cases and 5,800 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of textit{Vibrio cholera}, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan texttrademark project). The model directly account for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations, clean water supply and educational campaigns, thus emerging as an essential component of the control of future cholera