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Sample records for swine-origin h1n1 s-oiv

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

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

    2012-07-15

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

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

    International Nuclear Information System (INIS)

    Jo, Bang Sil; Lee, In Jae; Lee, Kwanseop; Im, Hyoung June

    2012-01-01

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

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

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    Schoop Roland

    2009-11-01

    Full Text Available Abstract Background Influenza virus (IV infections are a major threat to human welfare and animal health worldwide. Anti-viral therapy includes vaccines and a few anti-viral drugs. However vaccines are not always available in time, as demonstrated by the emergence of the new 2009 H1N1-type pandemic strain of swine origin (S-OIV in April 2009, and the acquisition of resistance to neuraminidase inhibitors such as Tamiflu® (oseltamivir is a potential problem. Therefore the prospects for the control of IV by existing anti-viral drugs are limited. As an alternative approach to the common anti-virals we studied in more detail a commercial standardized extract of the widely used herb Echinacea purpurea (Echinaforce®, EF in order to elucidate the nature of its anti-IV activity. Results Human H1N1-type IV, highly pathogenic avian IV (HPAIV of the H5- and H7-types, as well as swine origin IV (S-OIV, H1N1, were all inactivated in cell culture assays by the EF preparation at concentrations ranging from the recommended dose for oral consumption to several orders of magnitude lower. Detailed studies with the H5N1 HPAIV strain indicated that direct contact between EF and virus was required, prior to infection, in order to obtain maximum inhibition in virus replication. Hemagglutination assays showed that the extract inhibited the receptor binding activity of the virus, suggesting that the extract interferes with the viral entry into cells. In sequential passage studies under treatment in cell culture with the H5N1 virus no EF-resistant variants emerged, in contrast to Tamiflu®, which produced resistant viruses upon passaging. Furthermore, the Tamiflu®-resistant virus was just as susceptible to EF as the wild type virus. Conclusion As a result of these investigations, we believe that this standard Echinacea preparation, used at the recommended dose for oral consumption, could be a useful, readily available and affordable addition to existing control options

  4. Characterization of cross protection of Swine-Origin Influenza Virus (S-OIV) H1N1 and reassortant H5N1 influenza vaccine in BALB/c mice given a single-dose vaccination.

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    Lin, Hui-Tsu; Chuang, Chuan-Chang; Wu, Hsieh-Ling; Chu, Der-Ming; Wang, Yeau-Ching

    2013-03-21

    Influenza virus has antigen drift and antigen shift effect, vaccination with some influenza vaccine might not induce sufficient immunity for host to the threat of other influenza virus strains. S-OIV H1N1 and H5N1 influenza vaccines in single-dose immunization were evaluated in mice for cross protection to the challenge of A/California/7/2009 H1N1 or NIBRG-14 H5N1 virus. Both H1N1 and H5N1 induced significant homologous IgG, HAI, and microneutralization antibody responses in the mice, while only vaccines plus adjuvant produced significant heterogeneous IgG and HAI antibody responses. Both alum and MPLA adjuvants significantly reduced the S-OIV H1N1 vaccine dose required to elicit protective HAI antibody titers from 0.05 μg to 0.001 μg. Vaccines alone did not protect mice from challenge with heterogeneous influenza virus, while H5N1 vaccine plus alum and MPLA adjuvants did. Mouse body weight loss was also less significant in the presence of adjuvant than in the vaccine without adjuvant. Furthermore, both H1N1 and H5N1 lung viral titers of immunized mice were significantly reduced post challenge with homologous viruses. Only in the presence of MPLA adjuvant could the H5N1 vaccine significantly reduce mouse lung viral titers post H1N1 virus challenge, and not vice versa. MPLA adjuvant induced cross protection with a single dose vaccination to the challenge of heterogeneous influenza virus in mice. Lung viral titer seemed to be a better indicator compared to IgG, neutralization antibody, and HAI titer to predict survival of mice infected with influenza virus.

  5. 2009 Swine-origin influenza A (H1N1 resembles previous influenza isolates.

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    Carl Kingsford

    2009-07-01

    Full Text Available In April 2009, novel swine-origin influenza viruses (S-OIV were identified in patients from Mexico and the United States. The viruses were genetically characterized as a novel influenza A (H1N1 strain originating in swine, and within a very short time the S-OIV strain spread across the globe via human-to-human contact.We conducted a comprehensive computational search of all available sequences of the surface proteins of H1N1 swine influenza isolates and found that a similar strain to S-OIV appeared in Thailand in 2000. The earlier isolates caused infections in pigs but only one sequenced human case, A/Thailand/271/2005 (H1N1.Differences between the Thai cases and S-OIV may help shed light on the ability of the current outbreak strain to spread rapidly among humans.

  6. rapidSTRIPE H1N1 Test for Detection of the Pandemic Swine Origin Influenza A (H1N1) Virus▿

    OpenAIRE

    Patel, Pranav; Graser, Elmara; Robst, Stephan; Hillert, Roger; Meye, Axel; Hillebrand, Timo; Niedrig, Matthias

    2011-01-01

    The rapidSTRIPE H1N1 test, based on a nucleic acid lateral-flow assay, has been developed for diagnosis of a swine-origin influenza A (H1N1) virus. This test is simple and cost-effective and allows specific detection of the S-OIV A (H1N1) virus from swab sampling to final detection on a lateral-flow stripe within 2 to 3 h.

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

    Science.gov (United States)

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

    2010-08-01

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

  8. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico.

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    Perez-Padilla, Rogelio; de la Rosa-Zamboni, Daniela; Ponce de Leon, Samuel; Hernandez, Mauricio; Quiñones-Falconi, Francisco; Bautista, Edgar; Ramirez-Venegas, Alejandra; Rojas-Serrano, Jorge; Ormsby, Christopher E; Corrales, Ariel; Higuera, Anjarath; Mondragon, Edgar; Cordova-Villalobos, Jose Angel

    2009-08-13

    In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu. We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay. From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized. S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe. 2009 Massachusetts Medical Society

  9. Outbreak of swine-origin influenza A (H1N1) virus infection - Mexico, March-April 2009.

    Science.gov (United States)

    2009-05-08

    In March and early April 2009, Mexico experienced outbreaks of respiratory illness and increased reports of patients with influenza-like illness (ILI) in several areas of the country. On April 12, the General Directorate of Epidemiology (DGE) reported an outbreak of ILI in a small community in the state of Veracruz to the Pan American Health Organization (PAHO) in accordance with International Health Regulations. On April 17, a case of atypical pneumonia in Oaxaca State prompted enhanced surveillance throughout Mexico. On April 23, several cases of severe respiratory illness laboratory confirmed as swine-origin influenza A (H1N1) virus (S-OIV) infection were communicated to the PAHO. Sequence analysis revealed that the patients were infected with the same S-OIV strain detected in two children residing in California. This report describes the initial and ongoing investigation of the S-OIV outbreak in Mexico.

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

    International Nuclear Information System (INIS)

    Qi Wenxu; Liu Junpeng; Gao Song; Guo Qiyong

    2010-01-01

    Objective: To explore the manifestations of chest multi-slice spiral CT in patients with initial infection of swine-origin influenza A (H1N1) virus (S-OIV). Methods: The chest multi-slices spirals CT images of 19 firstly diagnosed patients with swine-origin influenza A (H1N1) in our institution were retrospectively studied. CT manifestations were evaluated by three experienced radiologists. Location, appearance of lung abnormalities, abnormal distribution, pleural effusion and others (pericadiaum, lymphadenopathy and pleural thickening) were observed and quantitatively analyzed. The correlation of ground-glass and consolidation CT scores with the fever time was studied. Results: The abnormal CT findings were observed bilaterally in 18 of 19 subjects including ground-glass (n=3), consolidation (n=3), consolidation accompanied with ground-glass (n=12). Most of these lesions were distributed diffusively (n=14) while the others located in the middle and low lobes (n=4). Unilateral (n=3) or bilateral (n=2) pleural effusion were observed. Lymphadenopathy (n=2), effusion of pericadium (n=1), pleural thickening (n=1) and cardiac enlargement (n=2) were also found in patients with H1N1. CT scores of ground-glass were 4.25 (n=2), 3.75 (n=1), 2.25 (n=1), 1.75 (n=1), 1.00 (n=6), 0.75 (n=2), 0.50 (n=2), 0 (n=4). CT scores of consolidation were 4.25 (n=1), 4.00 (n=1), 3.75 (n=1), 2.75 (n=1), 1.25 (n=3), 1.00 (n=2), 0.75 (n=2), 0.50 (n=1), 0.25 (n=3), 0 (n=4). CT scores of ground-glass were significantly correlated with the fever time (r=0.776, P 0.01). Conclusions: The most common CT findings in patients with S-OIV infection are diffuse distribution of bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. The increasing of ground-glass's range could be the marker of progression of H1N1 pulmonary infection at initial stage. (authors)

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

    Science.gov (United States)

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

    2011-03-01

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

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

    International Nuclear Information System (INIS)

    Li Ping; Su Dongju; Zhang Jifeng; Xia Xudong; Sui Hong; Zhao Donghui

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    Yamada, Kentaro; Shinmoto, Hiroshi; Hamamoto, Manabu; Yoshida, Yusuke; Kawauchi, Toshio; Kaji, Tatsumi; Kosuda, Shigeru

    2011-01-01

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

  14. Swine-origin influenza A viral (H1N1) infection in children. Chest computed tomography findings

    International Nuclear Information System (INIS)

    Im, Soo-Ah; Kim, Hyo-Lim; Yoon, Jong-seo; Kang, Jin-Han; Lee, Joon-Sung; Chun, Ho-Jong

    2011-01-01

    The aim of this study was to review the chest computed tomography (CT) findings in children with swine-origin influenza (H1N1) virus (S-OIV) infection. The radiologists retrospectively reviewed chest CT findings in 12 children with S-OIV infection and recorded the following findings: ground-glass opacities (GGO), consolidation, nodules, reticular opacities, peribronchial cuffing, and air trapping; distribution; affected lobes. The presence of pleural effusions, pneumomediastinum, pulmonary interstitial emphysema (PIE), and lymphadenopathy was also recorded. Chest CT revealed GGO (67%), consolidation (67%), nodules (25%), peribronchial cuffing (42%), and air trapping (33%). The distribution of the lesions was random (75%), peribronchial (17%), or subpleural (8%). The lobes affected were the lower (92%), upper (58%), and middle (17%) lobes. There were associated pleural effusions (42%), PIE (42%), pneumomediastinum (33%), and lymphadenopathy (75%). Among five patients with air-leak complications, three had a history of allergies and three required the intensive care unit. Chest CT findings in children with S-OIV infection were peribronchial thickening and a mixture of airspace consolidation and GGO with random distribution and lower lobe predominance. Pleural effusion, lymphadenopathy, PIE, and pneumomediastinum may be associated findings. (author)

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

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

    2011-11-15

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

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

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    Shukla Jyoti

    2011-06-01

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

  17. Pathogenesis and transmission of swine-origin 2009 A(H1N1) influenza virus in ferrets

    NARCIS (Netherlands)

    V.J. Munster (Vincent); E. de Wit (Emmie); J.M.A. van den Brand (Judith); S. Herfst (Sander); E.J.A. Schrauwen (Eefje); T.M. Bestebroer (Theo); D.A.M.C. van de Vijver (David); C.A.B. Boucher (Charles); M.P.G. Koopmans D.V.M. (Marion); G.F. Rimmelzwaan (Guus); T. Kuiken (Thijs); A.D.M.E. Osterhaus (Albert); R.A.M. Fouchier (Ron)

    2009-01-01

    textabstractThe swine-origin A(H1N1) influenza virus that has emerged in humans in early 2009 has raised concerns about pandemic developments. In a ferret pathogenesis and transmission model, the 2009 A(H1N1) influenza virus was found to be more pathogenic than a seasonal A(H1N1) virus, with more

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

    Science.gov (United States)

    2009-01-01

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

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

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    Swati Kumar

    2009-06-01

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

  20. Swine- Origin Influenza A (H1N1) Pandemic Revisited | Mathew ...

    African Journals Online (AJOL)

    Since the beginning of January 2008 sporadic cases of infections in humans caused by influenza A (H1N1) virus- resistant to available anti-influenza drugs have been reported worldwide [1,2]. The World Health Organization (WHO) in its report published on 18 March 2009 indicated that during weeks 1- 4 (28 December ...

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

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

    2011-06-15

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

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

    International Nuclear Information System (INIS)

    Bae, So Young; Hong, Eun Sook; Paik, Sang Hyun; Park, Seong Jin; Cha, Jang Gyu; Lee, Hae Kyung; Jang, Yun Woo

    2011-01-01

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

  3. Potential Intensive Care unit Ventilator Demand/Capacity Mismatch due to Novel Swine-Origin H1N1 in Canada

    Directory of Open Access Journals (Sweden)

    Paul Smetanin

    2009-01-01

    Full Text Available PURPOSE: To investigate the ability of Canadian intensive care units (ICUs and ventilators to handle widespread re-emergence of the swine-origin H1N1 virus in the context of an aggressive strategy of vaccination.

  4. Corticosteroid treatment ameliorates acute lung injury induced by 2009 swine origin influenza A (H1N1 virus in mice.

    Directory of Open Access Journals (Sweden)

    Chenggang Li

    Full Text Available BACKGROUND: The 2009 influenza pandemic affected people in almost all countries in the world, especially in younger age groups. During this time, the debate over whether to use corticosteroid treatment in severe influenza H1N1 infections patients resurfaced and was disputed by clinicians. There is an urgent need for a susceptible animal model of 2009 H1N1 infection that can be used to evaluate the pathogenesis and the therapeutic effect of corticosteroid treatment during infection. METHODOLOGY/PRINCIPAL FINDINGS: We intranasally inoculated two groups of C57BL/6 and BALB/c mice (using 4- or 6-to 8-week-old mice to compare the pathogenesis of several different H1N1 strains in mice of different ages. Based on the results, a very susceptible 4-week-old C57BL/6 mouse model of Beijing 501 strain of 2009 H1N1 virus infection was established, showing significantly elevated lung edema and cytokine levels compared to controls. Using our established animal model, the cytokine production profile and lung histology were assessed at different times post-infection, revealing increased lung lesions in a time-dependent manner. In additional,the mice were also treated with dexamethasone, which significantly improved survival rate and lung lesions in infected mice compared to those in control mice. Our data showed that corticosteroid treatment ameliorated acute lung injury induced by the 2009 A/H1N1 virus in mice and suggested that corticosteroids are valid drugs for treating 2009 A/H1N1 infection. CONCLUSIONS/SIGNIFICANCE: Using the established, very susceptible 2009 Pandemic Influenza A (H1N1 mouse model, our studies indicate that corticosteroids are a potential therapeutic remedy that may address the increasing concerns over future 2009 A/H1N1 pandemics.

  5. Antigenically diverse swine-origin H1N1 variant influenza viruses exhibit differential ferret pathogenesis and transmission phenotypes.

    Science.gov (United States)

    Pulit-Penaloza, Joanna A; Jones, Joyce; Sun, Xiangjie; Jang, Yunho; Thor, Sharmi; Belser, Jessica A; Zanders, Natosha; Creager, Hannah M; Ridenour, Callie; Wang, Li; Stark, Thomas J; Garten, Rebecca; Chen, Li-Mei; Barnes, John; Tumpey, Terrence M; Wentworth, David E; Maines, Taronna R; Davis, C Todd

    2018-03-14

    Influenza A(H1) viruses circulating in swine represent an emerging virus threat as zoonotic infections occur sporadically following exposure to swine. A fatal infection caused by an H1N1 variant (H1N1v) virus was detected in a patient with reported exposure to swine and who presented with pneumonia, respiratory failure, and cardiac arrest. To understand the genetic and phenotypic characteristics of the virus, genome sequence analysis, antigenic characterization, and ferret pathogenesis and transmissibility experiments were performed. Antigenic analysis of the virus isolated from the fatal case, A/Ohio/09/2015, demonstrated significant antigenic drift away from classical swine H1N1 variant viruses and H1N1 pandemic 2009 viruses. A substitution in the H1 hemagglutinin (G155E) was identified that likely impacted antigenicity, and reverse genetics was employed to understand the molecular mechanism of antibody escape. Reversion of the substitution to 155G, in a reverse genetics A/Ohio/09/2015 virus, showed that this residue was central to the loss of hemagglutination inhibition by ferret antisera raised against a prototypical H1N1 pandemic 2009 virus (A/California/07/2009), as well as gamma lineage classical swine H1N1 viruses, demonstrating the importance of this residue for antibody recognition of this H1 lineage. When analyzed in the ferret model, A/Ohio/09/2015 and another H1N1v virus (A/Iowa/39/2015), as well as A/California/07/2009, replicated efficiently in the respiratory tract of ferrets. The two H1N1v viruses transmitted efficiently among cohoused ferrets, but respiratory droplet transmission studies showed that A/California/07/2009 transmitted through the air more efficiently. Pre-existing immunity to A/California/07/2009 did not fully protect ferrets from challenge with A/Ohio/09/2015. IMPORTANCE Human infections with classical swine influenza A(H1N1) viruses that circulate in pigs continue to occur in the United States following exposure to swine. To

  6. High mortality from respiratory failure secondary to swine-origin influenza A (H1N1) in South Africa.

    Science.gov (United States)

    Koegelenberg, C F N; Irusen, E M; Cooper, R; Diacon, A H; Taljaard, J J; Mowlana, A; von Groote-Bidlingmaier, F; Bolliger, C T

    2010-05-01

    The novel influenza A (H1N1) pandemic affected South Africa late during the 2009 Southern hemisphere winter and placed an extra burden on a health care system already dealing with a high prevalence of chronic lung diseases and human immunodeficiency virus (HIV) infection. The aim of this study was to describe the epidemiological characteristics, clinical features, management and outcomes of patients with confirmed influenza A (H1N1) infection complicated by respiratory failure. We included all adult patients with confirmed influenza A (H1N1) infection that were referred to the medical intensive care unit of a large academic hospital in Cape Town for ventilatory support in this prospective observational study. A total of 19 patients (39.5 +/- 14.8 years) needed ventilatory support over a 6-week period. Of these, 15 were female and 16 had identifiable risk factors for severe disease, including pregnancy (n = 6), type 2 diabetes mellitus (n = 6), obesity (n = 4), HIV infection (n = 3), immunosuppressive therapy (n = 3) and active pulmonary tuberculosis (n = 2). The most frequent complications were acute renal failure (n = 13), acute respiratory distress syndrome (n = 12) and ventilator associated pneumonia (n = 10). Thirteen patients died (mortality: 68.4%). Fatal cases were significantly associated with an APACHE II score >or=20 (P = 0.034), but not with a P(a)O(2)/F(I)O(2) or=12 (P = 0.134). The majority of patients with respiratory failure secondary to influenza A (H1N1) infection were young females and had an underlying risk factor for severe disease. The condition had a high mortality, particularly amongst patients with an APACHE II score >or=20.

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    James Holland Jones

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

  9. Microneedle Vaccination Elicits Superior Protection and Antibody Response over Intranasal Vaccination against Swine-Origin Influenza A (H1N1 in Mice.

    Directory of Open Access Journals (Sweden)

    Ju-Hyung Shin

    Full Text Available Influenza is one of the critical infectious diseases globally and vaccination has been considered as the best way to prevent. In this study, immunogenicity and protection efficacy between intranasal (IN and microneedle (MN vaccination was compared using inactivated swine-origin influenza A/H1N1 virus vaccine. Mice were vaccinated by MN or IN administration with 1 μg of inactivated H1N1 virus vaccine. Antigen-specific antibody responses and hemagglutination-inhibition (HI titers were measured in all immunized sera after immunization. Five weeks after an immunization, a lethal challenge was performed to evaluate the protective efficacy. Furthermore, mice were vaccinated by IN administration with higher dosages (> 1 μg, analyzed in the same manner, and compared with 1 μg-vaccine-coated MN. Significantly higher antigen-specific antibody responses and HI titer were measured in sera in MN group than those in IN group. While 100% protection, slight weight loss, and reduced viral replication were observed in MN group, 0% survival rate were observed in IN group. As vaccine dose for IN vaccination increased, MN-immunized sera showed much higher antigen-specific antibody responses and HI titer than other IN groups. In addition, protective immunity of 1 μg-MN group was similar to those of 20- and 40 μg-IN groups. We conclude that MN vaccination showed more potential immune response and protection than IN vaccination at the same vaccine dosage.

  10. Protection of pigs against pandemic swine origin H1N1 influenza A virus infection by hemagglutinin- or neuraminidase-expressing attenuated pseudorabies virus recombinants.

    Science.gov (United States)

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

    2015-03-02

    Influenza is an important respiratory disease of pigs, and may lead to novel human pathogens like the 2009 pandemic H1N1 swine-origin influenza virus (SoIV). Therefore, improved influenza vaccines for pigs are required. Recently, we demonstrated that single intranasal immunization with a hemagglutinin (HA)-expressing pseudorabies virus recombinant of vaccine strain Bartha (PrV-Ba) protected pigs from H1N1 SoIV challenge (Klingbeil et al., 2014). Now we investigated enhancement of efficacy by prime-boost vaccination and/or intramuscular administration. Furthermore, a novel PrV-Ba recombinant expressing codon-optimized N1 neuraminidase (NA) was included. In vitro replication of this virus was only slightly affected compared to parental virus. Unlike HA, the abundantly expressed NA was efficiently incorporated into PrV particles. Immunization of pigs with the two PrV recombinants, either singly or in combination, induced B cell proliferation and the expected SoIV-specific antibodies, whose titers increased substantially after boost vaccination. After immunization of animals with either PrV recombinant H1N1 SoIV challenge virus replication was significantly reduced compared to PrV-Ba vaccinated or naïve controls. Protective efficacy of HA-expressing PrV was higher than of NA-expressing PrV, and not significantly enhanced by combination. Despite higher serum antibody titers obtained after intramuscular immunization, transmission of challenge virus to naïve contact animals was only prevented after intranasal prime-boost vaccination with HA-expressing PrV-Ba. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Difference between early clinical features of swine origin A H1N1 influenza confirmed and not confirmed infection in Mexico.

    Science.gov (United States)

    Rodríguez-Valero, Monica; Prado Calleros, Hector Manuel; Bravo Escobar, Gerardo Arturo; Valdez Vázquez, Rafael Ricardo; Figueroa Moreno, Rafael; Martínez Montes, Guillermo; Kawa Karasik, Simón

    2012-04-13

    The Swine Origin A H1N1 Influenza Virus (SOIV) pandemic emerged in April 2009 affecting people and health-care systems worldwide. This study examined the differences among the early clinical features presented in confirmed SOIV cases, those who tested negative for SOIV infection, fatalities, and hospitalized cases. We reviewed 1,024 initial medical records of patients presenting with acute respiratory symptoms who attended the respiratory emergency room of a general hospital in Mexico and had a confirmatory test for influenza AH1N1 by RT-PCR from April to December 2009. Out of 1,024 cases, 457 (44%) were men with a mean age of 31±17 years; however, of these, SOIV confirmed cases were younger (26±8, p=0.000). SOIV infection was confirmed in 36% of the patients. Most (%?) cases presented mild infection, 20% of the patients required hospitalization, and 0.09% patients died. Asthma was more frequent in confirmed cases (p=0.028). Presence of COPD, systemic arterial hypertension, and diabetes mellitus was significant in confirmed hospitalized cases. Pulmonary rales, wheezing, and sudden symptom onset were more frequent and statistically significant in confirmed patients. Influenza-like illness was more frequent in confirmed cases (p=0.049).  This study presents one of the largest series of the new SOIV infection confirmed by RT-PCR reported. This infection is frequently mild and affects mainly young adults. Sudden symptoms onset, pulmonary rales, and wheezing are early features of this infection. Asthma, COPD, systemic arterial hypertension, and diabetes mellitus should be identified to identify potentially severe and fatal cases. ILI helps distinguish SOIV infection.

  12. Identification and Epidemiology of Severe Respiratory Disease due to Novel Swine-Origin Influenza A (H1N1 Virus Infection in Alberta

    Directory of Open Access Journals (Sweden)

    George Zahariadis

    2010-01-01

    Full Text Available BACKGROUND: In March 2009, global surveillance started detecting cases of influenza-like illness in Mexico. By mid-April 2009, two pediatric patients were identified in the United States who were confirmed to be infected by a novel influenza A (H1N1 strain. The present article describes the first identified severe respiratory infection and the first death associated with pandemic H1N1 (pH1N1 in Canada.

  13. Development of two types of rapid diagnostic test kits to detect the hemagglutinin or nucleoprotein of the swine-origin pandemic influenza A virus H1N1.

    Science.gov (United States)

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

    2011-03-01

    Since its emergence in April 2009, pandemic influenza A virus H1N1 (H1N1 pdm), a new type of influenza A virus with a triple-reassortant genome, has spread throughout the world. Initial attempts to diagnose the infection in patients using immunochromatography (IC) relied on test kits developed for seasonal influenza A and B viruses, many of which proved significantly less sensitive to H1N1 pdm. Here, we prepared monoclonal antibodies that react with H1N1 pdm but not seasonal influenza A (H1N1 and H3N2) or B viruses. Using two of these antibodies, one recognizing viral hemagglutinin (HA) and the other recognizing nucleoprotein (NP), we developed kits for the specific detection of H1N1 pdm and tested them using clinical specimens of nasal wash fluid or nasopharyngeal fluid from patients with influenza-like illnesses. The specificities of both IC test kits were very high (93% for the HA kit, 100% for the NP kit). The test sensitivities for detection of H1N1 pdm were 85.5% with the anti-NP antibody, 49.4% with the anti-HA antibody, and 79.5% with a commercially available influenza A virus detection assay. Use of the anti-NP antibody could allow the rapid and accurate diagnosis of H1N1 pdm infections.

  14. Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure

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    Vera Luiza Capelozzi

    2010-01-01

    Full Text Available BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral-like particles in all cases. CONCLUSIONS: Viral-like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT-PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair.

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

    Directory of Open Access Journals (Sweden)

    Alcyone Artioli Machado

    2009-05-01

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

  16. Likely correlation between sources of information and acceptability of A/H1N1 swine-origin influenza virus vaccine in Marseille, France.

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    Antoine Nougairède

    Full Text Available BACKGROUND: In France, there was a reluctance to accept vaccination against the A/H1N1 pandemic influenza virus despite government recommendation and investment in the vaccine programme. METHODS AND FINDINGS: We examined the willingness of different populations to accept A/H1N1 vaccination (i in a French hospital among 3315 employees immunized either by in-house medical personnel or mobile teams of MDs and (ii in a shelter housing 250 homeless persons. Google was used to assess the volume of enquiries concerning incidence of influenza. We analyzed the information on vaccination provided by Google, the website of the major French newspapers, and PubMed. Two trust Surveys were used to assess public opinion on the trustworthiness of people in different professions. Paramedics were significantly more reluctant to accept immunisation than qualified medical staff. Acceptance was significantly increased when recommended directly by MDs. Anecdotal cases of directly observed severe infections were followed by enhanced acceptance of paramedical staff. Scientific literature was significantly more in favour of vaccination than Google and French newspaper websites. In the case of the newspaper websites, information correlated with their recognised political reputations, although they would presumably claim independence from political bias. The Trust Surveys showed that politicians were highly dis-trusted in contrast with doctors and pharmacists who were considered much more trustworthy. CONCLUSIONS: The low uptake of the vaccine could reflect failure to convey high quality medical information and advice relating to the benefits of being vaccinated. We believe that the media and internet contributed to this problem by raising concerns within the general population and that failure to involve GPs in the control programme may have been a mistake. GPs are highly regarded by the public and can provide face-to-face professional advice and information. The top

  17. Pandemic Swine-Origin H1N1 Influenza Virus Replicates to Higher Levels and Induces More Fever and Acute Inflammatory Cytokines in Cynomolgus versus Rhesus Monkeys and Can Replicate in Common Marmosets.

    Science.gov (United States)

    Mooij, Petra; Koopman, Gerrit; Mortier, Daniëlla; van Heteren, Melanie; Oostermeijer, Herman; Fagrouch, Zahra; de Laat, Rudy; Kobinger, Gary; Li, Yan; Remarque, Edmond J; Kondova, Ivanela; Verschoor, Ernst J; Bogers, Willy M J M

    2015-01-01

    The close immunological and physiological resemblance with humans makes non-human primates a valuable model for studying influenza virus pathogenesis and immunity and vaccine efficacy against infection. Although both cynomolgus and rhesus macaques are frequently used in influenza virus research, a direct comparison of susceptibility to infection and disease has not yet been performed. In the current study a head-to-head comparison was made between these species, by using a recently described swine-origin pandemic H1N1 strain, A/Mexico/InDRE4487/2009. In comparison to rhesus macaques, cynomolgus macaques developed significantly higher levels of virus replication in the upper airways and in the lungs, involving both peak level and duration of virus production, as well as higher increases in body temperature. In contrast, clinical symptoms, including respiratory distress, were more easily observed in rhesus macaques. Expression of sialyl-α-2,6-Gal saccharides, the main receptor for human influenza A viruses, was 50 to 73 times more abundant in trachea and bronchus of cynomolgus macaques relative to rhesus macaques. The study also shows that common marmosets, a New World non-human primate species, are susceptible to infection with pandemic H1N1. The study results favor the cynomolgus macaque as model for pandemic H1N1 influenza virus research because of the more uniform and high levels of virus replication, as well as temperature increases, which may be due to a more abundant expression of the main human influenza virus receptor in the trachea and bronchi.

  18. Pandemic Swine-Origin H1N1 Influenza Virus Replicates to Higher Levels and Induces More Fever and Acute Inflammatory Cytokines in Cynomolgus versus Rhesus Monkeys and Can Replicate in Common Marmosets.

    Directory of Open Access Journals (Sweden)

    Petra Mooij

    Full Text Available The close immunological and physiological resemblance with humans makes non-human primates a valuable model for studying influenza virus pathogenesis and immunity and vaccine efficacy against infection. Although both cynomolgus and rhesus macaques are frequently used in influenza virus research, a direct comparison of susceptibility to infection and disease has not yet been performed. In the current study a head-to-head comparison was made between these species, by using a recently described swine-origin pandemic H1N1 strain, A/Mexico/InDRE4487/2009. In comparison to rhesus macaques, cynomolgus macaques developed significantly higher levels of virus replication in the upper airways and in the lungs, involving both peak level and duration of virus production, as well as higher increases in body temperature. In contrast, clinical symptoms, including respiratory distress, were more easily observed in rhesus macaques. Expression of sialyl-α-2,6-Gal saccharides, the main receptor for human influenza A viruses, was 50 to 73 times more abundant in trachea and bronchus of cynomolgus macaques relative to rhesus macaques. The study also shows that common marmosets, a New World non-human primate species, are susceptible to infection with pandemic H1N1. The study results favor the cynomolgus macaque as model for pandemic H1N1 influenza virus research because of the more uniform and high levels of virus replication, as well as temperature increases, which may be due to a more abundant expression of the main human influenza virus receptor in the trachea and bronchi.

  19. Characterization of the 2009 pandemic A/Beijing/501/2009 H1N1 influenza strain in human airway epithelial cells and ferrets.

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    Penghui Yang

    Full Text Available BACKGROUND: A novel 2009 swine-origin influenza A H1N1 virus (S-OIV H1N1 has been transmitted among humans worldwide. However, the pathogenesis of this virus in human airway epithelial cells and mammals is not well understood. METHODOLOGY/PRINCIPAL FINDING: In this study, we showed that a 2009 A (H1N1 influenza virus strain, A/Beijing/501/2009, isolated from a human patient, caused typical influenza-like symptoms including weight loss, fluctuations in body temperature, and pulmonary pathological changes in ferrets. We demonstrated that the human lung adenocarcinoma epithelial cell line A549 was susceptible to infection and that the infected cells underwent apoptosis at 24 h post-infection. In contrast to the seasonal H1N1 influenza virus, the 2009 A (H1N1 influenza virus strain A/Beijing/501/2009 induced more cell death involving caspase-3-dependent apoptosis in A549 cells. Additionally, ferrets infected with the A/Beijing/501/2009 H1N1 virus strain exhibited increased body temperature, greater weight loss, and higher viral titers in the lungs. Therefore, the A/Beijing/501/2009 H1N1 isolate successfully infected the lungs of ferrets and caused more pathological lesions than the seasonal influenza virus. Our findings demonstrate that the difference in virulence of the 2009 pandemic H1N1 influenza virus and the seasonal H1N1 influenza virus in vitro and in vivo may have been mediated by different mechanisms. CONCLUSION/SIGNIFICANCE: Our understanding of the pathogenesis of the 2009 A (H1N1 influenza virus infection in both humans and animals is broadened by our findings that apoptotic cell death is involved in the cytopathic effect observed in vitro and that the pathological alterations in the lungs of S-OIV H1N1-infected ferrets are much more severe.

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

    OpenAIRE

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

    2011-01-01

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

  1. Triple-reassortant influenza A virus with H3 of human seasonal origin, NA of swine origin, and internal A(H1N1) pandemic 2009 genes is established in Danish pigs

    DEFF Research Database (Denmark)

    Krog, Jesper Schak; Hjulsager, Charlotte Kristiane; Larsen, Michael Albin

    2017-01-01

    This report describes a triple-reassortant influenza A virus with a HA that resembles H3 of human seasonal influenza from 2004 to 2005, N2 from influenza A virus already established in swine, and the internal gene cassette from A(H1N1)pdm09 has spread in Danish pig herds. The virus has been detec...

  2. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    International Nuclear Information System (INIS)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song

    2010-01-01

    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  3. Novel Influenza A (H1N1) Virus Infection in Children: Chest Radiographic and CT Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Min Jeong; Lee, Young Seok; Lee, Jee Young; Lee, Kun Song [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of)

    2010-12-15

    The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults. The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum. The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3). Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum

  4. Subsisting H1N1 influenza memory responses are insufficient to protect from pandemic H1N1 influenza challenge in C57BL/6 mice

    OpenAIRE

    Sage, Leo K.; Fox, Julie M.; Tompkins, Stephen M.; Tripp, Ralph A.

    2013-01-01

    The 2009 swine-origin pandemic H1N1 (pH1N1) influenza virus transmitted and caused disease in many individuals immune to pre-2009 H1N1 influenza virus. Whilst extensive studies on antibody-mediated pH1N1 cross-reactivity have been described, few studies have focused on influenza-specific memory T-cells. To address this, the immune response in pre-2009 H1N1 influenza-immune mice was evaluated after pH1N1 challenge and disease pathogenesis was determined. The results show that despite homology ...

  5. Transcriptomics and Proteomics in the Study of H1N1 2009

    OpenAIRE

    Zhang, Lijun; Zhang, Xiaojun; Ma, Qing; Ma, Fang; Zhou, Honghao

    2010-01-01

    Influenza A virus (H1N1) 2009, a new swine-origin influenza A virus, has been spread worldwidely and caused great public fear. High-throughput transcriptomics and proteomics methods are now being used to identify H1N1 and H1N1-host interaction. This article reviews recent transcriptomics and proteomics research in H1N1 diagnosis, treatment, and H1N1 virus-host interaction, to offer some help for further understanding the infection mechanism and controlling H1N1 transmission.

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

    DEFF Research Database (Denmark)

    Larsen, Lars Erik; Nielsen, L. P.; Breum, Solvej Østergaard

    In March-April 2009, a novel pandemic H1N1 virus (H1N1v) of likely swine origin emerged in the human population globally. The first case in pigs was reported from Canada in May 2009 and presently almost all countries with pig production have reported cases. The emergence of a new influenza subtype...

  7. Influenza A (H1N1) neuraminidase inhibitors from Vitis amurensis

    DEFF Research Database (Denmark)

    Nguyen, Ngoc Anh; Dao, Trong Tuan; Tung, Bui Thanh

    2011-01-01

    Recently, a novel H1N1 influenza A virus (H1N1/09 virus) was identified and considered a strong candidate for a novel influenza pandemic. As part of an ongoing anti-influenza screening programme on natural products, eight oligostilbenes were isolated as active principles from the methanol extract...... of Vitis amurensis. This manuscript reports the isolation, structural elucidation, and anti-viral activities of eight compounds on various neuraminidases from influenza A/PR/8/34 (H1N1), novel swine-origin influenza A (H1N1), and oseltamivir-resistant novel H1N1 (H274Y) expressed in 293T cells...

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

    Science.gov (United States)

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

  9. Safety and efficacy of a novel live attenuated influenza vaccine against pandemic H1N1 in swine

    Science.gov (United States)

    On June 11, 2009 the World Health Organization (WHO) declared that the outbreaks caused by novel swine-origin influenza A (H1N1) virus had reached pandemic proportions. The pandemic H1N1 (H1N1pdm) is the predominant influenza strain in the human population. It has also crossed the species barriers a...

  10. H1N1 influenza (Swine flu)

    Science.gov (United States)

    Swine flu; H1N1 type A influenza ... The H1N1 virus is now considered a regular flu virus. It is one of the three viruses included in the regular (seasonal) flu vaccine . You cannot get H1N1 flu virus from ...

  11. H1N1 viral pneum

    Directory of Open Access Journals (Sweden)

    Ahmed Samir

    2016-12-01

    Conclusion: MDCT picture of H1N1 chest infection is highly variable with a spectrum of HRCT findings ranging from focal patchy ground glass attenuation to diffuse alveolar damage (DAD or adult respiratory distress syndrome (ARDS. Still, constellation of clinical data and HRCT findings especially in endemic areas can raise the suspicion of H1N1.

  12. H1N1: pandemia e perspectiva atual H1N1: overview and perspectives

    Directory of Open Access Journals (Sweden)

    Nancy Bellei

    2011-12-01

    Full Text Available O vírus influenza de origem suína, A/California/04/2009 (H1N1, foi inicialmente detectado no México e determinou a pandemia de influenza de 2009. Em agosto de 2010, a Organização Mundial da Saúde (OMS declarou o início da fase pós-pandêmica. As características dessa última pandemia foram marcadamente diferentes das anteriores. O vírus emergiu de rearranjos genéticos originários em hospedeiro mamífero não humano, demonstrou transmissibilidade interespécies e afetou a população humana de forma diferente dos vírus pandêmicos anteriores (1918, 1957 e 1968 com maior morbidade e mortalidade em crianças e adultos jovens. Atualmente, o vírus apresenta padrão sazonal da mesma forma que o influenza A H3N2 e o influenza B, mantendo, até o momento, o mesmo perfil de patogenicidade, espectro clínico e sensibilidade a antivirais. A cepa foi incluída na vacina sazonal trivalente anual recomendada, principalmente para proteção dos grupos de risco mais vulneráveis a complicações pelas diferentes cepas de influenza.The swine origin influenza virus A/CALIFORNIA/04/2009 (H1N1 was first detected in Mexico and determined the 2009 influenza pandemic. In August 2010, World Health Organization (WHO declared the beginning of the post-pandemic period. This last pandemic was distinctly different from previous ones. The virus emerged from genetic rearrangement in non-human mammalian host. Moreover, its inter-species transmission is fully reported. However, it affected human population differently from previous pandemic viruses (1918, 1957, 1968, with increased morbidity and mortality among children and young adults. Currently, the virus has a seasonal pattern in the same way as influenza A H3N2 and influenza B, maintaining the same pathogenicity profile, clinical spectrum and sensitivity to antiviral agents. The strain was included in the annual trivalent seasonal vaccine formulation, mainly for risk groups, which are more vulnerable to

  13. Pandemic influenza A/H1N1 virus incursion into Africa: countries ...

    African Journals Online (AJOL)

    Swine origin influenza A/H1N1 virus was first detected in Mexico in April 2009. It thereafter spread to over a hundred countries in five continents including Africa and was declared a pandemic by the WHO. The disease was estimated to have caused 18,500 laboratory - confirmed deaths worldwide among millions of infected ...

  14. Pandemic influenza A (H1N1)

    African Journals Online (AJOL)

    ... in Port Shepstone, South Africa. Introduction. Influenza A (H1N1) 2009 'swine flu' variant is currently a global pandemic.1 The infection associated with this virus is usually a mild, self-limiting illness. However, it may progress to severe pneumonia requiring intensive care unit (ICU) therapy in 31% of patients.2 This may.

  15. Antiviral Prophylaxis and H1N1

    Centers for Disease Control (CDC) Podcasts

    2011-07-14

    Dr. Richard Pebody, a consultant epidemiologist at the Health Protection Agency in London, UK, discusses the use of antiviral post-exposure prophylaxis and pandemic H1N1.  Created: 7/14/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 7/18/2011.

  16. Piezoresistive measurement of Swine H1N1 Hemagglutinin peptide binding with microcantilever arrays

    Science.gov (United States)

    Bajwa, N.; Maldonado, C. J.; Thundat, T.; Passian, A.

    2014-03-01

    Effective detection of Swine H1N1 Hemagglutinin peptide is crucial as it could be used as a positive control to screen for highly infectious flu strains such as Swine-Origin Influenza A (H1N1). Piezoresistive microcantilever arrays present a pathway towards highly sensitive and label-free detection of biomolecules by transducing the antigen-antibody binding into change in resistivity via induced surface stress variation. We demonstrate a mechanical transduction of Swine H1N1 Hemagglutinin peptide binding and suggest the employed technique may offer a potential platform for detection of the H1N1 virus, which could be clinically used to diagnose and provide subsequent relief.

  17. Influenza Stigma during the 2009 H1N1 Pandemic

    OpenAIRE

    Earnshaw, Valerie A.; Quinn, Diane M.

    2013-01-01

    The current study examines the extent to which H1N1 was stigmatized at the height of the 2009 H1N1 pandemic in the U.S. and explores the role that H1N1 stigma played in people’s desire for physical distance from others with H1N1. H1N1 was the most stigmatized disease, with participants endorsing greater prejudice towards people with H1N1 than people with cancer or HIV/AIDS. Further, H1N1 stigma partially mediated the relationship between participants’ perceptions that H1N1 was threatening and...

  18. Swine influenza H1N1 virus induces acute inflammatory immune responses in pig lungs: a potential animal model for human H1N1 influenza virus.

    Science.gov (United States)

    Khatri, Mahesh; Dwivedi, Varun; Krakowka, Steven; Manickam, Cordelia; Ali, Ahmed; Wang, Leyi; Qin, Zhuoming; Renukaradhya, Gourapura J; Lee, Chang-Won

    2010-11-01

    Pigs are capable of generating reassortant influenza viruses of pandemic potential, as both the avian and mammalian influenza viruses can infect pig epithelial cells in the respiratory tract. The source of the current influenza pandemic is H1N1 influenza A virus, possibly of swine origin. This study was conducted to understand better the pathogenesis of H1N1 influenza virus and associated host mucosal immune responses during acute infection in humans. Therefore, we chose a H1N1 swine influenza virus, Sw/OH/24366/07 (SwIV), which has a history of transmission to humans. Clinically, inoculated pigs had nasal discharge and fever and shed virus through nasal secretions. Like pandemic H1N1, SwIV also replicated extensively in both the upper and lower respiratory tracts, and lung lesions were typical of H1N1 infection. We detected innate, proinflammatory, Th1, Th2, and Th3 cytokines, as well as SwIV-specific IgA antibody in lungs of the virus-inoculated pigs. Production of IFN-γ by lymphocytes of the tracheobronchial lymph nodes was also detected. Higher frequencies of cytotoxic T lymphocytes, γδ T cells, dendritic cells, activated T cells, and CD4+ and CD8+ T cells were detected in SwIV-infected pig lungs. Concomitantly, higher frequencies of the immunosuppressive T regulatory cells were also detected in the virus-infected pig lungs. The findings of this study have relevance to pathogenesis of the pandemic H1N1 influenza virus in humans; thus, pigs may serve as a useful animal model to design and test effective mucosal vaccines and therapeutics against influenza virus.

  19. Sequential Seasonal H1N1 Influenza Virus Infections Protect Ferrets against Novel 2009 H1N1 Influenza Virus

    Science.gov (United States)

    Carter, Donald M.; Bloom, Chalise E.; Nascimento, Eduardo J. M.; Marques, Ernesto T. A.; Craigo, Jodi K.; Cherry, Joshua L.; Lipman, David J.

    2013-01-01

    Individuals H1N1 influenza. Many people >60 years old also had preexisting antibodies to novel H1N1. These observations are puzzling because the seasonal H1N1 viruses circulating during the last 60 years were not antigenically similar to novel H1N1. We therefore hypothesized that a sequence of exposures to antigenically different seasonal H1N1 viruses can elicit an antibody response that protects against novel 2009 H1N1. Ferrets were preinfected with seasonal H1N1 viruses and assessed for cross-reactive antibodies to novel H1N1. Serum from infected ferrets was assayed for cross-reactivity to both seasonal and novel 2009 H1N1 strains. These results were compared to those of ferrets that were sequentially infected with H1N1 viruses isolated prior to 1957 or more-recently isolated viruses. Following seroconversion, ferrets were challenged with novel H1N1 influenza virus and assessed for viral titers in the nasal wash, morbidity, and mortality. There was no hemagglutination inhibition (HAI) cross-reactivity in ferrets infected with any single seasonal H1N1 influenza viruses, with limited protection to challenge. However, sequential H1N1 influenza infections reduced the incidence of disease and elicited cross-reactive antibodies to novel H1N1 isolates. The amount and duration of virus shedding and the frequency of transmission following novel H1N1 challenge were reduced. Exposure to multiple seasonal H1N1 influenza viruses, and not to any single H1N1 influenza virus, elicits a breadth of antibodies that neutralize novel H1N1 even though the host was never exposed to the novel H1N1 influenza viruses. PMID:23115287

  20. 2009 H1N1 Flu Vaccine Facts

    Science.gov (United States)

    ... turn Javascript on. Feature: Flu 2009 H1N1 Flu Vaccine Facts Past Issues / Fall 2009 Table of Contents ... H1N1 flu vaccine. 1 The 2009 H1N1 flu vaccine is safe and well tested. Clinical trials conducted ...

  1. A perspective on the 2009 A/H1N1 influenza pandemic in Mexico.

    Science.gov (United States)

    Acuña-Soto, Rodolfo; Castañeda-Davila, Luis; Chowell, Gerardo

    2011-01-01

    In this article, we provide a chronological description of the 2009 H1N1 influenza pandemic in Mexico from the detection of severe respiratory disease among young adults in central Mexico and the identification of the novel swine-origin influenza virus to the response of Mexican public health authorities with the swift implementation of the National Preparedness and Response Plan for Pandemic Influenza. Furthermore, we review some features of the 2009 H1N1 influenza pandemic in Mexico in relation to the devastating 1918-1920 influenza pandemic and discuss opportunities for the application of mathematical modeling in the transmission dynamics of pandemic influenza. The value of historical data in increasing our understanding of past pandemic events is highlighted.

  2. Pneumonia and Pandemic Influenza A H1N1 Virus Infection: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Servet Kayhan

    2014-01-01

    Full Text Available Influenza viruses cause seasonal epidemics and occasional pandemics. On 18 March 2009, A novel swine origin influenza A (H1N1 virus was seen in Mexico, then a global outbreak of respiratory illness started. The new H1N1 virus usually attaches to tracheobronchial epithelial cells and the clinical picture ranges from transient lower respiratory tract infections to severe pneumonia leading to acute respiratory distress syndrome. The main complication is extension of viral infection to the alveoli that causes primary viral pneumonia. The most common radiologic findings are unilateral or bilateral ground-glass opacities and multifocal areas of consolidations Bacterial coinfections, particularly Streptococcus pneumoniae and Staphylococcus aureus, increase the severity of illness. Patients with underlying cardiopulmonary comorbid conditions, pregnancy and obesity appear to be at higher risk of severe pneumonia. The severe cases have required admission to intensive care units and needs to mechanical ventilation. H1N1 influenza virus is now in post-pandemic period; however, localized outbreaks of various magnitudes are being reported. Keywords: H1N1; influenza; pandemic; pneumonia

  3. Functional Evolution of Influenza Virus NS1 Protein in Currently Circulating Human 2009 Pandemic H1N1 Viruses.

    Science.gov (United States)

    Clark, Amelia M; Nogales, Aitor; Martinez-Sobrido, Luis; Topham, David J; DeDiego, Marta L

    2017-09-01

    In 2009, a novel H1N1 influenza virus emerged in humans, causing a global pandemic. It was previously shown that the NS1 protein from this human 2009 pandemic H1N1 (pH1N1) virus was an effective interferon (IFN) antagonist but could not inhibit general host gene expression, unlike other NS1 proteins from seasonal human H1N1 and H3N2 viruses. Here we show that the NS1 protein from currently circulating pH1N1 viruses has evolved to encode 6 amino acid changes (E55K, L90I, I123V, E125D, K131E, and N205S) with respect to the original protein. Notably, these 6 residue changes restore the ability of pH1N1 NS1 to inhibit general host gene expression, mainly by their ability to restore binding to the cellular factor CPSF30. This is the first report describing the ability of the pH1N1 NS1 protein to naturally acquire mutations that restore this function. Importantly, a recombinant pH1N1 virus containing these 6 amino acid changes in the NS1 protein (pH1N1/NSs-6mut) inhibited host IFN and proinflammatory responses to a greater extent than that with the parental virus (pH1N1/NS1-wt), yet virus titers were not significantly increased in cell cultures or in mouse lungs, and the disease was partially attenuated. The pH1N1/NSs-6mut virus grew similarly to pH1N1/NSs-wt in mouse lungs, but infection with pH1N1/NSs-6mut induced lower levels of proinflammatory cytokines, likely due to a general inhibition of gene expression mediated by the mutated NS1 protein. This lower level of inflammation induced by the pH1N1/NSs-6mut virus likely accounts for the attenuated disease phenotype and may represent a host-virus adaptation affecting influenza virus pathogenesis. IMPORTANCE Seasonal influenza A viruses (IAVs) are among the most common causes of respiratory infections in humans. In addition, occasional pandemics are caused when IAVs circulating in other species emerge in the human population. In 2009, a swine-origin H1N1 IAV (pH1N1) was transmitted to humans, infecting people then and up

  4. 1918 pandemic H1N1 DNA vaccine protects ferrets against 2007 H1N1 virus infection

    DEFF Research Database (Denmark)

    Bragstad, Karoline; Martel, Cyril Jean-Marie; Aasted, Bent

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

  5. Epidemiological characteristics of Pandemic Influenza A (H1N1 ...

    African Journals Online (AJOL)

    Background: A novel influenza A virus strain (H1N1-2009) spread first in Mexico and the United Stated in late April 2009, leading to the first influenza pandemic of the 21st century. The objective of this study was to determine the epidemiological and virological characteristics of the pandemic influenza A (H1N1-2009) in ...

  6. Influenza A (H1N1) organising pneumonia.

    Science.gov (United States)

    Torrego, Alfons; Pajares, Virginia; Mola, Anna; Lerma, Enrique; Franquet, Tomás

    2010-04-27

    In November 2009, countries around the world reported confirmed cases of pandemic influenza H1N1, including over 6000 deaths. No peak in activity has been seen. The most common causes of death are pneumonia and acute respiratory distress syndrome. We report a case of a 55-year-old woman who presented with organising pneumonia associated with influenza A (H1N1) infection confirmed by transbronchial lung biopsy. Organising pneumonia should also be considered as a possible complication of influenza A (H1N1) infection, given that these patients can benefit from early diagnosis and appropriate specific management.

  7. Spreading patterns of the influenza A (H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Sergio de Picoli Junior

    Full Text Available We investigate the dynamics of the 2009 influenza A (H1N1/S-OIV pandemic by analyzing data obtained from World Health Organization containing the total number of laboratory-confirmed cases of infections--by country--in a period of 69 days, from 26 April to 3 July, 2009. Specifically, we find evidence of exponential growth in the total number of confirmed cases and linear growth in the number of countries with confirmed cases. We also find that, i at early stages, the cumulative distribution of cases among countries exhibits linear behavior on log-log scale, being well approximated by a power law decay; ii for larger times, the cumulative distribution presents a systematic curvature on log-log scale, indicating a gradual change to lognormal behavior. Finally, we compare these empirical findings with the predictions of a simple stochastic model. Our results could help to select more realistic models of the dynamics of influenza-type pandemics.

  8. Influenza A (H1N1) 2009: a pandemic alarm

    Indian Academy of Sciences (India)

    Prakash

    put the health authorities on a high alert(Myers et al. 2007). Swine flu virus, a respiratory ... time span with health personnel still devising ways to identify the novel H1N1 virus and develop vaccines against it. The H1N1 virus has caused a ..... for the safety of workers and personal hygiene, sequences of swine HINI virus and ...

  9. 64 multidetector CT findings of influenza A (H1N1) virus in patients with hematologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    El-Badrawy, Adel [Dept. of Radiology, Mansoura Faculty of Medicine, Mansoura (Egypt)], E-mail: adelelbadrawy@hotmail.com; Zeidan, Amany [Dept. of Thoracic Medicine, Mansoura Faculty of Medicine, Mansoura (Egypt); Ebrahim, Mohamed A. [Dept. of Medical Oncology, Mansoura Faculty of Medicine, Mansoura (Egypt)

    2012-07-15

    Background. The pandemic of swine-origin H1N1 influenza that began in early 2009 has provided evidence that radiology can assist in the early diagnosis of severe cases. Immunocompromised patients are at increased risk for morbidity and mortality. MDCT is superior to radiography in showing the distribution of the disease. Purpose. To review the 64 multidetector CT thoracic findings of novel swine-origin influenza A (H1N1) virus in patients with hematologic malignancies. Material and Methods. This study included 12 patients (3 women, 9 men; mean age, 32.2 years). All patients proved to be infected with influenza A (H1N1) virus. The hematologic malignancies were acute myeloid leukemia (n = 8), chronic lymphocytic leukemia (n = 2), multiple myeloma (n = 1), and myelodysplastic syndrome (n = 1). All the patients underwent CT scanning using a 64 multidetector CT scanner. Chest CT scans were reviewed for ground-glass opacities (GGOs), consolidation, airway thickening/dilatation, nodules, mediastinal lymphadenopathy, and pleural effusion. Results. More than one CT finding was detected in every patient. Pulmonary affection was bilateral, more on the left side. The affections were mainly peribronchial. Airway wall thickening and dilatation were detected in all 12 patients, GGO in 9/12 patients, nodules in 6/12 patients, consolidation in 6/12 patients, hilar lymphadenopathy in 3/12 patients, and pleural effusion in 2/12 patients. Conclusion. Acute myeloid leukemia is the most common hematologic malignancy affected by influenza A (H1N1) virus. The left lung is affected more than the right one. The most common multidetector CT findings are unilateral or bilateral airway thickening and dilatation. Multidetector CT can be used for early and accurate assessment of pulmonary affection with influenza A H1N1 virus infection.

  10. 64 multidetector CT findings of influenza A (H1N1) virus in patients with hematologic malignancies

    International Nuclear Information System (INIS)

    El-Badrawy, Adel; Zeidan, Amany; Ebrahim, Mohamed A.

    2012-01-01

    Background. The pandemic of swine-origin H1N1 influenza that began in early 2009 has provided evidence that radiology can assist in the early diagnosis of severe cases. Immunocompromised patients are at increased risk for morbidity and mortality. MDCT is superior to radiography in showing the distribution of the disease. Purpose. To review the 64 multidetector CT thoracic findings of novel swine-origin influenza A (H1N1) virus in patients with hematologic malignancies. Material and Methods. This study included 12 patients (3 women, 9 men; mean age, 32.2 years). All patients proved to be infected with influenza A (H1N1) virus. The hematologic malignancies were acute myeloid leukemia (n = 8), chronic lymphocytic leukemia (n = 2), multiple myeloma (n = 1), and myelodysplastic syndrome (n = 1). All the patients underwent CT scanning using a 64 multidetector CT scanner. Chest CT scans were reviewed for ground-glass opacities (GGOs), consolidation, airway thickening/dilatation, nodules, mediastinal lymphadenopathy, and pleural effusion. Results. More than one CT finding was detected in every patient. Pulmonary affection was bilateral, more on the left side. The affections were mainly peribronchial. Airway wall thickening and dilatation were detected in all 12 patients, GGO in 9/12 patients, nodules in 6/12 patients, consolidation in 6/12 patients, hilar lymphadenopathy in 3/12 patients, and pleural effusion in 2/12 patients. Conclusion. Acute myeloid leukemia is the most common hematologic malignancy affected by influenza A (H1N1) virus. The left lung is affected more than the right one. The most common multidetector CT findings are unilateral or bilateral airway thickening and dilatation. Multidetector CT can be used for early and accurate assessment of pulmonary affection with influenza A H1N1 virus infection

  11. Formal kinetics of H1N1 epidemic

    Directory of Open Access Journals (Sweden)

    Gurevich Konstantin G

    2009-09-01

    Full Text Available Abstract Background The formal kinetics of the H1N1 epidemic seems to take the form of an exponential curve. There is a good correlation between this theoretical model and epidemiological data on the number of H1N1-infected people. But this formal model leads to paradoxes about the dates when everyone becomes infected: in Mexico this will happen after one year, then in the rest of the world. Further implications of the formal model The general limitations of this formal kinetics model are discussed. More detailed modeling is examined and the implications are examined in the light of currently available data. The evidence indicates that not more than 10% of the population is initially resistant to the H1N1 virus. Conclusion We are probably only at the initial stage of development of the H1N1 epidemic. Increasing the number of H1N1-resistant people in future (e.g. due to vaccination may influence the dynamics of epidemic development. At present, the development of the epidemic depends only on the number of people in the population who are initially resistant to the virus.

  12. H1N1, globalization and the epidemiology of inequality.

    Science.gov (United States)

    Sparke, Matthew; Anguelov, Dimitar

    2012-07-01

    This paper examines the lessons learned from the 2009 H1N1 pandemic in relation to wider work on globalization and the epidemiology of inequality. The media attention and economic resources diverted to the threats posed by H1N1 were significant inequalities themselves when contrasted with weaker responses to more lethal threats posed by other diseases associated with global inequality. However, the multiple inequalities revealed by H1N1 itself in 2009 still provide important insights into the future of global health in the context of market-led globalization. These lessons relate to at least four main forms of inequality: (1) inequalities in blame for the outbreak in the media; (2) inequalities in risk management; (3) inequalities in access to medicines; and (4) inequalities encoded in the actual emergence of new flu viruses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. On the spread of the novel influenza A (H1N1) virus in Mexico.

    Science.gov (United States)

    López-Cervantes, Malaquías; Venado, Aida; Moreno, Andrés; Pacheco-Domínguez, Reyna L; Ortega-Pierres, Guadalupe

    2009-06-01

    A novel influenza A H1N1 virus of swine origin is responsible for the influenza epidemic affecting Mexico, the United States of America (USA), and 39 other countries. While the origin of this emerging pathogen remains uncertain, an increase in the reported incidence of respiratory diseases was noted during March 2009 at the town of La Gloria, in the southeastern state of Veracruz, Mexico. So far, this is the first community in which a case of novel influenza A H1N1 virus has been identified. Further cases were rapidly detected in other areas of Mexico and elsewhere. Initially, the atypical respiratory disease outbreak caused great uncertainty posing a challenge to the Mexican health system. Control measures such as social distancing, timely medical care, and personal hygiene have so far proven effective in containing the outbreak, resulting in a decline of the number of new cases. To the best of our knowledge, it appears that the virus might not be as virulent or contagious as previously thought. Here we provide a description of the influenza epidemic spread in Mexico. As the virus disseminates worldwide, there is concern about the possibility of a new reassortment resulting in a more pathogenic strain that will pose a threat for every country. The influenza epidemic provided lessons that underscore the importance of epidemiologic surveillance and preparedness. Further investigation to address questions about this new virus and conditions for its spread is warranted.

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

    Science.gov (United States)

    Flavia, Guntupally Balaswamy Arti; Natarajaseenivasan, Kalimuthusamy

    2011-02-15

    Since April 2009, a serious pandemic infection has been rapidly spread across the world. These infections are caused due to the novel swine origin influenza A (H1N1) virus and hence these are commonly called as "Swine Flu". This new virus is the reassortment of avian, human and swine influenza viruses and thus it has a unique genome composition. There are 16 different types of hemagglutinin (HA) and 9 different types of neuraminidase (NA) that can be genetically and antigenetically differentiated. The first influenza A virus isolated from pigs was of the H1N1 subtype and these viruses have been reported to cause infection in pigs in many countries. The outbreak of this virus has been transmitted from pigs to humans. This new reassorted (exchange of genes) virus which is the cause of 2009 pandemic infections has the ability to spread from human to human. This spread of infection should be brought to an end. In this study, a phylogenetic analysis of the nucleotide sequences of the RNA segments of human H1N1 viruses was carried using MEGA version 4.0 to demonstrate the route map of infection to India. Phylogenetic analysis of the sequences from India, published in Influenza Virus Resource (a database that integrates information gathered from the Influenza Genome Sequencing Project of the National Institute of Allergy and Infectious diseases (NIAID) and the genbank of the (NCBI)) was retrieved and used for the analysis. The results showed that the various segments of the Indian isolates clustered well with the sequences from American, Asian and European countries and thus indicating the transmission of viruses from these places to India.

  15. (H1N1) Influenza in Saurashtra, India

    African Journals Online (AJOL)

    of India had issued guidelines regarding the segregation of. A (H1N1) influenza cases to facilitate laboratory testing, isolation, hospitalization, treatment with specific antiviral medicine. The guideline described three categories namely: (1) Category‑A, (2) Category‑B 1 and 2, (3) Category‑C.[12]. Patients of category A and B ...

  16. Epidemiological characteristics of Pandemic Influenza A (H1N1 ...

    African Journals Online (AJOL)

    Methods: The case and outbreak reports of influenza-like illness (ILI) were collected from the Chinese information system of disease control and prevention and the influenza surveillance system of Zhanjiang city. ... Conclusion: The main population struck by the H1N1-2009 virus was young adults, youths and children.

  17. Influenza A (H1N1) pneumonia: HRCT findings

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Zanetti, Glaucia [Escola de Medicina de Petropolis, RJ (Brazil); Hochhegger, Bruno [Santa Casa de Misericordia de Porto Alegre, RS (Brazil)

    2013-11-01

    Objective: to describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. Methods: we retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. Results: the most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. Conclusions: the most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or cranio caudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms. (author)

  18. Influenza A (H1N1 pneumonia: HRCT findings

    Directory of Open Access Journals (Sweden)

    Viviane Brandao Amorim

    2013-06-01

    Full Text Available OBJECTIVE: To describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1 virus. METHODS: We retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. RESULTS: The most common HRCT findings were ground-glass opacities (85%, consolidation (64%, or a combination of ground-glass opacities and consolidation (58%. Other findings were airspace nodules (25%, bronchial wall thickening (25%, interlobular septal thickening (21%, crazy-paving pattern (15%, perilobular pattern (3%, and air trapping (3%. The findings were frequently bilateral (89%, with a random distribution (68%. Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. CONCLUSIONS: The most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or craniocaudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms.

  19. Pneumococcal Pneumonia and Pandemic H1N1

    Centers for Disease Control (CDC) Podcasts

    2012-06-06

    Dr. George Nelson, a CDC medical officer, discusses the relationship between pneumococcal pneumonia and Pandemic H1N1.  Created: 6/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/6/2012.

  20. Pandemic (H1N1) 2009 in India

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Pandemic (H1N1) 2009 in India. First positive case detected on 16th May 09 in a traveler from Hyderabad from USA. During June, 108 cases tested positive from many major cities. First case in Pune was a US traveler detected on 21 June.

  1. Influenza A (H1N1) 2009: a pandemic alarm

    Indian Academy of Sciences (India)

    At this critical juncture when the world has not yet recovered from the threat of avian influenza, the virus has returned in the disguise of swine influenza, a lesser known illness common in pigs. It has reached pandemic proportions in a short time span with health personnel still devising ways to identify the novel H1N1 virus ...

  2. Influenza A (H1N1) 2009: a pandemic alarm

    Indian Academy of Sciences (India)

    Keywords. Antigenic shift; genetic reassortment; H1N1; pandemic; swine influenza; zoonosis. Abstract. At this critical juncture when the world has not yet recovered from the threat of avian influenza, the virus has returned in the disguise of swine influenza, a lesser known illness common in pigs. It has reached pandemic ...

  3. H1N1 Influenza A hos mennesker og svin

    DEFF Research Database (Denmark)

    Larsen, Lars Erik

    2009-01-01

    Den nye pandemiske influenza A stamme H1N1 er hovedsagelig et nyt virus, som spredes mellem mennesker, men virusset er formodentlig opstået ved blanding af to svineinfluenza-virus og har derfor bibeholdt evnen til at kunne smitte fra mennesker til svin og fra svin til svin. Det er derfor vigtigt...

  4. Influenza A (H1N1) pneumonia: HRCT findings

    International Nuclear Information System (INIS)

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson; Zanetti, Glaucia; Hochhegger, Bruno

    2013-01-01

    Objective: to describe aspects found on HRCT scans of the chest in patients infected with the influenza A (H1N1) virus. Methods: we retrospectively analyzed the HRCT scans of 71 patients (38 females and 33 males) with H1N1 infection, confirmed through laboratory tests, between July and September of 2009. The HRCT scans were interpreted by two thoracic radiologists independently, and in case of disagreement, the decisions were made by consensus. Results: the most common HRCT findings were ground-glass opacities (85%), consolidation (64%), or a combination of ground-glass opacities and consolidation (58%). Other findings were airspace nodules (25%), bronchial wall thickening (25%), interlobular septal thickening (21%), crazy-paving pattern (15%), perilobular pattern (3%), and air trapping (3%). The findings were frequently bilateral (89%), with a random distribution (68%). Pleural effusion, when observed, was typically minimal. No lymphadenopathy was identified. Conclusions: the most common findings were ground-glass opacities and consolidations, or a combination of both. Involvement was commonly bilateral with no axial or cranio caudal predominance in the distribution. Although the major tomographic findings in H1N1 infection are nonspecific, it is important to recognize such findings in order to include infection with the H1N1 virus in the differential diagnosis of respiratory symptoms. (author)

  5. Treatment and Prevention of Pandemic H1N1 Influenza.

    Science.gov (United States)

    Rewar, Suresh; Mirdha, Dashrath; Rewar, Prahlad

    2015-01-01

    Swine influenza is a respiratory infection common to pigs worldwide caused by type A influenza viruses, principally subtypes H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3. Swine influenza viruses also can cause moderate to severe illness in humans and affect persons of all age groups. People in close contact with swine are at especially high risk. Until recently, epidemiological study of influenza was limited to resource-rich countries. The World Health Organization declared an H1N1 pandemic on June 11, 2009, after more than 70 countries reported 30,000 cases of H1N1 infection. In 2015, incidence of swine influenza increased substantially to reach a 5-year high. In India in 2015, 10,000 cases of swine influenza were reported with 774 deaths. The Centers for Disease Control and Prevention recommend real-time polymerase chain reaction as the method of choice for diagnosing H1N1. Antiviral drugs are the mainstay of clinical treatment of swine influenza and can make the illness milder and enable the patient to feel better faster. Antiviral drugs are most effective when they are started within the first 48 hours after the clinical signs begin, although they also may be used in severe or high-risk cases first seen after this time. The Centers for Disease Control and Prevention recommends use of oseltamivir (Tamiflu, Genentech) or zanamivir (Relenza, GlaxoSmithKline). Prevention of swine influenza has 3 components: prevention in swine, prevention of transmission to humans, and prevention of its spread among humans. Because of limited treatment options, high risk for secondary infection, and frequent need for intensive care of individuals with H1N1 pneumonia, environmental control, including vaccination of high-risk populations and public education are critical to control of swine influenza out breaks. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Comparative virulence of wild-type H1N1pdm09 influenza A isolates in swine.

    Science.gov (United States)

    Henningson, Jamie N; Rajao, Daniela S; Kitikoon, Pravina; Lorusso, Alessio; Culhane, Marie R; Lewis, Nicola S; Anderson, Tavis K; Vincent, Amy L

    2015-03-23

    In 2009, a novel swine-origin H1N1 (H1N1pdm09) influenza A virus (IAV) reached pandemic status and was soon after detected in pigs worldwide. The objective of this study was to evaluate whether differences in the HA protein can affect pathogenicity and antigenicity of H1N1pdm09 in swine. We compared lung pathology, viral replication and shedding and the antigenic relationships of four wild-type H1N1pdm09 viruses in pigs: one human (CA/09) and three isolated in swine after the pandemic (IL/09, IL/10, and MN/10). The swine strains were selected based upon unique amino acid substitutions in the HA protein. All selected viruses resulted in mild disease and viral shedding through nasal and oral fluids, however, viral replication and the degree of pathology varied between the isolates. A/Swine/IL/5265/2010 (IL/10), with substitutions I120M, S146G, S186P, V252M, had lower viral titers in the lungs and nasal secretions and fewer lung lesions. The other two swine viruses caused respiratory pathology and replicated to titers similar to the human CA/09, although MN/10 (with mutations D45Y, K304E, A425S) had lower nasal shedding. Swine-adapted H1N1pdm09 have zoonotic potential, and have reassorted with other co-circulating swine viruses, influencing the evolution of IAV in swine globally. Further, our results suggest that amino acid changes in the HA gene have the potential to alter the virulence of H1N1pdm09 in swine. Importantly, the limited clinical signs in pigs could result in continued circulation of these viruses with other endemic swine IAVs providing opportunities for reassortment. Published by Elsevier B.V.

  7. Contextualizing ethics: ventilators, H1N1 and marginalized populations.

    Science.gov (United States)

    Silva, Diego S; Nie, Jason X; Rossiter, Kate; Sahni, Sachin; Upshur, Ross E G

    2010-01-01

    If the H1N1 pandemic worsens, there may not be enough ventilated beds to care for all persons with respiratory failure. To date, researchers who explicitly discuss the ethics of intensive care unit admission and the allocation of ventilators during an influenza pandemic have based criteria predominantly on the principles of utility and efficiency, that is, promoting actions that maximize the greatest good for the greatest number of people. However, haphazardly applying utility and efficiency potentially disadvantages marginalized populations who might be at increased risk of severe reactions to H1N1. In Canada, Aboriginals represent 3% of Canadians, yet 11% of H1N1 cases requiring hospitalization involve Aboriginal persons. Aboriginal persons suffer from high rates of obesity due to socio-economic inequalities. Obesity is also a risk factor for severe H1N1 reactions. Yet, since obesity is found to increase the duration of stay in ventilated beds and a long stay is not considered an optimal use of ventilators, applying the principles of utility and efficiency may magnify existing social inequalities. Although promoting utility and efficiency is important, other ethical principles, such as equity and need, require thoughtful consideration and implementation. Furthermore, since public resources are being used to address a public health hazard, the viewpoints of the public, and specifically stakeholders who will be disproportionately affected, should inform decision-makers. Finally, giving attention to the needs and rights of marginalized populations means that ventilators should not be allocated based on criteria that exacerbate the social injustices faced by these groups of people.

  8. Spread of H1N1 within Households

    Centers for Disease Control (CDC) Podcasts

    2010-03-29

    This podcast describes an investigation into how H1N1 was spreading within households during the initial days of the pandemic in Texas. CDC's Dr. Oliver Morgan discusses what investigators learned about the role that children played in introducing the virus into households and spreading flu.  Created: 3/29/2010 by Emerging Infectious Diseases.   Date Released: 3/29/2010.

  9. Myastenia gravis following H1N1 infection

    OpenAIRE

    Silva, Horta e; Nascimento, A.; Zwolinski, N.; André, A.

    2016-01-01

    Introduction: Myasthenia gravis is an auto-immune disease, resulting from the production of anti-Ach receptor antibodies at the neuromuscular junction. In spite of its unknown etiology, there seems to exist some factors which withstand its arise and/or the worsening of the patient's clinical condition.The mainstay of medical treatment relies on anticholinesterase drugs and immunosuppression. Thymectomy is considered the treatment of choice in selected cases.Influenza A (H1N1) viral infection ...

  10. Computed tomography findings from patients with ARDS due to Influenza A (H1N1) virus-associated pneumonia

    International Nuclear Information System (INIS)

    Grieser, Christian; Goldmann, Anton; Steffen, Ingo G.; Kastrup, Marc; Fernández, Carmen María Pérez; Engert, Ulrike; Deja, Maria; Lojewski, Christian; Denecke, Timm

    2012-01-01

    Purpose: The purpose of this study was to retrospectively evaluate whether computed tomography (CT) findings have prognostic value for the prediction of mortality and severity of the clinical course in patients presenting with early stage of acute respiratory distress syndrome (ARDS) due to swine-origin influenza A (S-OIV). Materials and methods: Chest CT (16-/64-row multidetector CT) of 23 patients (of whom 9 patients died) were retrospectively reviewed by three independent blinded observers. The CT findings were graded on a 3-point scale (1: normal attenuation, 2: ground-glass attenuation, 3: consolidation). The extent of each abnormality was determined by visually estimating the percentage (to the nearest 10%) of the affected lung parenchyma in each zone and multiplied by the CT-score described above. Results: All patients presented with a mixture of bilateral patchy consolidations and ground glass opacities. Spearman rank correlation in evaluation of the presence and extent of lung abnormalities by the three different observers was good (correlation coefficient, 0.876–0.922; p < 0.001). The overall CT-score in survivors (mean, 96.0 (±26.2); range, 53–158) was significantly lower than that in non-survivors (mean, 116.2 (±14.0); range, 101–139). ROC analysis revealed an area under curve of 0.79 (p = 0.021) for the CT score with an optimal cutoff value of a CT-score of 100 for prediction of survival, with a sensitivity of 100% and a specificity of 64% (accuracy, 78%). For this optimal cutoff, Kaplan–Meier estimator showed a significant difference for the survival ratio (p = 0.011). Conclusion: In patients with severe ARDS due to S-OIV-infection, the CT-score has a prognostic value in the prediction of mortality.

  11. Pneumonia associada a influenza A (H1N1 Influenza A (H1N1-associated pneumonia

    Directory of Open Access Journals (Sweden)

    Antonello Nicolini

    2011-10-01

    Full Text Available OBJETIVO: Descrever as características dos pacientes com pneumonia associada a influenza A (H1N1 tratados em dois hospitais na região da Ligúria, Itália, e descrever seu tratamento e desfechos. MÉTODOS: Estudo prospectivo observacional que incluiu todos os pacientes com mais de 16 anos de idade e com diagnóstico confirmado de influenza A (H1N1 admitidos no Hospital Villa Scassi, em Gênova, ou no Hospital Geral de Sestri Levante, em Sestri Levante, Itália, entre setembro de 2009 e janeiro de 2010. O desfecho primário foi mortalidade em até 60 dias do diagnóstico, e os desfechos secundários foram necessidade de ventilação mecânica e tempo de hospitalização. RESULTADOS: Durante o período do estudo, dos 40 pacientes com diagnóstico confirmado de influenza A (H1N1, 27 apresentaram pneumonia. A média de idade dos 27 pacientes foi de 42,8 ± 14,8 anos, e o tempo médio de hospitalização foi de 11,6 ± 8,2 dias. Dos 27 pacientes, 20 tiveram insuficiência respiratória, 4 necessitaram de ventilação mecânica invasiva e 5, de ventilação mecânica não invasiva. Somente 1 paciente com várias comorbidades teve falência múltipla de órgãos e faleceu. CONCLUSÕES: Embora a influenza A (H1N1 tenha sido mais branda e com menor incidência de mortalidade na Itália do que em outros países, 9 de nossos pacientes (33% tiveram evolução rápida para falência respiratória e necessitaram de ventilação mecânica.OBJECTIVE: To describe the characteristics of patients with influenza A (H1N1-associated pneumonia treated at two hospitals in the region of Liguria, Italy, as well as to describe their treatment and outcomes. METHODS: This was a prospective observational study including all patients older than 16 years of age with a confirmed diagnosis of influenza A (H1N1 who were admitted to Villa Scassi Hospital, in the city of Genoa, Italy, or to the Sestri Levante General Hospital, in the city of Sestri Levante, Italy, between

  12. Pulmonary function in patients with pandemic H1N1

    Directory of Open Access Journals (Sweden)

    Soraia Koppe

    Full Text Available Abstract Introduction: The influenza A (H1N1 was responsible for the 2009 pandemic, especially with severe pulmonary complications. Objective: To describe characteristics of patients in a university hospital in Curitiba - PR with laboratory diagnosis of influenza A (H1N1 and its post hospital discharge in the 2009 lung function pandemic. Methodology: A retrospective observational study. It was used as a data source the institution Epidemiology Service (SEPIH and spirometry tests of patients who were admitted in 2009, 18 years without lung disease associated and non-pregnant. Descriptive statistics were used and applied Fisher's exact test for relationship between comorbidity and spirometry tests. Results: There were 84 confirmed cases, of these 11 were eligible for the study with a mean age of 44.27 years (± 9.63 and 63.63% males. 54.54% of the 11 patients had comorbidities associated with systemic arterial hypertension (54.54%, diabetes (18.18% and late postoperative period of kidney transplantation (18.18% were the most frequent. Most patients (81.81% had BMI ≥ 25kg / m². The Spirometry test was performed approximately 40.09 (± 15.27 days after discharge, of these, 5 had restrictive pattern and all had abnormal chest radiograph results. There was no statistically significant difference between the results of Spirometry and comorbidities (p=0.24. Conclusions: The group evaluated in this research did not show a direct relationship between Spirometry and comorbidities, but changes in Spirometry in some patients after hospital discharge stood out, suggesting changes in lung function due to influenza A (H1N1.

  13. Underreporting of 2009 H1N1 Influenza Cases

    Centers for Disease Control (CDC) Podcasts

    2009-12-08

    Influenza cases are difficult to track because many people don't go to the doctor or get tested for flu when they're sick. The first months of the 2009 H1N1 influenza pandemic were no different. In this podcast, CDC's Dr. Carrie Reed discusses a study in the December issue of Emerging Infectious Diseases that looked at the actual number of cases reported and estimated the true number of cases when correcting for underreporting.  Created: 12/8/2009 by Emerging Infectious Diseases.   Date Released: 12/8/2009.

  14. Caveolin-1 influences human influenza A virus (H1N1 multiplication in cell culture

    Directory of Open Access Journals (Sweden)

    Hemgård Gun-Viol

    2010-05-01

    Full Text Available Abstract Background The threat of recurring influenza pandemics caused by new viral strains and the occurrence of escape mutants necessitate the search for potent therapeutic targets. The dependence of viruses on cellular factors provides a weak-spot in the viral multiplication strategy and a means to interfere with viral multiplication. Results Using a motif-based search strategy for antiviral targets we identified caveolin-1 (Cav-1 as a putative cellular interaction partner of human influenza A viruses, including the pandemic influenza A virus (H1N1 strains of swine origin circulating from spring 2009 on. The influence of Cav-1 on human influenza A/PR/8/34 (H1N1 virus replication was determined in inhibition and competition experiments. RNAi-mediated Cav-1 knock-down as well as transfection of a dominant-negative Cav-1 mutant results in a decrease in virus titre in infected Madin-Darby canine kidney cells (MDCK, a cell line commonly used in basic influenza research as well as in virus vaccine production. To understand the molecular basis of the phenomenon we focussed on the putative caveolin-1 binding domain (CBD located in the lumenal, juxtamembranal portion of the M2 matrix protein which has been identified in the motif-based search. Pull-down assays and co-immunoprecipitation experiments showed that caveolin-1 binds to M2. The data suggest, that Cav-1 modulates influenza virus A replication presumably based on M2/Cav-1 interaction. Conclusion As Cav-1 is involved in the human influenza A virus life cycle, the multifunctional protein and its interaction with M2 protein of human influenza A viruses represent a promising starting point for the search for antiviral agents.

  15. Safety and immunogenicity of influenza A H1N1 vaccines.

    Science.gov (United States)

    Lu, Wei; Tambyah, Paul A

    2010-04-01

    Evaluation of: Liang XF, Wang HQ, Wang JZ et al. Safety and immunogenicity of 2009 pandemic influenza A H1N1 vaccines in China: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet 375(9708), 56-66 (2009). The novel swine-origin influenza A H1N1 2009 virus was first identified in April 2009 in Mexico. Since then, it has caused a worldwide pandemic with more than 10,000 deaths documented by December 2009. While many countries adopted pandemic plans and border controls to try to control the spread of the virus, it was quickly realized that the virus was unstoppable. The virus was initially largely susceptible to oseltamivir and zanamivir, and various strategies that included treatment of severe cases, all cases or targeted chemoprophylaxis were used to try to limit the mortality and morbidity due to the virus. However, predictably, resistance to neuraminidase inhibitors has increasingly appeared in different settings and outbreaks of resistant virus have been reported. Mass vaccination is the most economic and effective measure to reduce infection and mortality from influenza. Before this pandemic, several studies were conducted using H5N1 prepandemic vaccines to try to determine the optimal composition and dose of vaccine for a novel strain of influenza. Most of these studies found significantly higher doses required for novel influenza strains and all previous studies showed the need for two doses of vaccine to achieve protective levels of antibody. Once it became apparent that the pandemic was due to H1N1 2009 instead, efforts were redirected to finding the optimal antigen dose and composition including the use of adjuvant combinations. This unique study conducted in ten centers across the People's Republic of China found that a single-dose, 7.5-microg, nonadjuvanted, split-virion vaccine was sufficiently immunogenic for adults and adolescents aged 12 years and above to meet regulatory requirements for registration. The vaccine was relatively

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

    Science.gov (United States)

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

    2014-12-01

    In 2009 a novel pandemic H1N1 influenza virus (H1N1pdm09) emerged as the first official influenza pandemic of the 21st century. Early genomic sequence analysis pointed to the swine origin of the virus. Here we report a novel computational approach to determine the evolutionary trajectory of viral sequences that uses data-driven estimations of nucleotide substitution rates to track the gradual accumulation of observed sequence alterations over time. Phylogenetic analysis and multiple sequence alignments show that sequences belonging to the resulting evolutionary trajectory of the H1N1pdm09 lineage exhibit a gradual accumulation of sequence variations and tight temporal correlations in the topological structure of the phylogenetic trees. These results suggest that our evolutionary trajectory analysis (ETA) can more effectively pinpoint the evolutionary history of viruses, including the host and geographical location traversed by each segment, when compared against either BLAST or traditional phylogenetic analysis alone. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Pandemic H1N1 influenza virus in Chilean commercial turkeys with genetic and serologic comparisons to U.S. H1N1 avian influenza vaccine isolates

    Science.gov (United States)

    Beginning in April 2009, a novel H1N1 influenza virus has caused acute respiratory disease in humans, first in Mexico and then spreading around the world. The resulting pandemic influenza A H1N1 2009 (pH1N1) virus was isolated in swine in Canada in June, 2009, and later in turkey breeders in Chile, ...

  18. H1N1 pandemic preparedness and business continuity plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    SaskPower's H1N1 pandemic preparedness and business continuity plan was designed to prepare SaskPower employees for elevated levels of absenteeism during a potential pandemic. Emergency management and business continuity will be facilitated if critical duties and essential services are maintained without interruption. A layered approach was used to develop a range of response measures designed to meet a range of possible pandemic threats. The plan identified essential activities, tasks and functions and outlined methods of mitigating supply disruptions and possible shortages. Methods of minimizing illness in employees were discussed, as well as methods of maintaining a safe and secure work environment. The measures were developed in accordance with the World Health Organization (WHO) 6 phases of pandemic alert. The plan was also designed to be read by SaskPower's key suppliers in order to ensure their pandemic readiness. 5 tabs.

  19. Complex patterns of human antisera reactivity to novel 2009 H1N1 and historical H1N1 influenza strains.

    Directory of Open Access Journals (Sweden)

    Donald M Carter

    Full Text Available During the 2009 influenza pandemic, individuals over the age of 60 had the lowest incidence of infection with approximately 25% of these people having pre-existing, cross-reactive antibodies to novel 2009 H1N1 influenza isolates. It was proposed that older people had pre-existing antibodies induced by previous 1918-like virus infection(s that cross-reacted to novel H1N1 strains.Using antisera collected from a cohort of individuals collected before the second wave of novel H1N1 infections, only a minority of individuals with 1918 influenza specific antibodies also demonstrated hemagglutination-inhibition activity against the novel H1N1 influenza. In this study, we examined human antisera collected from individuals that ranged between the ages of 1 month and 90 years to determine the profile of seropositive influenza immunity to viruses representing H1N1 antigenic eras over the past 100 years. Even though HAI titers to novel 2009 H1N1 and the 1918 H1N1 influenza viruses were positively associated, the association was far from perfect, particularly for the older and younger age groups.Therefore, there may be a complex set of immune responses that are retained in people infected with seasonal H1N1 that can contribute to the reduced rates of H1N1 influenza infection in older populations.

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

    Directory of Open Access Journals (Sweden)

    Yu Hong

    2010-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Yong-Jae Park

    2011-10-01

    Full Text Available Purpose : In autumn 2009, the swine-origin influenza A (H1N1 virus spread throughout South Korea. The aims of this study were to determine the clinical characteristics of children infected by the 2009 H1N1 influenza A virus, and to compare the rapid antigen and realtime polymerase chain reaction (PCR tests. Methods : We conducted a retrospective review of patients ?#241;8 years of age who presented to Soonchunhyang University Hospital in Seoul with respiratory symptoms, including fever, between September 2009 and January 2010. A real-time PCR test was used to definitively diagnose 2009 H1N1 influenza A infection. Medical records of confirmed cases were reviewed for sex, age, and the time of infection. The decision to perform rapid antigen testing was not influenced by clinical conditions, but by individual factors such as economic conditions. Its sensitivity and specificity were evaluated compared to real-time PCR test results. Results : In total, 934 patients tested positive for H1N1 by real-time PCR. The highest number of patients (48.9% was diagnosed in November. Most patients (48.2% were aged between 6 and 10 years. Compared with the H1N1 real-time PCR test results, the rapid antigen test showed 22% sensitivity and 83% specificity. Seventy-eight patients were hospitalized for H1N1 influenza A virus infection, and fever was the most common symptom (97.4%. Conclusion : For diagnosis of 2009 H1N1 influenza A virus infection, the rapid antigen test was inferior to the real-time PCR test in both sensitivity and specificity. This outcome suggests that the rapid antigen test is inappropriate for screening.

  2. 'Presenting CXR phenotype of H1N1' flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks'.

    Science.gov (United States)

    Minns, F C; Mhuineachain, A Ni; van Beek, E J R; Ritchie, G; Hill, A; Murchison, J T

    2015-09-01

    To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were 'blinded' to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p=0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p=0.001). H1N1 radiographs were more likely to be 'patchy' versus 'confluent' changes of non-H1N1 CAP (p=0.03) and more often demonstrated peripheral distribution (p=0.01). H1N1 patients tended to stay in hospital longer (not significant; p=0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p=0.02). The findings were the same for the two evaluated seasons. H1N1 patients demonstrated more extensive disease, which was more likely bilateral, 'patchy', and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients, particularly where rapid viral testing is not available. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. The Role of Radiology in Influenza: Novel H1N1 and Lessons Learned From the 1918 Pandemic

    Science.gov (United States)

    Mollura, Daniel J.; Morens, David M.; Taubenberger, Jeffery K.; Bray, Mike

    2012-01-01

    The pandemic of swine-origin H1N1 influenza that began in early 2009 has provided evidence that radiology can assist in the early diagnosis of severe cases, raising new opportunities for the further development of infectious disease imaging. To help define radiology’s role in present and future influenza outbreaks, it is important to understand how radiologists have responded to past epidemics and how these outbreaks influenced the development of imaging science. The authors review the role of radiology in the most severe influenza outbreak in history, the “great pandemic” of 1918, which arrived only 23 years after the discovery of x-rays. In large part because of the coincidental increase in the radiologic capacity of military hospitals for World War I, the 1918 pandemic firmly reinforced the role of radiologists as collaborators with clinicians and pathologists at an early stage in radiology’s development, in addition to producing a radical expansion of radiologic research on pulmonary infections. Radiology’s solid foundation from the 1918 experience in medical practice and research now affords significant opportunities to respond to the current H1N1 pandemic and future epidemics through similar interdisciplinary strategies that integrate imaging science with pathology, virology, and clinical studies. The broad range of current imaging capabilities will make it possible to study influenza at the cellular level, in animal models, and in human clinical trials to elucidate the pathogenesis of severe illness and improve clinical outcomes. PMID:20816630

  4. Life threatening severe Influenza A Virus (H1N1) infection in ...

    African Journals Online (AJOL)

    ABSTRACT: H1N1 influenza is an emerging threat that is life threatening to pregnant women in the third trimester. Pregnant women are a high-risk group for morbidity and mortality from influenza (H1N1). During the current pandemic of H1N1 influenza, few cases of H1N1 have been reported in pregnancy. We report a case ...

  5. A retrospective evaluation of critically ill patients infected with H1N1 ...

    African Journals Online (AJOL)

    2009-11-12

    Nov 12, 2009 ... Background: H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. The aim of this study ... Key words: pandemic influenza, H1N1 infection, critically ill patient, intensive care unit ..... Borgatta B, Pérez M, Rello J et al; pH1N1 GTEI/. SEMICYUC.

  6. Chalcones as novel influenza A (H1N1) neuraminidase inhibitors from Glycyrrhiza inflata

    DEFF Research Database (Denmark)

    Dao, Trong Tuan; Nguyen, Phi Hung; Lee, Hong Sik

    2011-01-01

    -8) chalcones were isolated as active principles from the acetone extract of Glycyrrhiza inflata. Compounds 3 and 6 without prenyl group showed strong inhibitory effects on various neuraminidases from influenza viral strains, H1N1, H9N2, novel H1N1 (WT), and oseltamivir-resistant novel H1N1 (H274Y) expressed...

  7. Influenza A(H1N1)pdm09 in critically ill children admitted to a ...

    African Journals Online (AJOL)

    Objective. To describe the clinical course of critically ill children with confirmed pandemic influenza A(H1N1)pdm09 (H1N1) infection in a southern African paediatric intensive care unit (PICU), and to compare them with a similar group with respiratory virus infections other than H1N1 admitted to the same PICU during the ...

  8. Factors Influencing School Closure and Dismissal Decisions: Influenza A (H1N1), Michigan 2009

    Science.gov (United States)

    Dooyema, Carrie A.; Copeland, Daphne; Sinclair, Julie R.; Shi, Jianrong; Wilkins, Melinda; Wells, Eden; Collins, Jim

    2014-01-01

    Background: In fall 2009, many US communities experienced school closures during the influenza A H1N1 pandemic (pH1N1) and the state of Michigan reported 567 closures. We conducted an investigation in Michigan to describe pH1N1-related school policies, practices, and identify factors related to school closures. Methods: We distributed an online…

  9. Protection of mice against lethal challenge with 2009 H1N1 influenza A virus by 1918-like and classical swine H1N1 based vaccines.

    Directory of Open Access Journals (Sweden)

    Balaji Manicassamy

    2010-01-01

    Full Text Available The recent 2009 pandemic H1N1 virus infection in humans has resulted in nearly 5,000 deaths worldwide. Early epidemiological findings indicated a low level of infection in the older population (>65 years with the pandemic virus, and a greater susceptibility in people younger than 35 years of age, a phenomenon correlated with the presence of cross-reactive immunity in the older population. It is unclear what virus(es might be responsible for this apparent cross-protection against the 2009 pandemic H1N1 virus. We describe a mouse lethal challenge model for the 2009 pandemic H1N1 strain, used together with a panel of inactivated H1N1 virus vaccines and hemagglutinin (HA monoclonal antibodies to dissect the possible humoral antigenic determinants of pre-existing immunity against this virus in the human population. By hemagglutinination inhibition (HI assays and vaccination/challenge studies, we demonstrate that the 2009 pandemic H1N1 virus is antigenically similar to human H1N1 viruses that circulated from 1918-1943 and to classical swine H1N1 viruses. Antibodies elicited against 1918-like or classical swine H1N1 vaccines completely protect C57B/6 mice from lethal challenge with the influenza A/Netherlands/602/2009 virus isolate. In contrast, contemporary H1N1 vaccines afforded only partial protection. Passive immunization with cross-reactive monoclonal antibodies (mAbs raised against either 1918 or A/California/04/2009 HA proteins offered full protection from death. Analysis of mAb antibody escape mutants, generated by selection of 2009 H1N1 virus with these mAbs, indicate that antigenic site Sa is one of the conserved cross-protective epitopes. Our findings in mice agree with serological data showing high prevalence of 2009 H1N1 cross-reactive antibodies only in the older population, indicating that prior infection with 1918-like viruses or vaccination against the 1976 swine H1N1 virus in the USA are likely to provide protection against the 2009

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

    Directory of Open Access Journals (Sweden)

    Xue Chunyi

    2011-03-01

    Full Text Available Abstract Background The swine influenza (SI is an infectious disease of swine and human. The novel swine-origin influenza A (H1N1 that emerged from April 2009 in Mexico spread rapidly and caused a human pandemic globally. To determine whether the tremendous virus had existed in or transmitted to pigs in southern China, eight H1N1 influenza strains were identified from pigs of Guangdong province during 2008-2009. Results Based on the homology and phylogenetic analyses of the nucleotide sequences of each gene segments, the isolates were confirmed to belong to the classical SI group, with HA, NP and NS most similar to 2009 human-like H1N1 influenza virus lineages. All of the eight strains were low pathogenic influenza viruses, had the same host range, and not sensitive to class of antiviral drugs. Conclusions This study provides the evidence that there is no 2009 H1N1-like virus emerged in southern China, but the importance of swine influenza virus surveillance in China should be given a high priority.

  11. Predicting H1N1 vaccine uptake and H1N1-related health beliefs: the role of individual difference in consideration of future consequences.

    Science.gov (United States)

    Nan, Xiaoli; Kim, Jarim

    2014-01-01

    This research examines the influence of individual difference in consideration of future consequences on H1N1 vaccine uptake and H1N1-related health beliefs (i.e., perceived susceptibility to and severity of the H1N1 flu, perceived efficacy and safety of the H1N1 vaccine, and perceived self-efficacy in obtaining the H1N1 vaccine). A survey of 411 college students showed that consideration of future consequences had no direct effect on vaccine uptake, but higher consideration of future consequences was associated with greater perceived severity of the flu, higher perceived effectiveness of the vaccine, and greater perceived self-efficacy. Additional analysis suggested that consideration of future consequences had a significant indirect effect on vaccine uptake through perceived vaccine efficacy. Results of the study also revealed gender and racial differences in some of the H1N1-related health beliefs. Implications of the findings for vaccine risk communication are discussed.

  12. Characteristics of atopic children with pandemic H1N1 influenza viral infection: pandemic H1N1 influenza reveals 'occult' asthma of childhood.

    Science.gov (United States)

    Hasegawa, Shunji; Hirano, Reiji; Hashimoto, Kunio; Haneda, Yasuhiro; Shirabe, Komei; Ichiyama, Takashi

    2011-02-01

    The number of human cases of pandemic H1N1 influenza viral infection has increased in Japan since April 2009, as it has worldwide. This virus is widespread in the Yamaguchi prefecture in western Japan, where most infected children exhibited respiratory symptoms. Bronchial asthma is thought to be one of the risk factors that exacerbate respiratory symptoms of pandemic H1N1-infected patients, but the pathogenesis remains unclear. We retrospectively investigated the records of 33 children with pandemic H1N1 influenza viral infection who were admitted to our hospital between October and December 2009 and analyzed their clinical features. The percentage of children with asthma attack, with or without abnormal findings on chest radiographs (pneumonia, atelectasis, etc.), caused by pandemic H1N1 influenza infection was significantly higher than that of children with asthma attack and 2008-2009 seasonal influenza infection. Of the 33 children in our study, 22 (66.7%) experienced an asthma attack. Among these children, 20 (90.9%) did not receive long-term management for bronchial asthma, whereas 7 (31.8%) were not diagnosed with bronchial asthma and had experienced their first asthma attack. However, the severity of the attack did not correlate with the severity of the pulmonary complications of pandemic H1N1 influenza viral infection. The pandemic H1N1 influenza virus greatly increases the risk of lower respiratory tract complications such as asthma attack, pneumonia, and atelectasis, when compared to the seasonal influenza virus. Furthermore, our results suggest that pandemic H1N1 influenza viral infection can easily induce a severe asthma attack, pneumonia, and atelectasis in atopic children without any history of either an asthma attack or asthma treatment. © 2011 John Wiley & Sons A/S.

  13. H1N1 viral proteome peptide microarray predicts individuals at risk for H1N1 infection and segregates infection versus Pandemrix® vaccination

    Science.gov (United States)

    Ambati, Aditya; Valentini, Davide; Montomoli, Emanuele; Lapini, Guilia; Biuso, Fabrizio; Wenschuh, Holger; Magalhaes, Isabelle; Maeurer, Markus

    2015-01-01

    A high content peptide microarray containing the entire influenza A virus [A/California/08/2009(H1N1)] proteome and haemagglutinin proteins from 12 other influenza A subtypes, including the haemagglutinin from the [A/South Carolina/1/1918(H1N1)] strain, was used to gauge serum IgG epitope signatures before and after Pandemrix® vaccination or H1N1 infection in a Swedish cohort during the pandemic influenza season 2009. A very narrow pattern of pandemic flu-specific IgG epitope recognition was observed in the serum from individuals who later contracted H1N1 infection. Moreover, the pandemic influenza infection generated IgG reactivity to two adjacent epitopes of the neuraminidase protein. The differential serum IgG recognition was focused on haemagglutinin 1 (H1) and restricted to classical antigenic sites (Cb) in both the vaccinated controls and individuals with flu infections. We further identified a novel epitope VEPGDKITFEATGNL on the Ca antigenic site (251–265) of the pandemic flu haemagglutinin, which was exclusively recognized in serum from individuals with previous vaccinations and never in serum from individuals with H1N1 infection (confirmed by RNA PCR analysis from nasal swabs). This epitope was mapped to the receptor-binding domain of the influenza haemagglutinin and could serve as a correlate of immune protection in the context of pandemic flu. The study shows that unbiased epitope mapping using peptide microarray technology leads to the identification of biologically and clinically relevant target structures. Most significantly an H1N1 infection induced a different footprint of IgG epitope recognition patterns compared with the pandemic H1N1 vaccine. PMID:25639813

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

    Directory of Open Access Journals (Sweden)

    Russell D. Ravert

    2012-01-01

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

  15. The Neurological Manifestations of H1N1 Influenza Infection; Diagnostic Challenges and Recommendations

    OpenAIRE

    Ali Akbar Asadi-Pooya; Ehsan Yaghoubi; Alireza Nikseresht; Mohsen Moghadam; Behnam Honarvar

    2011-01-01

    Background: World Health Organization declared pandemic phase of human infection with novel influenza A (H1N1) in April 2009. There are very few reports about the neurological complications of H1N1 virus infection in the literature. Occasionally, these complications are severe and even fatal in some individuals. The aims of this study were to report neurological complaints and/or complications associated with H1N1 virus infection. Methods: The medical files of all patients with H1N1 influenza...

  16. Diagnosis of influenza viruses with special reference to novel H1N1 2009 influenza virus

    OpenAIRE

    Broor, Shobha; Chahar, Harendra Singh; Kaushik, Samander

    2009-01-01

    On 15 April and 17 April 2009, novel swineorigin influenza A (H1N1) virus was identifi ed in specimens obtained from two epidemiologically unlinked patients in the United States. The ongoing outbreak of novel H1N1 2009 influenza (swine influenza) has caused more than 3,99,232 laboratory confi rmed cases of pandemic influenza H1N1 and over 4735 deaths globally. This novel 2009 influenza virus designated as H1N1 A/swine/California/04/2009 virus is not zoonotic swine flu and is transmitted from ...

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

    Directory of Open Access Journals (Sweden)

    Nishiura Hiroshi

    2010-01-01

    Full Text Available Abstract Background A pandemic novel H1N1 swine-origin influenza virus has emerged. Most recently the World Health Organization has announced that in a country-dependent fashion, up to 15% of cases may require hospitalization, often including respiratory support. It is now clear that healthy children and young adults are disproportionately affected, most unusually among those with severe respiratory disease without underlying conditions. One possible explanation for this case age distribution is the doctrine of Original Antigenic Sin, i.e., novel H1N1 may be antigenically similar to H1N1 viruses that circulated at an earlier time. Persons whose first exposure to influenza viruses was to such similar viruses would be relatively immune. However, this principle is not sufficient to explain the graded susceptibility between ages 20 and 60, the reduced susceptibility in children below age 10, and the unusual toxicity observed. Methods We collected case data from 11 countries, about 60% of all cases reported through mid-July 2009. We compared sequence data for the hemagglutinin of novel H1N1 with sequences of H1N1 viruses from 1918 to the present. We searched for sequence differences that imply loss of antigenicity either directly through amino acid substitution or by the appearance of sites for potential glycosylation proximal to sites known to be antigenic in humans. We also considered T-cell epitopes. Results In our composite, over 75% of confirmed cases of novel H1N1 occurred in persons ≤ 30 years old, with peak incidence in the age range 10-19 years. Less than 3% of cases occurred in persons over 65, with a gradation in incidence between ages 20 and 60 years. The sequence data indicates that novel H1N1 is most similar to H1N1 viruses that circulated before 1943. Novel H1N1 lacks glycosylation sites on the globular head of hemagglutinin (HA1 near antigenic regions, a pattern shared with the 1918 pandemic strain and H1N1 viruses that circulated

  18. Ethnic differences in susceptibilities to A(H1N1) flu: An epidemic ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-12-29

    Dec 29, 2009 ... MacFarlane KF, Shu B, Olsen SJ, Novel Influenza A (H1N1). Pregnancy Working Group (2009). H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet, 374: 451-458. Modiano D, Petrarca V, Sirima BS, Nebie I, Diallo D, Esposito F Coluzzi. M (1996). Different response to Plasmodium ...

  19. A retrospective evaluation of critically ill patients infected with H1N1 ...

    African Journals Online (AJOL)

    African Health Sciences ... Background: H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. ... Methods: Demographic characteristics, clinical features, and outcome relating to H1N1 infection were retrospectively analysed in patients treated in the ICU.

  20. Influenza A (H1N1) neuraminidase inhibitors from Vitis amurensis

    DEFF Research Database (Denmark)

    Nguyen, Ngoc Anh; Dao, Trong Tuan; Tung, Bui Thanh

    2011-01-01

    Recently, a novel H1N1 influenza A virus (H1N1/09 virus) was identified and considered a strong candidate for a novel influenza pandemic. As part of an ongoing anti-influenza screening programme on natural products, eight oligostilbenes were isolated as active principles from the methanol extract...

  1. Pandemic (H1N1) 2009 Vaccination and Class Suspensions after Outbreaks, Taipei City, Taiwan

    Science.gov (United States)

    Hsueh, Po-Ren; Lee, Ping-Ing; Chiu, Allen Wen-Hsiang

    2010-01-01

    In Taipei City, class suspensions were implemented beginning September 1, 2009 when transmission of pandemic (H1N1) 2009 infection was suspected. The uptake rate of pandemic (H1N1) 2009 vaccination (starting on November 16, 2009) among students 7–18 years of age was 74.7%. Outbreaks were mitigated after late November 2009. PMID:20678333

  2. Outcomes of Oseltamivir Treatment for H1N1 Infection During Pregnancy: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Nermin Akdemir

    2011-04-01

    CONCLUSION: In this retrospective, study, we found that, H1N1 infection during pregnancy has a good prognosis and without complication for maternal health. Although oseltamivir therapy is safe in pregnant women, it can be associated with cardiac structural cardiac malformations in H1N1 infected pregnancy newborns

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

    Directory of Open Access Journals (Sweden)

    Shrestha Sirjana

    2011-03-01

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

  4. Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009

    OpenAIRE

    Louie, Janice K.; Guevara, Hugo; Boston, Erica; Dahlke, Melissa; Nevarez, Maria; Kong, Tong; Schechter, Robert; Glaser, Carol A.; Schnurr, David P.

    2010-01-01

    We compared the QuickVue Influenza test with PCR for diagnosing pandemic (H1N1) 2009 in 404 persons with influenza-like illness. Overall sensitivity, specificity, and positive and negative predictive values were 66%, 84%, 84%, and 64%, respectively. Rapid test results should be interpreted cautiously when pandemic (H1N1) 2009 virus is suspected.

  5. Adoption of Preventive Measures and Attitudes toward the H1N1 Influenza Pandemic in Schools

    Science.gov (United States)

    Pérez, Anna; Rodríguez, Tània; López, Maria José; Continente, Xavier; Nebot, Manel

    2016-01-01

    Background: This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. Methods: A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was…

  6. Safety of pandemic H1N1 vaccines in children and adolescents

    NARCIS (Netherlands)

    E.G. Wijnans (Leonoor); S. de Bie (Sandra); J.P. Dieleman (Jeanne); J. Bonhoeffer (Jan); M.C.J.M. Sturkenboom (Miriam)

    2011-01-01

    textabstractDuring the 2009 influenza A (H1N1) pandemic several pandemic H1N1 vaccines were licensed using fast track procedures, with relatively limited data on the safety in children and adolescents. Different extensive safety monitoring efforts were put in place to ensure timely detection of

  7. Oseltamivir-resistant influenza virus A (H1N1), Europe, 2007/08 season.

    NARCIS (Netherlands)

    Meijer, A.; Lackenby, A.; Hungnes, O.; Lina, B.; Werf, S. van der; Schweiger, B.; Opp, M.; Paget, J.; Kassteele, J. van de; Hay, A.; Zambon, M.

    2009-01-01

    In Europe, the 2007/08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country,

  8. H1N1 Flu & U.S. Schools: Answers to Frequently Asked Questions

    Science.gov (United States)

    US Department of Education, 2009

    2009-01-01

    A severe form of influenza known as H1N1, commonly being called swine flu, has health officials around the world concerned. In the United States, the outbreak of H1N1 has prompted school closures and cancellation of school-related events. As the flu spreads, the Department of Education encourages school leaders, parents and students to know how to…

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

    Directory of Open Access Journals (Sweden)

    Trivellin Valeria

    2011-11-01

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

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

    Science.gov (United States)

    Trivellin, Valeria; Gandini, Vera; Nespoli, Luigi

    2011-11-10

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

  11. Clinical course of asthma patients with H1N1 influenza infection and oseltamivir.

    Science.gov (United States)

    Kim, Min-Hye; Song, Woo-Jung; Yang, Min-Suk; Lee, So-Hee; Kwon, Jae-Woo; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Cho, Young-Joo; Cho, Sang-Heon; Min, Kyung-Up; Kim, You-Young; Chang, Yoon-Seok

    2018-02-01

    H1N1 influenza virus prevailed throughout the world in 2009. However, there are few reports on the clinical features of H1N1 influenza infection in adult asthma patients. We evaluated the clinical features in asthma patients with H1N1 influenza infection who took oseltamivir and compared them to those with other upper respiratory infections. We reviewed asthma patients over 15 years of age who had visited Seoul National University Hospital and Seoul National University Bundang Hospital for suspected H1N1 influenza infection from August 2009 to March 2010. Various clinical features such as hospital admission days, respiratory symptoms, basal lung function, and past history was compared between H1N1 influenza PCR positive and negative groups. A total of 111 asthmatics were enrolled. All patients took oseltamivir. H1N1 RT-PCR was positive in 62 patients (55.9%), negative in 49 patients (44.1%). Wheezing developed more frequently in the H1N1 positive group. (43.5 vs. 16.7%, P=0.044). The rate of acute asthma exacerbations and pneumonia development were higher in the H1N1 positive group (59.7 vs. 51%, P=0.015, 25.0% vs. 0%, PH1N1 negative patients (21.6% vs. 30.6%, P=0.002), especially cardiac disease (7.2% vs. 15.3%, P=0.011). H1N1 influenza infection may affect the clinical course of asthma combined with more severe manifestations; however, Oseltamivir could have affected the clinical course of H1N1 infected patients and made it milder than expected.

  12. A host transcriptional signature for presymptomatic detection of infection in humans exposed to influenza H1N1 or H3N2.

    Directory of Open Access Journals (Sweden)

    Christopher W Woods

    Full Text Available There is great potential for host-based gene expression analysis to impact the early diagnosis of infectious diseases. In particular, the influenza pandemic of 2009 highlighted the challenges and limitations of traditional pathogen-based testing for suspected upper respiratory viral infection. We inoculated human volunteers with either influenza A (A/Brisbane/59/2007 (H1N1 or A/Wisconsin/67/2005 (H3N2, and assayed the peripheral blood transcriptome every 8 hours for 7 days. Of 41 inoculated volunteers, 18 (44% developed symptomatic infection. Using unbiased sparse latent factor regression analysis, we generated a gene signature (or factor for symptomatic influenza capable of detecting 94% of infected cases. This gene signature is detectable as early as 29 hours post-exposure and achieves maximal accuracy on average 43 hours (p = 0.003, H1N1 and 38 hours (p-value = 0.005, H3N2 before peak clinical symptoms. In order to test the relevance of these findings in naturally acquired disease, a composite influenza A signature built from these challenge studies was applied to Emergency Department patients where it discriminates between swine-origin influenza A/H1N1 (2009 infected and non-infected individuals with 92% accuracy. The host genomic response to Influenza infection is robust and may provide the means for detection before typical clinical symptoms are apparent.

  13. Prevention of influenza virus shedding and protection from lethal H1N1 challenge using a consensus 2009 H1N1 HA and NA adenovirus vector vaccine.

    Science.gov (United States)

    Jones, Frank R; Gabitzsch, Elizabeth S; Xu, Younong; Balint, Joseph P; Borisevich, Viktoriya; Smith, Jennifer; Smith, Jeanon; Peng, Bi-Hung; Walker, Aida; Salazar, Magda; Paessler, Slobodan

    2011-09-16

    Vaccines against emerging pathogens such as the 2009 H1N1 pandemic virus can benefit from current technologies such as rapid genomic sequencing to construct the most biologically relevant vaccine. A novel platform (Ad5 [E1-, E2b-]) has been utilized to induce immune responses to various antigenic targets. We employed this vector platform to express hemagglutinin (HA) and neuraminidase (NA) genes from 2009 H1N1 pandemic viruses. Inserts were consensuses sequences designed from viral isolate sequences and the vaccine was rapidly constructed and produced. Vaccination induced H1N1 immune responses in mice, which afforded protection from lethal virus challenge. In ferrets, vaccination protected from disease development and significantly reduced viral titers in nasal washes. H1N1 cell mediated immunity as well as antibody induction correlated with the prevention of disease symptoms and reduction of virus replication. The Ad5 [E1-, E2b-] should be evaluated for the rapid development of effective vaccines against infectious diseases. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Molecular characterization of pandemic H1N1 influenza viruses isolated from turkeys and pathogenicity of a human pH1N1 isolate in turkeys.

    Science.gov (United States)

    Berhane, Yohannes; Ojkic, Davor; Neufeld, James; Leith, Marsha; Hisanaga, Tamiko; Kehler, Helen; Ferencz, Arpad; Wojcinski, Helen; Cottam-Birt, Colleen; Suderman, Matthew; Handel, Katherine; Alexandersen, Soren; Pasick, John

    2010-12-01

    Suspected human-to-animal transmission of the 2009 pandemic H1N1 (pH1N1) virus has been reported in several animal species, including pigs, dogs, cats, ferrets, and turkeys. In this study we describe the genetic characterization of pH1N1 viruses isolated from breeder turkeys that was associated with a progressive drop in egg production. Sequence analysis of all eight gene segments from three viruses isolated from this outbreak demonstrated homology with other human and swine pH1N1 isolates. The susceptibility of turkeys to a human pH1N1 isolate was further evaluated experimentally. The 50% turkey infectious dose (TID50) for the human isolate A/Mexico/LnDRE/4487/2009 was determined by inoculating groups of 8-10-week-old turkeys with serial 10-fold dilutions of virus by oronasal and cloacal routes. We estimated the TID50 to be between 1 x 10(5) and 1 x 10(6) TCID50. The pathogenesis of pH1N1 in oronasally or cloacally inoculated juvenile turkeys was also examined. None of the turkeys exhibited clinical signs, and no significant difference in virus shedding or seroconversion was observed between the two inoculation groups. More than 50% of the turkeys in both oronasal and cloacal groups shed virus beginning at 2 days postinoculation (dpi). All birds that actively shed virus seroconverted by 14 dpi. Virus antigen was demonstrated by immunohistochemistry in the cecal tonsils and bursa of Fabricius in two of the birds that were infected by the cloacal route. Virus transmission to naive contact turkeys was at best doubtful. This report provides additional evidence that pH1N1 can cross the species barrier and cause disease outbreaks in domestic turkeys. However, it appears that the reproductive status of the host as well as environmental factors such as concurrent infections, stress, the presence or absence of litter, and stocking density may also contribute to efficient infection and transmission of this agent.

  15. Acute respiratory distress syndrome induced by a swine 2009 H1N1 variant in mice.

    Directory of Open Access Journals (Sweden)

    Yi Zhang

    Full Text Available Acute respiratory distress syndrome (ARDS induced by pandemic 2009 H1N1 influenza virus has been widely reported and was considered the main cause of death in critically ill patients with 2009 H1N1 infection. However, no animal model has been developed for ARDS caused by infection with 2009 H1N1 virus. Here, we present a mouse model of ARDS induced by 2009 H1N1 virus.Mice were inoculated with A/swine/Shandong/731/2009 (SD/09, which was a 2009 H1N1 influenza variant with a G222D mutation in the hemagglutinin. Clinical symptoms were recorded every day. Lung injury was assessed by lung water content and histopathological observation. Arterial blood gas, leukocyte count in the bronchial alveolar lavage fluid and blood, virus titers, and cytokine levels in the lung were measured at various times post-inoculation. Mice infected with SD/09 virus showed typical ARDS symptoms characterized by 60% lethality on days 8-10 post-inoculation, highly edematous lungs, inflammatory cellular infiltration, alveolar and interstitial edema, lung hemorrhage, progressive and severe hypoxemia, and elevated levels of proinflammatory cytokines and chemokines.These results suggested that we successfully established an ARDS mouse model induced by a virulent 2009 H1N1 variant without previous adaptation, which may be of benefit for evaluating the pathogenesis or therapy of human ARDS caused by 2009 H1N1 virus.

  16. Pulmonary Embolism Associated with Pandemic H1N1 Influenza A Virus Infection: a Case Report

    Directory of Open Access Journals (Sweden)

    Ahmet Cumhur Dülger

    2011-11-01

    Full Text Available On May 15, 2009, the Turkish Ministry of Health reported the first case of 2009 pandemic influenza A (H1N1 virus infection in the Republic of Turkey. Pandemic H1N1virus is a new and mutant influenza virus and has many epidemiologic and clinic features. These cases have been reported in multiple geographic regions of the world. School children are more affected than adults. In the elderly, it has a higher mortality rate. The clinical aspects of infection with H1N1 influenza A virus remains to be understood. A few cases of pulmonary embolism associated with H1N1 influenza A virus infection were reported. We herein report a pulmonary embolism in a patient with pandemic influenza A (H1N1 virus infection. A 42-year-old Turkish woman was admitted to our emergency department with dyspnea and pleuritic chest pain. She complained of fever, myalgia, sore throat and cough of four days duration on admission to our hospital. She was tested for pandemic influenza A (H1N1 virus by a polymerase chain reaction (PCR test which revealed a positive result. Chest tomography showed pulmonary embolism. She was successfully treated with intravenous heparin and oseltamivir. This case report demonstrates the importance of considering pulmvonary embolism as a diagnosis in 2009 pandemic influenza A (H1N1 virus infected persons who present with sudden onset of dyspnea, fever and chest pain.

  17. Plasma metabolomics for the diagnosis and prognosis of H1N1 influenza pneumonia.

    Science.gov (United States)

    Banoei, Mohammad M; Vogel, Hans J; Weljie, Aalim M; Kumar, Anand; Yende, Sachin; Angus, Derek C; Winston, Brent W

    2017-04-19

    Metabolomics is a tool that has been used for the diagnosis and prognosis of specific diseases. The purpose of this study was to examine if metabolomics could be used as a potential diagnostic and prognostic tool for H1N1 pneumonia. Our hypothesis was that metabolomics can potentially be used early for the diagnosis and prognosis of H1N1 influenza pneumonia. 1 H nuclear magnetic resonance spectroscopy and gas chromatography-mass spectrometry were used to profile the metabolome in 42 patients with H1N1 pneumonia, 31 ventilated control subjects in the intensive care unit (ICU), and 30 culture-positive plasma samples from patients with bacterial community-acquired pneumonia drawn within the first 24 h of hospital admission for diagnosis and prognosis of disease. We found that plasma-based metabolomics from samples taken within 24 h of hospital admission can be used to discriminate H1N1 pneumonia from bacterial pneumonia and nonsurvivors from survivors of H1N1 pneumonia. Moreover, metabolomics is a highly sensitive and specific tool for the 90-day prognosis of mortality in H1N1 pneumonia. This study demonstrates that H1N1 pneumonia can create a quite different plasma metabolic profile from bacterial culture-positive pneumonia and ventilated control subjects in the ICU on the basis of plasma samples taken within 24 h of hospital/ICU admission, early in the course of disease.

  18. Thromboembolic events in patients with severe pandemic influenza A/H1N1.

    Science.gov (United States)

    Avnon, Lone Sølling; Munteanu, Daniela; Smoliakov, Alexander; Jotkowitz, Alan; Barski, Leonid

    2015-10-01

    The 2009 pandemic influenza A/H1N1 developed as a novel swine influenza which caused more diseases among younger age groups than in the elderly. Severe hypoxemic respiratory failure from A/H1N1 pneumonia resulted in an increased need for ICU beds. Several risk groups were identified that were at a higher risk for adverse outcomes. Pregnant women were a particularly vulnerable group of patients The CDC reported on the first ten patients with severe illness and acute hypoxemic respiratory failure associated with A/H1N1 infection, none of whom were pregnant, but they noticed that half of the patients had a pulmonary embolism. During a four-month period from September to December 2009, 252 patients were admitted to our hospital with confirmed pandemic influenza H1N1 by real-time reverse transcriptase-polymerase chain reaction test (rRT-PCR). We cared for twenty patients (7.9%) admitted to MICU with severe A/H1N1. Results on Thrombotic events were identified in five (25%) of our critically ill patients. We recommend that patients with severe influenza A/H1N1 pneumonitis and respiratory failure be administered DVT prophylaxis in particular if there are additional risk factors for TVE. Further prospective studies on the relationship of influenza A/H1N1 and VTE are needed. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  19. The Neurological Manifestations of H1N1 Influenza Infection; Diagnostic Challenges and Recommendations

    Directory of Open Access Journals (Sweden)

    Ali Akbar Asadi-Pooya

    2011-03-01

    Full Text Available Background: World Health Organization declared pandemic phase of human infection with novel influenza A (H1N1 in April 2009. There are very few reports about the neurological complications of H1N1 virus infection in the literature. Occasionally, these complications are severe and even fatal in some individuals. The aims of this study were to report neurological complaints and/or complications associated with H1N1 virus infection. Methods: The medical files of all patients with H1N1 influenza infection admitted to a specified hospital in the city of Shiraz, Iran from October through November 2009 were reviewed. More information about the patients were obtained by phone calls to the patients or their care givers. All patients had confirmed H1N1 virus infection with real-time PCR assay. Results: Fifty-five patients with H1N1 infection were studied. Twenty-three patients had neurological signs and/or symptoms. Mild neurological complaints may be reported in up to 42% of patients infected by H1N1 virus. Severe neurological complications occurred in 9% of the patients. The most common neurological manifestations were headache, numbness and paresthesia, drowsiness and coma. One patient had a Guillain-Barre syndrome-like illness, and died in a few days. Another patient had focal status epilepticus and encephalopathy. Conclusions: The H1N1 infection seems to have been quite mild with a self-limited course in much of the world, yet there appears to be a subset, which is severely affected. We recommend performing diagnostic tests for H1N1influenza virus in all patients with respiratory illness and neurological signs/symptoms. We also recommend initiating treatment with appropriate antiviral drugs as soon as possible in those with any significant neurological presentation accompanied with respiratory illness and flu-like symptoms

  20. Evolutionary trends of A(H1N1 influenza virus hemagglutinin since 1918.

    Directory of Open Access Journals (Sweden)

    Jun Shen

    2009-11-01

    Full Text Available The Pandemic (H1N1 2009 is spreading to numerous countries and causing many human deaths. Although the symptoms in humans are mild at present, fears are that further mutations in the virus could lead to a potentially more dangerous outbreak in subsequent months. As the primary immunity-eliciting antigen, hemagglutinin (HA is the major agent for host-driven antigenic drift in A(H3N2 virus. However, whether and how the evolution of HA is influenced by existing immunity is poorly understood for A(H1N1. Here, by analyzing hundreds of A(H1N1 HA sequences since 1918, we show the first evidence that host selections are indeed present in A(H1N1 HAs. Among a subgroup of human A(H1N1 HAs between 1918 approximately 2008, we found strong diversifying (positive selection at HA(1 156 and 190. We also analyzed the evolutionary trends at HA(1 190 and 225 that are critical determinants for receptor-binding specificity of A(H1N1 HA. Different A(H1N1 viruses appeared to favor one of these two sites in host-driven antigenic drift: epidemic A(H1N1 HAs favor HA(1 190 while the 1918 pandemic and swine HAs favor HA(1 225. Thus, our results highlight the urgency to understand the interplay between antigenic drift and receptor binding in HA evolution, and provide molecular signatures for monitoring future antigenically drifted 2009 pandemic and seasonal A(H1N1 influenza viruses.

  1. The Influenza Virus and the 2009 H1N1 Outbreak

    Science.gov (United States)

    2016-04-08

    vaccine contents 2 Video depicting USAF ’’Epi lab’s’’ discovery of H1N1 April 1 2009 Video team comes to our lab to film a documentary on our role...98.2°/o homology with respect to the HA 1 region of HA Swine H1 N1 has about 73°/o homology with respect to the current vaccine for H1 N1 (anything...below 97°/o is a preliminary predictive factor for a strain that the vaccine will not protect against) A.SouthCarolina.2510.200 A.Georgia

  2. Hospitalizations Associated with Pandemic Influenza A (H1N1) 2009 in Asthmatic Children in Japan

    OpenAIRE

    Toshio Katsunuma; Takehiko Matsui; Tsutomu Iwata; Mitsuhiko Nambu; Naomi Kondo

    2012-01-01

    Background: The pandemic influenza A (H1N1) 2009 [pdm (H1N1) 2009] spread through the world in 2009, producing a serious epidemic in Japan. Since it was suggested early that asthma is a risk factor for an increased severity of the infection, the Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI) organized a working group for countermeasures, and investigated asthmatic children admitted to the hospitals for pdm (H1N1) 2009 infection. Methods: An appeal was made on the ho...

  3. Pulmonary Embolism Associated with Pandemic H1N1 Influenza A Virus Infection: a Case Report

    OpenAIRE

    Dülger, Ahmet Cumhur; Avcu, Serhat; Arslan, Harun; Özbay, Bülent; Günbatar, Hülya; Küçükoğlu, Mehmet Emin; Bartın, Mehmet Kadir

    2011-01-01

    On May 15, 2009, the Turkish Ministry of Health reported the first case of 2009 pandemic influenza A (H1N1) virus infection in the Republic of Turkey. Pandemic H1N1virus is a new and mutant influenza virus and has many epidemiologic and clinic features. These cases have been reported in multiple geographic regions of the world. School children are more affected than adults. In the elderly, it has a higher mortality rate. The clinical aspects of infection with H1N1 influenza A virus remains to...

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

    OpenAIRE

    Adhikari, Bal Ram; Shakya, Geeta; Upadhyay, Bishnu Prasad; Prakash KC, Khagendra; Shrestha, Sirjana Devi; Dhungana, Guna Raj

    2011-01-01

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

  5. Elicitation of Protective Antibodies against a Broad Panel of H1N1 Viruses in Ferrets Preimmune to Historical H1N1 Influenza Viruses.

    Science.gov (United States)

    Carter, Donald M; Darby, Christopher A; Johnson, Scott K; Carlock, Michael A; Kirchenbaum, Greg A; Allen, James D; Vogel, Thorsten U; Delagrave, Simon; DiNapoli, Joshua; Kleanthous, Harold; Ross, Ted M

    2017-12-15

    Most preclinical animal studies test influenza vaccines in immunologically naive animal models, even though the results of vaccination may not accurately reflect the effectiveness of vaccine candidates in humans that have preexisting immunity to influenza. In this study, novel, broadly reactive influenza vaccine candidates were assessed in preimmune ferrets. These animals were infected with different H1N1 isolates before being vaccinated or infected with another influenza virus. Previously, our group has described the design and characterization of computationally optimized broadly reactive hemagglutinin (HA) antigens (COBRA) for H1N1 isolates. Vaccinating ferrets with virus-like particle (VLP) vaccines expressing COBRA HA proteins elicited antibodies with hemagglutination inhibition (HAI) activity against more H1N1 viruses in the panel than VLP vaccines expressing wild-type HA proteins. Specifically, ferrets infected with the 1986 virus and vaccinated with a single dose of the COBRA HA VLP vaccines elicited antibodies with HAI activity against 11 to 14 of the 15 H1N1 viruses isolated between 1934 and 2013. A subset of ferrets was infected with influenza viruses expressing the COBRA HA antigens. These COBRA preimmune ferrets had superior breadth of HAI activity after vaccination with COBRA HA VLP vaccines than COBRA preimmune ferrets vaccinated with VLP vaccines expressing wild-type HA proteins. Overall, priming naive ferrets with COBRA HA based viruses or using COBRA HA based vaccines to boost preexisting antibodies induced by wild-type H1N1 viruses, COBRA HA antigens elicited sera with the broadest HAI reactivity against multiple antigenic H1N1 viral variants. This is the first report demonstrating the effectiveness of a broadly reactive or universal influenza vaccine in a preimmune ferret model. IMPORTANCE Currently, many groups are testing influenza vaccine candidates to meet the challenge of developing a vaccine that elicits broadly reactive and long

  6. Critical analysis of deaths due to atypical pneumonia during the onset of the influenza A (H1N1) virus epidemic.

    Science.gov (United States)

    Grijalva-Otero, Israel; Talavera, Juan Osvaldo; Solorzano-Santos, Fortino; Vazquez-Rosales, Guillermo; Vladislavovna-Doubova, Svetlana; Pérez-Cuevas, Ricardo; Miranda-Novales, Guadalupe; García-Peña, Carmen; Espinel-Bermúdez, Claudia; Torres, Javier; de la Peña, Jorge Escobedo

    2009-11-01

    The ongoing influenza A (H1N1) pandemic stroked Mexico and posed a huge challenge to the medical care and public health systems. This report analyzes the clinical course and process of care of patients who died due to atypical pneumonia and fulfilled the clinical criteria of suspected case of novel influenza A (H1N1) virus infection. We conducted a retrospective analysis of a series of 38 patients who died between April 7 and April 28, 2009 at Instituto Mexicano del Seguro Social (IMSS) hospitals due to severe pneumonia and respiratory distress. These cases coincided with the beginning of the outbreak, so patients did not undergo laboratory testing to diagnose influenza. According to IMSS and CDC criteria, post-hoc analysis allowed considering the presumptive diagnosis of S-OIV infection. A multidisciplinary group analyzed the information from the clinical charts, laboratory tests, radiographic studies and death certificates, using descriptive statistics. Most cases were middle-aged (mean 33 years, range: 4-62 years) and previously healthy; 18.4% had an underlying chronic disease, 23.7% were obese and 7.9% were current smokers. None had received the seasonal influenza vaccine; they had cough (92%), fever (86.8%), and malaise (73.7%). The median time from disease onset to hospital admission was 6 days (range 0-8 days). All were admitted to the intensive care unit with pneumonia and/or respiratory distress. Average time from disease onset to death was 8 days (range 4-18 days). An increased number of severe cases of atypical pneumonia in previously healthy adults highlight the importance of the availability of a timely surveillance system able to identify sudden increases in the number of cases or presentation of apparently known diseases.

  7. H1N1 infection in emergency surgery: A cautionary tale.

    LENUS (Irish Health Repository)

    Galbraith, J G

    2010-01-01

    Pandemic 2009 influenza A H1N1 has spread rapidly since its first report in Mexico in March 2009. This is the first influenza pandemic in over 40 years and it atypically affects previously healthy young adults, with higher rates of morbidity and mortality. The medical literature has been inundated with reports of H1N1 infection, the majority found in critical care and internal medicine journals with a relative paucity in the surgical literature. Despite this, it remains an important entity that can impact greatly on acute surgical emergencies. We present a case of previously healthy 31-year-old male who underwent open appendectomy. His post-operative recovery was complicated by acute respiratory distress syndrome secondary to H1N1 infection. This case report highlights the impact that H1N1 virus can have on acute surgical emergencies and how it can complicate the post-operative course.

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

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

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

  9. A highly specific ELISA for diagnosis of 2009 influenza A (H1N1 virus infections

    Directory of Open Access Journals (Sweden)

    Chun-Yi Lu

    2012-12-01

    Conclusion: The ELISA is an easy to perform, highly specific, and fairly sensitive diagnostic tool for the 2009 pandemic influenza A (H1N1 virus infections. A strong correlation was found between viral load and specificity.

  10. H1N1 and influenza viruses: why pregnant women might be hesitant to be vaccinated.

    Science.gov (United States)

    Mirdamadi, Kamelia; Einarson, Adrienne

    2011-09-01

    I have been encouraging pregnant women to receive both the H1N1 and influenza vaccines since I became aware of Health Canada's guidelines. However, some of the women in my practice have heard conflicting information, often from media sources, and they are hesitant to be vaccinated. What is the evidence behind these guidelines, and should I really be convincing these women to be vaccinated? Pregnant women and growing fetuses are considered a population vulnerable to H1N1 and influenza viruses. Health Canada published a report in late 2010 estimating that this population was at increased risk of hospitalization and severe outcomes of H1N1 infection. Recommendations included pregnant women as a priority group to receive the H1N1 vaccine as well as the influenza vaccine. This information should be explained unambiguously to pregnant women, and they should be made aware of the sensationalism of media reports, which are often based on opinion and not evidence.

  11. The seroprevalence of pandemic influenza H1N1 (2009 virus in China.

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    Cuiling Xu

    2011-04-01

    Full Text Available Mainland China experienced pandemic influenza H1N1 (2009 virus (pH1N1 with peak activity during November-December 2009. To understand the geographic extent, risk factors, and attack rate of pH1N1 infection in China we conducted a nationwide serological survey to determine the prevalence of antibodies to pH1N1.Stored serum samples (n = 2,379 collected during 2006-2008 were used to estimate baseline serum reactogenicity to pH1N1. In January 2010, we used a multistage-stratified random sampling method to select 50,111 subjects who met eligibility criteria and collected serum samples and administered a standardized questionnaire. Antibody response to pH1N1 was measured using haemagglutination inhibition (HI assay and the weighted seroprevalence was calculated using the Taylor series linearization method. Multivariable logistic regression analyses were used to examine risk factors for pH1N1 seropositivity. Baseline seroprevalence of pH1N1 antibody (HI titer ≥40 was 1.2%. The weighted seroprevalence of pH1N1 among the Chinese population was 21.5%(vaccinated: 62.0%; unvaccinated: 17.1%. Among unvaccinated participants, those aged 6-15 years (32.9% and 16-24 years (30.3% had higher seroprevalence compared with participants aged 25-59 years (10.7% and ≥60 years (9.9%, P<0.0001. Children in kindergarten and students had higher odds of seropositivity than children in family care (OR: 1.36 and 2.05, respectively. We estimated that 207.7 million individuals (15.9% experienced pH1N1 infection in China.The Chinese population had low pre-existing immunity to pH1N1 and experienced a relatively high attack rate in 2009 of this virus. We recommend routine control measures such as vaccination to reduce transmission and spread of seasonal and pandemic influenza viruses.

  12. Clinical and Demographic Characteristics of Confirmed Cases in H1N1 (2009) Influenza.

    Science.gov (United States)

    Moradi, Ahmadreza; Sigaroodi, Afsaneh; Poosh-Ashkan, Leila; Nadji, Seyed Alireza; Tabarsi, Payam; Mansouri, Seyed Davood; Masjedi, Mohammadreza; Velayati, Ali Akbar

    2011-01-01

    Presentation of pandemic H1N1 influenza (H1N1) is widely evolving as it continues to involve different geographic locations and populations. This study was conducted to improve the precision of clinical diagnosis of H1N1 (2009) influenza infection in an outpatient setting. A prospective cross-sectional study was conducted among adult patients (age >15 years) with influenza-like illnesses (ILI) from November 2009 to February 2010. Clinical, laboratory and epidemiological findings in the first week of illness were collected using a standardized datasheet. Influenza testing was performed by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Thirty nine (24%) patients were positive for H1N1 and 123 (76%) were negative for any subtype of influenza A virus. Whilst otalgia (14% vs. 0 p= 0.01) was more prevalent in non-influenza A cases, cough (90% vs. 72% p = 0.03) and shortness of breath (67% vs. 47% p = 0.02) were more often associated with H1N1-infection. Comparative analysis of co-existing conditions and demographic factors of patients revealed no other significant differences between the two groups. The clinical presentation of H1N1 (2009) infection is largely indistinguishable from other acute respiratory diseases. Although previous studies suggested significant differences in demographic and co-existing conditions of H1N1 infected patients, our study shows that as the pandemic spreads worldwide and affects the majority of the population, H1N1 diagnosis based on clinical presentation and demographic characteristics has become less practical and much more difficult in tertiary care centers.

  13. Radiologic Findings of Influenza A (H1N1) Pneumonia: Report of Two Cases

    International Nuclear Information System (INIS)

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Park, Seog Hee; Park, Chan Kwon; Kim, Young Kyoon

    2010-01-01

    Novel influenza A (H1N1) infection is a highly infectious disease, which has been rapidly spreading worldwide since it was first documented in March of 2009 in Mexico. We experienced and report two cases of Influenza A (H1N1) pneumonia, accompanied by chest radiographic and CT findings. The chest radiographs revealed diffuse haziness and extensive airspace consolidation, whereas the CT scans demonstrated multifocal areas of ground glass opacity and airspace consolidation with a CT halo sign

  14. Pandemic (H1N1) 2009 and Hajj Pilgrims Who Received Predeparture Vaccination, Egypt

    Science.gov (United States)

    Kandeel, Amr; Abdel Kereem, Eman; El-Refay, Samir; Afifi, Salma; Abukela, Mohammed; Earhart, Kenneth; El-Sayed, Nasr; El-Gabaly, Hatem

    2011-01-01

    In Egypt, vaccination against pandemic (H1N1) 2009 virus was required of pilgrims departing for the 2009 Hajj. A survey of 551 pilgrims as they returned to Egypt found 542 (98.1% [weighted]) reported receiving the vaccine; 6 (1.0% [weighted]) were infected with influenza virus A (H3N2) but none with pandemic (H1N1) 2009 virus. PMID:21762583

  15. Rapid Development of an Efficacious Swine Vaccine for Novel H1N1

    OpenAIRE

    Vander Veen, Ryan; Kamrud, Kurt; Mogler, Mark; Loynachan, Alan T.; McVicker, Jerry; Berglund, Peter; Owens, Gary; Timberlake, Sarah; Lewis, Whitney; Smith, Jonathan; Harris, DL Hank

    2009-01-01

    Recombinant hemagglutinin (HA) from a novel H1N1 influenza strain was produced using an alphavirus replicon expression system. The recombinant HA vaccine was produced more rapidly than traditional vaccines, and was evaluated as a swine vaccine candidate at different doses in a challenge model utilizing the homologous influenza A/California/04/2009 (H1N1) strain. Vaccinated animals showed significantly higher specific antibody response, reduced lung lesions and viral shedding, and higher avera...

  16. H1N1pdm influenza infection in hospitalized cancer patients: clinical evolution and viral analysis.

    Directory of Open Access Journals (Sweden)

    Thiago Moreno L Souza

    Full Text Available BACKGROUND: The novel influenza A pandemic virus (H1N1pdm caused considerable morbidity and mortality worldwide in 2009. The aim of the present study was to evaluate the clinical course, duration of viral shedding, H1N1pdm evolution and emergence of antiviral resistance in hospitalized cancer patients with severe H1N1pdm infections during the winter of 2009 in Brazil. METHODS: We performed a prospective single-center cohort study in a cancer center in Rio de Janeiro, Brazil. Hospitalized patients with cancer and a confirmed diagnosis of influenza A H1N1pdm were evaluated. The main outcome measures in this study were in-hospital mortality, duration of viral shedding, viral persistence and both functional and molecular analyses of H1N1pdm susceptibility to oseltamivir. RESULTS: A total of 44 hospitalized patients with suspected influenza-like illness were screened. A total of 24 had diagnosed H1N1pdm infections. The overall hospital mortality in our cohort was 21%. Thirteen (54% patients required intensive care. The median age of the studied cohort was 14.5 years (3-69 years. Eighteen (75% patients had received chemotherapy in the previous month, and 14 were neutropenic at the onset of influenza. A total of 10 patients were evaluated for their duration of viral shedding, and 5 (50% displayed prolonged viral shedding (median 23, range=11-63 days; however, this was not associated with the emergence of a resistant H1N1pdm virus. Viral evolution was observed in sequentially collected samples. CONCLUSIONS: Prolonged influenza A H1N1pdm shedding was observed in cancer patients. However, oseltamivir resistance was not detected. Taken together, our data suggest that severely ill cancer patients may constitute a pandemic virus reservoir with major implications for viral propagation.

  17. Bleeding Follicular Conjunctivitis due to Influenza H1N1 Virus

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    Maria Jesus Lopez-Prats

    2010-01-01

    Full Text Available Influenza H1N1 or A virus is a new virus serotype capable of human-to-human transmission. This infection causes a flu syndrome similar to that of seasonal influenza, with only one case of conjunctivitis described and no clinical details or microbiological confirmation. Its diagnosis is performed by PCR of pharyngeal smear of the patients affected. We report the first well-documented case in the medical literature of conjunctivitis by H1N1 virus.

  18. Obstetricians and the 2009-2010 H1N1 vaccination effort: implications for future pandemics.

    Science.gov (United States)

    Clark, Sarah J; Cowan, Anne E; Wortley, Pascale M

    2013-09-01

    Our objective was to describe the experiences of obstetricians during the 2009-2010 H1N1 vaccination campaign in order to identify possible improvements for future pandemic situations. We conducted a cross-sectional mail survey of a national random sample of 4,000 obstetricians, fielded in Summer 2010. Survey items included availability, recommendation, and patient acceptance of H1N1 vaccine; prioritization of H1N1 vaccine when supply was limited; problems with H1N1 vaccination; and likelihood of providing vaccine during a future influenza pandemic. Response rate was 66 %. Obstetricians strongly recommended H1N1 vaccine during the second (85 %) and third (86 %) trimesters, and less often during the first trimester (71 %) or the immediate postpartum period (76 %); patient preferences followed a similar pattern. H1N1 vaccine was typically available in outpatient obstetrics clinics (80 %). Overall vaccine supply was a major problem for 30 % of obstetricians, but few rated lack of thimerosal-free vaccine as a major problem (12 %). Over half of obstetricians had no major problems with the H1N1 vaccine campaign. Based on this experience, 74 % would be "very likely" and 12 % "likely" to provide vaccine in the event of a future influenza pandemic. Most obstetricians strongly recommended H1N1 vaccine, had few logistical problems beyond limited vaccine supply, and are willing to vaccinate in a future pandemic. Addressing concerns about first-trimester vaccination, developing guidance for prioritization of vaccine in the event of severe supply constraints, and continued facilitation of the logistical aspects of vaccination should be emphasized in future influenza pandemics.

  19. Kompliceret influenza A (H1N1) hos gravid i andet trimester

    DEFF Research Database (Denmark)

    Ersboell, Anne Schjoedt; Hesselvig, Anne Brun; Hedegaard, Morten

    2012-01-01

    A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded...... and an emergency caesarean was performed at 26 weeks + 2 days of gestation. The neonatal period was uncomplicated. Influenza A (H1N1) is especially dangerous in pregnant women and vaccination is important....

  20. Radiologic Findings of Influenza A (H1N1) Pneumonia: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Park, Seog Hee; Park, Chan Kwon; Kim, Young Kyoon [Seoul St. Mary' s Hospital, Seoul (Korea, Republic of)

    2010-08-15

    Novel influenza A (H1N1) infection is a highly infectious disease, which has been rapidly spreading worldwide since it was first documented in March of 2009 in Mexico. We experienced and report two cases of Influenza A (H1N1) pneumonia, accompanied by chest radiographic and CT findings. The chest radiographs revealed diffuse haziness and extensive airspace consolidation, whereas the CT scans demonstrated multifocal areas of ground glass opacity and airspace consolidation with a CT halo sign.

  1. Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports

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    Iannuzzi Michele

    2011-10-01

    Full Text Available Abstract Introduction Media sensationalism on the H1N1 outbreak may have influenced decisional processes and clinical diagnosis. Case Presentation We report two cases of patients who presented in 2009 with coexisting H1N1 virus and Legionella infections: a 69-year-old Caucasian man and a 71-year-old Caucasian woman. In our cases all the signs and symptoms, including vomiting, progressive respiratory disease leading to respiratory failure, refractory hypoxemia, leukopenia, lymphopenia, thrombocytopenia, and elevated levels of creatine kinase and hepatic aminotransferases, were consistent with critical illness due to 2009 H1N1 virus infection. Other infectious disorders may mimic H1N1 viral infection especially Legionnaires' disease. Because the swine flu H1N1 pandemic occurred in Autumn in Italy, Legionnaires disease was to be highly suspected since the peak incidence usually occurs in early fall. We do think that our immediate suspicion of Legionella infection based on clinical history and X-ray abnormalities was fundamental for a successful resolution. Conclusion Our two case reports suggest that patients with H1N1 should be screened for Legionella, which is not currently common practice. This is particularly important since the signs and symptoms of both infections are similar.

  2. Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports.

    Science.gov (United States)

    Iannuzzi, Michele; De Robertis, Edoardo; Piazza, Ornella; Rispoli, Fabio; Servillo, Giuseppe; Tufano, Rosalba

    2011-10-21

    Media sensationalism on the H1N1 outbreak may have influenced decisional processes and clinical diagnosis. We report two cases of patients who presented in 2009 with coexisting H1N1 virus and Legionella infections: a 69-year-old Caucasian man and a 71-year-old Caucasian woman. In our cases all the signs and symptoms, including vomiting, progressive respiratory disease leading to respiratory failure, refractory hypoxemia, leukopenia, lymphopenia, thrombocytopenia, and elevated levels of creatine kinase and hepatic aminotransferases, were consistent with critical illness due to 2009 H1N1 virus infection. Other infectious disorders may mimic H1N1 viral infection especially Legionnaires' disease. Because the swine flu H1N1 pandemic occurred in Autumn in Italy, Legionnaires disease was to be highly suspected since the peak incidence usually occurs in early fall. We do think that our immediate suspicion of Legionella infection based on clinical history and X-ray abnormalities was fundamental for a successful resolution. Our two case reports suggest that patients with H1N1 should be screened for Legionella, which is not currently common practice. This is particularly important since the signs and symptoms of both infections are similar.

  3. Intense seasonal A/H1N1 influenza in Mexico, winter 2013-2014.

    Science.gov (United States)

    Dávila-Torres, Javier; Chowell, Gerardo; Borja-Aburto, Víctor H; Viboud, Cécile; Grajalez-Muñiz, Concepción; Miller, Mark A

    2015-01-01

    A recrudescent wave of pandemic influenza A/H1N1 affected Mexico during the winter of 2013-2014 following a mild 2012-2013 A/H3N2 influenza season. We compared the demographic and geographic characteristics of hospitalizations and inpatient deaths for severe acute respiratory infection (SARI) and laboratory-confirmed influenza during the 2013-2014 influenza season compared to previous influenza seasons, based on a large prospective surveillance system maintained by the Mexican Social Security health care system. A total of 14,236 SARI hospitalizations and 1,163 inpatient deaths (8.2%) were reported between October 1, 2013 and March 31, 2014. Rates of laboratory-confirmed A/H1N1 hospitalizations and deaths were significantly higher among individuals aged 30-59 years and lower among younger age groups for the 2013-2014 A/H1N1 season compared to the previous A/H1N1 season in 2011-2012 (χ(2) test, p influenza season in central Mexico was estimated at 1.3-1.4, in line with that reported for the 2011-2012 A/H1N1 season but lower than during the initial waves of pandemic A/H1N1 activity in 2009. We documented a substantial increase in the number of A/H1N1-related hospitalizations and deaths during the period from October 2013-March 2014 in Mexico and a proportionate shift of severe disease to middle-aged adults, relative to the preceding A/H1N1 2011-2012 season. In the absence of clear antigenic drift in globally circulating A/H1N1 viruses in the post-2009 pandemic period, the gradual change in the age distribution of A/H1N1 infections observed in Mexico suggests a slow build-up of immunity among younger populations, reminiscent of the age profile of past pandemics. Copyright © 2015 IMSS. All rights reserved.

  4. Clinical profile and outcome of critically ill pregnant females with H1N1 influenza

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    Minal Shastri

    2016-12-01

    Full Text Available Background Record based review of the 2009 H1N1 Influenza pandemic suggests that pregnant women are at higher risk for hospitalization and death due to H1N1 Influenza. Aims To study the clinical profile and outcome of critically ill pregnant females admitted in intensive care unit (ICU with real-time recombinant polymerase chain reaction (rRT-PCR proven positive H1N1 cases. Methods A retrospective record-review based study was conducted at Sir SayajiRao General Hospital (SSGH and Medical College, Vadodara on data of confirmed rRT-PCR H1N1 pregnant females admitted during the pandemics of 2010and 2015. Demographics, clinical profile and laboratory investigations were recorded and outcomes (survived or expired were analysed. Results There were a total of 20 H1N1 positive pregnant females requiring ICU admission. With equal demographic distribution among rural and urban population, cough and fever were the most common presenting complaints. 65 per cent were in third trimester, the subgroup which also had the highest mortality. Mean days from onset until presentation was 5.05 days. 12 (60 per cent patients’ required invasive mode of ventilation and all died. Average hospital stay was 7 days. Foetus had favourable outcome in patients who recovered from H1N1 acute illness. Conclusion Pregnant females in our study had 60 per cent mortality. Thus, awareness, early diagnosis and treatment should be provided to them. Guidelines, policy changes and government protocols are required specifically for pregnant females with H1N1 Influenza A infection. Our study was an observational study and comparisons with non-pregnant females were not done, conclusions applicable to entire pregnant population was not derived.

  5. Pandemic influenza (H1N1 2009 is associated with severe disease in India.

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    Akhilesh C Mishra

    2010-05-01

    Full Text Available Pandemic influenza A (H1N1 2009 has posed a serious public health challenge world-wide. In absence of reliable information on severity of the disease, the nations are unable to decide on the appropriate response against this disease.Based on the results of laboratory investigations, attendance in outpatient department, hospital admissions and mortality from the cases of influenza like illness from 1 August to 31 October 2009 in Pune urban agglomeration, risk of hospitalization and case fatality ratio were assessed to determine the severity of pandemic H1N1 and seasonal influenza-A infections.Prevalence of pandemic H1N1 as well as seasonal-A cases were high in Pune urban agglomeration during the study period. The cases positive for pandemic H1N1 virus had significantly higher risk of hospitalization than those positive for seasonal influenza-A viruses (OR: 1.7. Of 93 influenza related deaths, 57 and 8 deaths from Pune (urban and 27 and 1 death from Pune (rural were from pandemic H1N1 positive and seasonal-A positive cases respectively. The case fatality ratio 0.86% for pandemic H1N1 was significantly higher than that of seasonal-A (0.13% and it was in category 3 of the pandemic severity index of CDC, USA. The data on the cumulative fatality of rural and urban Pune revealed that with time the epidemic is spreading to rural areas.The severity of the H1N1 influenza pandemic is less than that reported for 'Spanish flu 1918' but higher than other pandemics of the 20(th century. Thus, pandemic influenza should be considered as serious health threat and unprecedented global response seems justified.

  6. [Influenza H1N1 in obstetric population of a general hospital in Oaxaca].

    Science.gov (United States)

    Calvo Aguilar, Omar; Canalizo Mendoza, Yazmín Ruth; Hernández Cuevas, Maritza Jenny

    2011-06-01

    In April 2009 are reported the first cases of H1N1 influenza in Mexico, presenting the first death from this cause in the city of Oaxaca in the same month. Different epidemiological reports of pandemics brought to the pregnant and high risk population for complications secondary to infection with influenza H1N1 due to immune status. describe the obstetric population infected with H1N1 influenza in the Hospital General Dr. Aurelio Valdivieso of Oaxaca. Retrospective and observational study conducted in pregnant women with suspected infection by the virus of the influenza A/H1N1 served in the General Hospital Aurelio Valdivieso of Oaxaca, Oax in 13 patients with influenza H1N1 confirmed by RT-PCR during the pandemic occurred from May 2009 to April 2010. We reported 27 suspected cases of H1N1 influenza in pregnant women of which 13 were positive by RT-PCR, the cumulative incidence was 1.6 per 1000 pregnant women during the period. The fatality rate was 7.6 per hundred pregnant women affected, one case of maternal death indirectly by fluid and electrolyte imbalance occurred and the attack rate was 0.16 per 100 pregnant women, the main complication of atypical pneumonia occurred in four cases followed by three cases of preeclampsia, infants showed no defects and perinatal outcomes were good to present two cases of admission to the NICU for iatrogenic prematurity without deaths. H1N1 influenza infection has a high fatality rate in late pregnancy. Perinatal outcomes did not worsen the condition or management.

  7. Canadian newspaper coverage of the A/H1N1 vaccine program.

    Science.gov (United States)

    Rachul, Christen M; Ries, Nola M; Caulfield, Timothy

    2011-01-01

    The A/H1N1 mass vaccination program in Canada garnered considerable attention from the media, including extensive newspaper coverage. Media reports have been shown to influence the public's health care decisions, including vaccination choices. We analyzed Canadian newspapers' portrayal of the A/H1N1 vaccine including mention of risks and benefits of the vaccine and whether the article supported, questioned or was neutral about the vaccine. We compiled a data set of Canadian newspaper articles (N = 234) and conducted a frequency content analysis to examine discussion and/or mention of evidence concerning vaccination, risks of the A/H1N1 virus and the vaccine, and tone of article in regards to the vaccination program in Canada. Reasons for getting vaccinated appeared in 71.8% of the articles, whereas only 18.4% provided reasons against getting vaccinated. Discussion of evidence to support claims for or against getting vaccinated appeared in only 27.8% and 6.8% of the articles, respectively. Risks associated with contracting the A/H1N1 virus were discussed in 49.6% of the articles and risks of the A/H1N1 vaccine were discussed in 12.4% of the articles. Newspaper coverage in Canada was largely supportive of the A/H1N1 mass vaccination program. However, serious risks associated with contracting the A/H1N1 virus were also frequently discussed in the print media. The news articles rarely presented direct evidence to support statements that the vaccine was safe, effective and properly tested. Known risks (such as potential allergic reactions and flu-like side effects) of the vaccine were rarely reported. The relationship between media portrayals and vaccine uptake warrants further research.

  8. New Onset Refractory Status Epilepticus in a Young Man with H1N1 Infection

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    Faisal Ibrahim

    2014-01-01

    Full Text Available Objective. To report a case of refractory status epilepticus (SE as an unusual early manifestation of H1N1 influenza infection. Introduction. H1N1 neurological complications have been reported and consist mainly of seizures or encephalopathy occurring in children. However, we only found a single report of an adult developing complex partial SE with H1N1 infection. Case Report. A 21-year-old previously healthy man was brought to the emergency room (ER after a witnessed generalized tonic clonic seizure (GTCS. He was fully alert and afebrile upon ER arrival, but a second GTCS prompted treatment with Lorazepam and Fosphenytoin. The initial EEG showed diffuse slowing, but a repeat one requested as the patient failed to regain consciousness revealed recurrent focal seizures of independent bihemispheric origin, fulfilling the criteria for nonconvulsive SE. Chest X-ray, followed by chest CT scan, showed a left upper lobe consolidation. H1N1 infection was confirmed with PCR on bronchoalveolar lavage material. Despite aggressive treatment with Midazolam, Propofol, and multiple high dose antiepileptic drugs, the electrographic seizures recurred at every attempt to reduce the intravenous sedative drugs. The patient died two weeks after his initial presentation. Conclusion. H1N1 should be added to the list of rare causes of refractory SE, regardless of the patient’s age.

  9. The social determinants of health and pandemic H1N1 2009 influenza severity.

    Science.gov (United States)

    Lowcock, Elizabeth C; Rosella, Laura C; Foisy, Julie; McGeer, Allison; Crowcroft, Natasha

    2012-08-01

    We explored the effects of social determinants of health on pandemic H1N1 2009 influenza severity and the role of clinical risk factors in mediating such associations. We used multivariate logistic regression with generalized estimating equations to examine the associations between individual- and ecological-level social determinants of health and hospitalization for pandemic H1N1 2009 illness in a case-control study in Ontario, Canada. During the first pandemic phase (April 23-July 20, 2009), hospitalization was associated with having a high school education or less and living in a neighborhood with high material or total deprivation. We also observed the association with education in the second phase (August 1-November 6, 2009). Clinical risk factors for severe pandemic H1N1 2009 illness mediated approximately 39% of the observed association. The main clinical risk factors for severe pandemic H1N1 2009 illness explain only a portion of the associations observed between social determinants of health and hospitalization, suggesting that the means by which the social determinants of health affect pandemic H1N1 2009 outcomes extend beyond clinically recognized risk factors.

  10. The economic burden of the 2009 pandemic H1N1 influenza in Korea.

    Science.gov (United States)

    Kim, Yang-Woo; Yoon, Seok-Jun; Oh, In-Hwan

    2013-05-01

    Although there have been numerous studies concerning the 2009 pandemic H1N1 influenza, limited data are available on the economic burden of the pandemic. The present study was undertaken to help policy makers prepare for future H1N1 pandemics. We assessed the socioeconomic burden of the 2009 pandemic H1N1 influenza that infected 3,082,113 patients in South Korea, which represents 6.6% of the population of South Korea. Data were obtained from the National Health Insurance Claims database using claims submitted from 1 August 2009 to 31 July 2010. Costs were converted to United States dollars (US$). The annual socioeconomic costs of the 2009 pandemic H1N1 influenza were US$1.09 billion (0.14% of the national GDP). Direct costs included US$322.6 million (29.6% of total costs) of direct medical costs, with an additional US$105.4 million (9.7% of total cost) of direct non-medical costs. The indirect costs totaled US$662.5 million (60.8% of total cost). The economic impact was much higher for men than for women due to the fact that indirect costs were 2.2-times higher because of the higher male wage. Also direct medical costs peaked for patients in the children and adolescent groups. These findings demonstrate the socioeconomic burden associated with the 2009 pandemic H1N1 influenza in Korea and can be used for future pandemic planning.

  11. Characteristics of US public schools with reported cases of novel influenza A (H1N1).

    Science.gov (United States)

    Hoen, Anne Gatewood; Buckeridge, David L; Chan, Emily H; Freifeld, Clark C; Keller, Mikaela; Charland, Katia; Donnelly, Christl A; Brownstein, John S

    2010-09-01

    The 2009 pandemic of influenza A (H1N1) has disproportionately affected children and young adults, resulting in attention by public health officials and the news media on schools as important settings for disease transmission and spread. We aimed to characterize US schools affected by novel influenza A (H1N1) relative to other schools in the same communities. A database of US school-related cases was obtained by electronic news media monitoring for early reports of novel H1N1 influenza between April 23 and June 8, 2009. We performed a matched case-control study of 32 public primary and secondary schools that had one or more confirmed cases of H1N1 influenza and 6815 control schools located in the same 23 counties as case schools. Compared with controls from the same county, schools with reports of confirmed cases of H1N1 influenza were less likely to have a high proportion of economically disadvantaged students (adjusted odds ratio (aOR) 0.385; 95% confidence interval (CI) 0.166-0.894) and less likely to have older students (aOR 0.792; 95% CI 0.670-0.938). We conclude that public schools with younger, more affluent students may be considered sentinels of the epidemic and may have played a role in its initial spread. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  12. A(H1N1)pdm09 influenza infection: vaccine inefficiency.

    Science.gov (United States)

    Friedman, Nehemya; Drori, Yaron; Pando, Rakefet; Glatman-Freedman, Aharona; Sefty, Hanna; Bassal, Ravit; Stein, Yaniv; Shohat, Tamy; Mendelson, Ella; Hindiyeh, Musa; Mandelboim, Michal

    2017-05-16

    The last influenza pandemic, caused by the swine A(H1N1)pdm09 influenza virus, began in North America at 2009. Since then, the World Health Organization (WHO) recommended integration of the swine-based virus A/California/07/2009 strain in yearly vaccinations. Yet, infections with A(H1N1)pdm09 have continued in subsequent years. The reasons for this are currently unknown. During the 2015-2016 influenza season, we noted an increased prevalence of A(H1N1)pdm09 influenza virus infection in Israel. Our phylogenetic analysis indicated that the circulating A(H1N1)pdm09 strains belonged to 6B.1 and 6B.2 clades and differed from the vaccinating strain, with approximately 18 amino acid differences found between the circulating strains and the immunizing A/California/07/2009 strain. Hemmaglutination inhibition (HI) assays demonstrated higher antibodies titer against the A/California/07/2009 vaccinating strain as compared to the circulating Israeli strains. We thus suggest that the current vaccination was not sufficiently effective and propose inclusion of the current circulating A(H1N1)pdm09 influenza viruses in the annual vaccine composition.

  13. Outcome of pandemic H1N1 infections in hematopoietic stem cell transplant recipients.

    Science.gov (United States)

    Ljungman, Per; de la Camara, Rafael; Perez-Bercoff, Lena; Abecasis, Manuel; Nieto Campuzano, Jose Bartolo; Cannata-Ortiz, M Jimena; Cordonnier, Catherine; Einsele, Hermann; Gonzalez-Vicent, Marta; Espigado, Ildefonso; Halter, Jörg; Martino, Rodrigo; Mohty, Bilal; Sucak, Gülsan; Ullmann, Andrew J; Vázquez, Lourdes; Ward, Katherine N; Engelhard, Dan

    2011-08-01

    During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.

  14. Influenza A viral loads in respiratory samples collected from patients infected with pandemic H1N1, seasonal H1N1 and H3N2 viruses

    Directory of Open Access Journals (Sweden)

    Chuchottaworn Charoen

    2010-04-01

    Full Text Available Abstract Background Nasopharyngeal aspirate (NPA, nasal swab (NS, and throat swab (TS are common specimens used for diagnosis of respiratory virus infections based on the detection of viral genomes, viral antigens and viral isolation. However, there is no documented data regarding the type of specimen that yields the best result of viral detection. In this study, quantitative real time RT-PCR specific for M gene was used to determine influenza A viral loads present in NS, NPA and TS samples collected from patients infected with the 2009 pandemic H1N1, seasonal H1N1 and H3N2 viruses. Various copy numbers of RNA transcripts derived from recombinant plasmids containing complete M gene insert of each virus strain were assayed by RT-PCR. A standard curve for viral RNA quantification was constructed by plotting each Ct value against the log quantity of each standard RNA copy number. Results Copy numbers of M gene were obtained through the extrapolation of Ct values of the test samples against the corresponding standard curve. Among a total of 29 patients with severe influenza enrolled in this study (12 cases of the 2009 pandemic influenza, 5 cases of seasonal H1N1 and 12 cases of seasonal H3N2 virus, NPA was found to contain significantly highest amount of viral loads and followed in order by NS and TS specimen. Viral loads among patients infected with those viruses were comparable regarding type of specimen analyzed. Conclusion Based on M gene copy numbers, we conclude that NPA is the best specimen for detection of influenza A viruses, and followed in order by NS and TS.

  15. Monoclonal Antibody Kit for Identification of the Novel 2009 H1N1 Influenza A Virus ▿

    OpenAIRE

    Higgins, Angela D.; Shaw, Carl J.; Johnson, Jennifer G.; Navarro, Adriana; Chapman, Nathan A.; Ewers, Steven D.; Stockwell, James W.; Carpenter, Julie M.; Olivo, Paul D.; Miao, Lynn Yihong

    2010-01-01

    To develop an immunofluorescence assay for identification of the 2009 H1N1 influenza A virus, we generated a number of monoclonal antibodies (MAbs) by using inactivated H1N1 2009 virus (A/California/07/2009) as the immunogen. Two MAbs that target two different epitopes of the 2009 H1N1 hemagglutinin (HA) were selected to make the D3 Ultra 2009 H1N1 Influenza A ID kit (2009 H1N1 ID kit; Diagnostic Hybrids, Inc., Athens, OH), which is intended for the identification of the 2009 H1N1 virus by in...

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

    OpenAIRE

    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 basel...

  17. Mongrelised genetics of H1N1 virus: A bird′s eyeview

    Directory of Open Access Journals (Sweden)

    Nagarathna C

    2010-01-01

    Full Text Available H1N1 influenza, also known as "novel H1N1 virus" has led to a "global outcry." This virus is more virulent when compared with other seasonal flu viruses. Virulence may change as the adaptive mutation gene increases within the virus. A study at the US Centre for Disease Control and Prevention published in May 2009 found that children had no preexisting immunity to the new strain as they showed no cross-reactive antibody reaction when compared with adults aged 18-64 years, who showed a cross-reactive antibody reaction of 6-9% and older adults with 33% immunity. This review article depicts H1N1 virus, its virulence with genetic evolution potential and preventive protocol for the dental professionals. This would allow us to comprehend the changes in the disease process and contribute in its prevention as "prevention is better than cure."

  18. Susceptibility of turkeys to pandemic-H1N1 virus by reproductive tract insemination

    Directory of Open Access Journals (Sweden)

    Suarez David L

    2010-02-01

    Full Text Available Abstract The current pandemic influenza A H1N1 2009 (pH1N1 was first recognized in humans with acute respiratory diseases in April 2009 in Mexico, in swine in Canada in June, 2009 with respiratory disease, and in turkeys in Chile in June 2009 with a severe drop in egg production. Several experimental studies attempted to reproduce the disease in turkeys, but failed to produce respiratory infection in turkeys using standard inoculation routes. We demonstrated that pH1N1 virus can infect the reproductive tract of turkey hens after experimental intrauterine inoculation, causing decreased egg production. This route of exposure is realistic in modern turkey production because turkey hens are handled once a week for intrauterine insemination in order to produce fertile eggs. This understanding of virus exposure provides an improved understanding of the pathogenesis of the disease and can improve poultry husbandry to prevent disease outbreaks.

  19. Kompliceret influenza A (H1N1) hos gravid i andet trimester

    DEFF Research Database (Denmark)

    Ersbøll, A.S.; Hedegaard, M.; Hesselvig, A.B.

    2012-01-01

    A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded and an ...... and an emergency caesarean was performed at 26 weeks + 2 days of gestation. The neonatal period was uncomplicated. Influenza A (H1N1) is especially dangerous in pregnant women and vaccination is important.......A 27-year-old woman at 25 weeks of gestation was admitted to hospital due to bilateral pneumonia with increasing hypoxia. She was tested positive for influenza A (H1N1) and successfully treated with oral oseltamivir. Nine days after the admission pathological umbilical flows were recorded...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: Data from prospectively planned cohort studies on risk of major clinical outcomes and prognostic factors for patients with influenza A(H1N1)pdm09 virus are limited. In 2009, in order to assess outcomes and evaluate risk factors for progression of illness, two cohort studies were...... and/or death for outpatients, and hospitalization for >28 days, transfer to intensive care unit (ICU) if enrolled from general ward, and/or death for inpatients. Infection was confirmed by RT-PCR. 590 FLU 002 and 392 FLU 003 patients with influenza A (H1N1)pdm09 were enrolled from 81 sites in 17...... during the pandemic period had a poorer prognosis than in subsequent seasons. CONCLUSIONS: Patients with influenza A(H1N1)pdm09, particularly when requiring hospital admission, are at high risk for disease progression, especially if they are older, immunodeficient, or admitted late in infection...

  1. Infection and death from influenza A H1N1 virus in Mexico: a retrospective analysis.

    Science.gov (United States)

    Echevarría-Zuno, Santiago; Mejía-Aranguré, Juan Manuel; Mar-Obeso, Alvaro J; Grajales-Muñiz, Concepción; Robles-Pérez, Eduardo; González-León, Margot; Ortega-Alvarez, Manuel Carlos; Gonzalez-Bonilla, Cesar; Rascón-Pacheco, Ramón Alberto; Borja-Aburto, Víctor Hugo

    2009-12-19

    In April, 2009, the first cases of influenza A H1N1 were registered in Mexico and associated with an unexpected number of deaths. We report the timing and spread of H1N1 in cases, and explore protective and risk factors for infection, severe disease, and death. We analysed information gathered by the influenza surveillance system from April 28 to July 31, 2009, for patients with influenza-like illness who attended clinics that were part of the Mexican Institute for Social Security network. We calculated odds ratios (ORs) to compare risks of testing positive for H1N1 in those with influenza-like illness at clinic visits, the risk of admission for laboratory-confirmed cases of H1N1, and of death for inpatients according to demographic characteristics, clinical symptoms, seasonal influenza vaccine status, and elapsed time from symptom onset to admission. By July 31, 63 479 cases of influenza-like illness were reported; 6945 (11%) cases of H1N1 were confirmed, 6407 (92%) were outpatients, 475 (7%) were admitted and survived, and 63 (influenza (OR 0.65 [95% CI 0.55-0.77]). Delayed admission (1.19 [1.11-1.28] per day) and presence of chronic diseases (6.1 [2.37-15.99]) were associated with increased risk of dying. Risk communication and hospital preparedness are key factors to reduce mortality from H1N1 infection. Protective effects of seasonal influenza vaccination for the virus need to be investigated. None. Copyright 2009 Elsevier Ltd. All rights reserved.

  2. Pandemic influenza A (H1N1 2009 vaccine: An update

    Directory of Open Access Journals (Sweden)

    M K Goel

    2011-01-01

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

  3. H1N1 seasonal influenza virus evolutionary rate changed over time.

    Science.gov (United States)

    Suptawiwat, Ornpreya; Kongchanagul, Alita; Boonarkart, Chompunuch; Auewarakul, Prasert

    2018-03-30

    It was previously shown that the seasonal H1N1 influenza virus antigenic drift occurred at a slower rate than the seasonal H3N2 virus during the first decade of the 21 t h century. It was hypothesized that the slower antigenic evolution led to a decrease in average ages of infection, which in turn resulted in lower level of global viral circulation. It is unclear what caused the difference between the two viruses, but a plausible explanation may be related to the fact that the H1N1 virus had been in human population for much longer than the H3N2 virus. This would suggest that H1N1 antigenic drift in an earlier period may have been different from a more recent period. To test this hypothesis, we analyzed seasonal H1N1 influenza sequences during various time periods. In comparison to more recent H1N1 virus, the older H1N1 virus during the first half of the 20 t h century showed evidences of higher nonsynnonymous/synonymous ration (dN/dS) in its hemagglutinin (HA) gene. We compared amino acid sequence changes in the HA epitopes for each outbreak season and found that there were less changes in later years. Amino acid sequence diversity in the epitopes as measured by sequence entropy became smaller for each passing decade. These suggest that there might be some limit to the antigenic drift. The longer an influenza virus has drifted in human population, the less flexibility it may become. With less flexibility to adapt and escape the host immunity, the virus may have to rely more on younger naïve population. Copyright © 2018. Published by Elsevier B.V.

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

    Directory of Open Access Journals (Sweden)

    Paola Faverio

    2014-01-01

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

  5. Rapid development of an efficacious swine vaccine for novel H1N1.

    Science.gov (United States)

    Vander Veen, Ryan; Kamrud, Kurt; Mogler, Mark; Loynachan, Alan T; McVicker, Jerry; Berglund, Peter; Owens, Gary; Timberlake, Sarah; Lewis, Whitney; Smith, Jonathan; Harris, D L Hank

    2009-10-29

    Recombinant hemagglutinin (HA) from a novel H1N1 influenza strain was produced using an alphavirus replicon expression system. The recombinant HA vaccine was produced more rapidly than traditional vaccines, and was evaluated as a swine vaccine candidate at different doses in a challenge model utilizing the homologous influenza A/California/04/2009 (H1N1) strain. Vaccinated animals showed significantly higher specific antibody response, reduced lung lesions and viral shedding, and higher average daily gain when compared to non-vaccinated control animals. These data demonstrate that the swine vaccine candidate was efficacious at all of the evaluated doses.

  6. How Does Influenza A (H1N1 Infection Proceed in Allogeneic Stem Cell Transplantation Recipients?

    Directory of Open Access Journals (Sweden)

    Sinem Civriz Bozdağ

    2012-03-01

    Full Text Available Clinical course of H1N1 infection in Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT patients is contraversial. We report three AHSCT patients who were infected with Influenza A/H1N1 infection. All of the patients were diagnosed with different hematological diagnosis and were at different stages of transplantation.All of them were treated with oseltamivir,zanamivir was switched with oseltamivir in one patient. All of the three patients were survived without any complication. Swine flu, can display with different courses and progress with bacterial or other viral infections in immunsupressed patients.

  7. Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season

    OpenAIRE

    Meijer, Adam; Lackenby, Angie; Hungnes, Olav; Lina, Bruno; van der Werf, Sylvie; Schweiger, Brunhilde; Opp, Matthias; Paget, John; van de Kassteele, Jan; Hay, Alan; Zambon, Maria; Buchholz, Udo; Haas, Walter

    2009-01-01

    In Europe, the 2007-08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of ...

  8. [Influenza A H1N1v treated with extra-corporal membrane oxygenation.

    DEFF Research Database (Denmark)

    Jensen, Reinhold; Severinsen, Inge Krogh; Terp, Kim

    2010-01-01

    A 37-year-old woman with body mass index > 30 was admitted to hospital with severe pneumonia due to H1N1v. Thoracic X-ray showed bilateral, diffuse infiltrates. There was no sign of complicating bacterial infection and all microbiological tests of tracheal secretion, blood and urine were negative....... Polymerase chain reaction test for H1N1v was positive until day ten. No mutations were found in the virus. The patient was given oseltamivir tablets and inhalable zanamivir as well as antibiotics. The patient was treated with extra-corporal membrane oxygenation (EcmO) for 12 days followed by ventilator...

  9. Clinical characteristics of acute encephalopathies associated with influenza H1N1-2009 in children

    International Nuclear Information System (INIS)

    Watanabe, Yashihiro; Tsuji, Megumi; Sameshima, Kiyoko; Wada, Takahito; Iai, Mizue; Yamashita, Sumimasa; Hayashi, Takuya; Aida, Noriko; Osaka, Hiroshi

    2012-01-01

    We report 12 cases of acute encephalopathy associated with influenza H1N1-2009 treated according to Japanese guideline (2009). In all 12 cases, electroencephalogram presented diffuse or localized high-amplitude slow waves. Brain CT and MRI showed abnormalities in 4 and 6 cases, respectively. We used hypothermia therapy for 5 patients. One patient showed impairment in short term memory, while the rest of the patients showed no sequelae. These 12 cases presented here suggest the early recognition and therapy according to the newly proposed guideline may reduce severe sequelae and mortality by acute encephalopathy associated with influenza H1N1-2009. (author)

  10. Pulmonary Complication of Novel Influenza A (H1N1) Infection: Imaging Features in Two Patients

    International Nuclear Information System (INIS)

    Lee, Choong Wook; Seo, Joon Beom; Song, Jae Woo; Lee, Hyun Joo; Lee, Jin Seong; Kim, Mi Young; Chae, Eun Jin; Song, Jin Woo; Kim, Won Young

    2009-01-01

    Novel influenza A (H1N1) virus is the pathogen of recent global outbreaks of febrile respiratory infection. We herein report the imaging findings of pulmonary complication in two patients with novel influenza A (H1N1) infection. The first patient without secondary infection showed the ill-defined ground-glass opacity nodules and patch areas of ground-glass opacities. The second patient with secondary pneumococcal pneumonia showed areas of lobar consolidation in the right middle lobe and left lower lobe and ground-glass opacities

  11. Prevalence and risk factors for H1N1 and H3N2 influenza A virus infections in Minnesota turkey premises.

    Science.gov (United States)

    Corzo, Cesar A; Gramer, Marie; Lauer, Dale; Davies, Peter R

    2012-09-01

    Influenza virus infections can cause respiratory and systemic disease of variable severity and also result in economic losses for the turkey industry. Several subtypes of influenza can infect turkeys, causing diverse clinical signs. Influenza subtypes of swine origin have been diagnosed in turkey premises; however, it is not known how common these infections are nor the likely routes of transmission. We conducted a cross-sectional study to estimate the prevalence of influenza viruses and examine factors associated with infection on Minnesota turkey premises. Results from influenza diagnostic tests and turkey and pig premise location data were obtained from the Minnesota Poultry Testing Laboratory and the Minnesota Board of Animal Health, respectively, from January 2007 to September 2008. Diagnostic data from 356 premises were obtained, of which 17 premises tested positive for antibodies to influenza A virus by agar gel immunodiffusion assay and were confirmed as either H1N1 or H3N2 influenza viruses by hemagglutination and neuraminidase inhibition assays. Influenza infection status was associated with proximity to pig premises and flock size. The latter had a sparing effect on influenza status. This study suggests that H1N1 and H3N2 influenza virus infections of turkey premises in Minnesota are an uncommon event. The route of influenza virus transmission could not be determined; however, the findings suggest that airborne transmission should be considered in future studies.

  12. Genetic characterization of an adapted pandemic 2009 H1N1 influenza virus that reveals improved replication rates in human lung epithelial cells

    Energy Technology Data Exchange (ETDEWEB)

    Wörmann, Xenia [Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin (Germany); Lesch, Markus [Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin (Germany); Steinbeis Innovation gGmbH, Center for Systems Biomedicine, Falkensee (Germany); Welke, Robert-William [Department of Biology, Molecular Biophysics, IRI Life Sciences, Humboldt-Universität zu Berlin (Germany); Okonechnikov, Konstantin; Abdurishid, Mirshat [Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin (Germany); Sieben, Christian [Department of Biology, Molecular Biophysics, IRI Life Sciences, Humboldt-Universität zu Berlin (Germany); Geissner, Andreas [Department for Biomolecular Systems, Max Planck Institute for Colloids and Interfaces, Potsdam (Germany); Institute of Chemistry and Biochemistry, Free University, Berlin (Germany); Brinkmann, Volker [Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin (Germany); Kastner, Markus [Institute for Biophysics, Johannes Kepler University, Linz (Austria); Karner, Andreas [Center for Advanced Bioanalysis GmbH (CBL), Linz (Austria); Zhu, Rong; Hinterdorfer, Peter [Institute for Biophysics, Johannes Kepler University, Linz (Austria); Anish, Chakkumkal [Department for Biomolecular Systems, Max Planck Institute for Colloids and Interfaces, Potsdam (Germany); Seeberger, Peter H. [Department for Biomolecular Systems, Max Planck Institute for Colloids and Interfaces, Potsdam (Germany); Institute of Chemistry and Biochemistry, Free University, Berlin (Germany); Herrmann, Andreas [Department of Biology, Molecular Biophysics, IRI Life Sciences, Humboldt-Universität zu Berlin (Germany); and others

    2016-05-15

    The 2009 influenza pandemic originated from a swine-origin H1N1 virus, which, although less pathogenic than anticipated, may acquire additional virulence-associated mutations in the future. To estimate the potential risk, we sequentially passaged the isolate A/Hamburg/04/2009 in A549 human lung epithelial cells. After passage 6, we observed a 100-fold increased replication rate. High-throughput sequencing of viral gene segments identified five dominant mutations, whose contribution to the enhanced growth was analyzed by reverse genetics. The increased replication rate was pinpointed to two mutations within the hemagglutinin (HA) gene segment (HA{sub 1} D130E, HA{sub 2} I91L), near the receptor binding site and the stem domain. The adapted virus also replicated more efficiently in mice in vivo. Enhanced replication rate correlated with increased fusion pH of the HA protein and a decrease in receptor affinity. Our data might be relevant for surveillance of pre-pandemic strains and development of high titer cell culture strains for vaccine production. - Highlights: • We observed a spontaneous mutation of a 2009-pandemic H1N1 influenza virus in vitro. • The adaptation led to a 100-fold rise in replication rate in human A549 cells. • Adaptation was caused by two mutations in the HA gene segment. • Adaptation correlates with increased fusion pH and decreased receptor affinity.

  13. Reassortment process after co-infection of pigs with avian H1N1 and swine H3N2 influenza viruses.

    Science.gov (United States)

    Urbaniak, Kinga; Markowska-Daniel, Iwona; Kowalczyk, Andrzej; Kwit, Krzysztof; Pomorska-Mól, Małgorzata; Frącek, Barbara; Pejsak, Zygmunt

    2017-07-08

    The influenza A virus is highly variable, which, to some degree, is caused by the reassortment of viral genetic material. This process plays a major role in the generation of novel influenza virus strains that can emerge in a new host population. Due to the susceptibility of pigs to infections with avian, swine and human influenza viruses, they are considered intermediate hosts for the adaptation of the avian influenza virus to humans. In order to test the reassortment process in pigs, they were co-infected with H3N2 A/swine/Gent/172/2008 (Gent/08) and H1N1 A/duck/Italy/1447/2005 (Italy/05) and co-housed with a group of naïve piglets. The Gent/08 strains dominated over Italy/05, but reassortment occurred. The reassortant strains of the H1N1 subtype (12.5%) with one gene (NP or M) of swine-origin were identified in the nasal discharge of the contact-exposed piglets. These results demonstrate that despite their low efficiency, genotypically and phenotypically different influenza A viruses can undergo genetic exchange during co-infection of pigs.

  14. Genetic characterization of an adapted pandemic 2009 H1N1 influenza virus that reveals improved replication rates in human lung epithelial cells

    International Nuclear Information System (INIS)

    Wörmann, Xenia; Lesch, Markus; Welke, Robert-William; Okonechnikov, Konstantin; Abdurishid, Mirshat; Sieben, Christian; Geissner, Andreas; Brinkmann, Volker; Kastner, Markus; Karner, Andreas; Zhu, Rong; Hinterdorfer, Peter; Anish, Chakkumkal; Seeberger, Peter H.; Herrmann, Andreas

    2016-01-01

    The 2009 influenza pandemic originated from a swine-origin H1N1 virus, which, although less pathogenic than anticipated, may acquire additional virulence-associated mutations in the future. To estimate the potential risk, we sequentially passaged the isolate A/Hamburg/04/2009 in A549 human lung epithelial cells. After passage 6, we observed a 100-fold increased replication rate. High-throughput sequencing of viral gene segments identified five dominant mutations, whose contribution to the enhanced growth was analyzed by reverse genetics. The increased replication rate was pinpointed to two mutations within the hemagglutinin (HA) gene segment (HA 1 D130E, HA 2 I91L), near the receptor binding site and the stem domain. The adapted virus also replicated more efficiently in mice in vivo. Enhanced replication rate correlated with increased fusion pH of the HA protein and a decrease in receptor affinity. Our data might be relevant for surveillance of pre-pandemic strains and development of high titer cell culture strains for vaccine production. - Highlights: • We observed a spontaneous mutation of a 2009-pandemic H1N1 influenza virus in vitro. • The adaptation led to a 100-fold rise in replication rate in human A549 cells. • Adaptation was caused by two mutations in the HA gene segment. • Adaptation correlates with increased fusion pH and decreased receptor affinity.

  15. International collaboration to assess the risk of Guillain Barre Syndrome following Influenza A (H1N1) 2009 monovalent vaccines

    NARCIS (Netherlands)

    Dodd, Caitlin N.; Romio, Silvana A.; Black, Steven; Vellozzi, Claudia; Andrews, Nick; Sturkenboom, Miriam; Zuber, Patrick; Hua, Wei; Bonhoeffer, Jan; Buttery, Jim; Crawford, Nigel; Deceuninck, Genevieve; de Vries, Corinne; De Wals, Philippe; Gutierrez-Gimeno, M. Victoria; Heijbel, Harald; Hughes, Hayley; Hur, Kwan; Hviid, Anders; Kelman, Jeffrey; Kilpi, Tehri; Chuang, S. K.; Macartney, Kristine; Rett, Melisa; Lopez-Callada, Vesta Richardson; Salmon, Daniel; Sanchez, Francisco Gimenez; Sanz, Nuria; Silverman, Barbara; Storsaeter, Jann; Thirugnanam, Umapathi; van der Maas, Nicoline; Yih, Katherine; Zhang, Tao; Izurieta, Hector

    2013-01-01

    Background: The global spread of the 2009 novel pandemic influenza A (H1N1) virus led to the accelerated production and distribution of monovalent 2009 Influenza A (H1N1) vaccines (pH1N1). This pandemic provided the opportunity to evaluate the risk of Guillain-Barre syndrome (GBS), which has been an

  16. Influenza A(H1N1)pdm09 in critically ill children admitted to a ...

    African Journals Online (AJOL)

    positive for the following respiratory viruses: H1N1, seasonal influenza. A, influenza B, parainfluenza 1/2/3, rhinovirus, respiratory syncytial virus (RSV), human metapneumovirus (HMPV) and adenovirus. Patients were tested for the above respiratory viruses if they met the clinical case definition for a moderate or severe ...

  17. Antivirals Use During the Pandemic H1N1 2009 Outbreak

    Centers for Disease Control (CDC) Podcasts

    2012-01-23

    Charisma Atkins, CDC public health analyst, discusses antiviral use during the 2009 H1N1 pandemic flu outbreak.  Created: 1/23/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/23/2012.

  18. Distribution and risk factors of 2009 pandemic influenza A (H1N1) in mainland China

    NARCIS (Netherlands)

    L-Q. Fang (Li-Qun); L-P. Wang (Li-Ping); S.J. de Vlas (Sake); S. Liang (Song); S-L. Tong (Shi-Lu); Y-L. Li (Yan-Li); Y-P. Li (Ya-Pin); Q. Qian (Quan); H. Yang (Hong); M-G. Zhou (Mai-Geng); X-F. Wang (Xiao-Feng); J.H. Richardus (Jan Hendrik); J-Q. Ma (Jia-Qi); W.-C. Cao (Wu-Chun)

    2012-01-01

    textabstractData from all reported cases of 2009 pandemic influenza A (H1N1) were obtained from the China Information System for Disease Control and Prevention. The spatiotemporal distribution patterns of cases were characterized through spatial analysis. The impact of travel-related risk factors on

  19. Radiological findings in patients with H1N1 influenza pneumonia

    Directory of Open Access Journals (Sweden)

    Magdy Abdelsalam

    2016-01-01

    Conclusion: The predominant radiological pattern in H1N1 pneumonia is bilateral GGO and alveolar consolidation. In the CXR, the opacities were basal and midzonal while in the chest CT were peripheral and peribronchovascular with diffuse zonal involvement. Chest CT is more sensitive than CXR in diagnosing doubtful cases and in showing different patterns of opacities.

  20. Factors influencing school closure and dismissal decisions: influenza A (H1N1), Michigan 2009.

    Science.gov (United States)

    Dooyema, Carrie A; Copeland, Daphne; Sinclair, Julie R; Shi, Jianrong; Wilkins, Melinda; Wells, Eden; Collins, Jim

    2014-01-01

    In fall 2009, many US communities experienced school closures during the influenza A H1N1 pandemic (pH1N1) and the state of Michigan reported 567 closures. We conducted an investigation in Michigan to describe pH1N1-related school policies, practices, and identify factors related to school closures. We distributed an online survey to all Michigan K-12 school principals. Descriptive statistics and chi-square tests summarize school policies, practices, adherence to government guidelines, and differences between schools that closed and those that remained open during the pandemic. Of 4441 traditional K-12 Michigan schools, 937 (21%) principals responded to our survey representing approximately 374,000 students and 17,700 teachers. The majority (88%) of schools had influenza preparedness plans and followed government school influenza guidelines. Among respondents, 15% (137/937) of schools closed in fall 2009 with high absenteeism as the primary reason for closure. Schools that closed reported significant illness in their school, had schools appears high in Michigan. Closures occurred in schools that reported significant illness and were likely motivated by excessive absenteeism. Understanding factors related to closures during pH1N1 may inform future pandemic preparedness efforts. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  1. The Influenza A(H1N1)v Pandemic : An Exploratory System Dynamics Approach

    NARCIS (Netherlands)

    Pruyt, E.; Hamarat, C.

    2010-01-01

    This paper presents a small exploratory System Dynamics model related to the dynamics of the 2009 flu pandemic, also known as the Mexican flu, swine flu, or A(H1N1)v. The model was developed in May 2009 in order to quickly foster understanding about the possible dynamics of this new flu variant and

  2. Influenza Virus A (H1N1) in Giant Anteaters (Myrmecophaga tridactyla)

    OpenAIRE

    Nofs, Sally; Abd-Eldaim, Mohamed; Thomas, Kathy V.; Toplon, David; Rouse, Dawn; Kennedy, Melissa

    2009-01-01

    In February 2007, an outbreak of respiratory disease occurred in a group of giant anteaters (Myrmecophaga tridactyla) at the Nashville Zoo. Isolates from 2 affected animals were identified in March 2007 as a type A influenza virus related to human influenza subtype H1N1.

  3. Influenza virus A (H1N1) in giant anteaters (Myrmecophaga tridactyla).

    Science.gov (United States)

    Nofs, Sally; Abd-Eldaim, Mohamed; Thomas, Kathy V; Toplon, David; Rouse, Dawn; Kennedy, Melissa

    2009-07-01

    In February 2007, an outbreak of respiratory disease occurred in a group of giant anteaters (Myrmecophaga tridactyla) at the Nashville Zoo. Isolates from 2 affected animals were identified in March 2007 as a type A influenza virus related to human influenza subtype H1N1.

  4. Determinants of Parental Acceptance of the H1N1 Vaccine

    Science.gov (United States)

    Hilyard, Karen M.; Quinn, Sandra Crouse; Kim, Kevin H.; Musa, Don; Freimuth, Vicki S.

    2014-01-01

    Although designated as a high-risk group during the 2009-2010 H1N1 pandemic, only about 40% of U.S. children received the vaccine, a relatively low percentage compared with high-risk groups in seasonal influenza, such as the elderly, whose vaccine rates typically top 70%. To better understand parental decision making and predictors of acceptance…

  5. Learning from Successful School-based Vaccination Clinics during 2009 pH1N1

    Science.gov (United States)

    Klaiman, Tamar; O'Connell, Katherine; Stoto, Michael A.

    2014-01-01

    Background: The 2009 H1N1 vaccination campaign was the largest in US history. State health departments received vaccines from the federal government and sent them to local health departments (LHDs) who were responsible for getting vaccines to the public. Many LHD's used school-based clinics to ensure children were the first to receive limited…

  6. Zoonoses: USDA ARS Lessons Learned During Novel Influenza H1N1 Investigations

    Science.gov (United States)

    Influenza illness was first recognized in pigs during the 1918 human Spanish flu pandemic, and influenza A virus has since remained of importance to the swine industry as a primary respiratory pathogen. Influenza virus H1N1 remained relatively stable in U.S. swine for nearly 80 years following 1918...

  7. Polymyositis following Pandemic Influenza A (H1N1 and 2009-10 Seasonal Trivalent Vaccines

    Directory of Open Access Journals (Sweden)

    Clodoveo Ferri

    2012-01-01

    Full Text Available Sporadic associations between inflammatory myopathies with vaccinations were described in the literature, raising the possible trigger value of vaccines in the development of these autoimmune disorders. Here, we reported the clinical history of 3 patients who developed polymyositis complicated by interstitial lung disease (2 cases and dermatomyositis (1 case, after influenza A (H1N1 vaccination.

  8. Correlates of 2009 H1N1 Influenza Vaccine Acceptability among Parents and Their Adolescent Children

    Science.gov (United States)

    Painter, Julia E.; Gargano, Lisa M.; Sales, Jessica M.; Morfaw, Christopher; Jones, LaDawna M.; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.

    2011-01-01

    School-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression…

  9. Pandemic (H1N1) 2009, Abu Dhabi, United Arab Emirates, May 2009-March 2010.

    Science.gov (United States)

    Khan, Gulfaraz; Al-Mutawa, Jamal; Hashim, Muhammad Jawad

    2011-02-01

    To ascertain characteristics of pandemic (H1N1) 2009 virus infection, we reviewed medical records for all suspected or confirmed cases reported in Abu Dhabi during May 2009-March 2010. Overall case-fatality rate was 1.4/100,000 population. Most patients who died had ≥1 risk factor, and female decedents were considerably younger than male decedents.

  10. Emergence of Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus within 48 Hours

    OpenAIRE

    Inoue, Masafumi; Barkham, Timothy; Leo, Yee-Sin; Chan, Kwai-Peng; Chow, Angela; Wong, Christopher W.; Lee, Raphael Tze-Chuen; Maurer-Stroh, Sebastian; Lin, Raymond; Lin, Cui

    2010-01-01

    An oseltamivir-resistant influenza A pandemic (H1N1) 2009 virus evolved and emerged from zero to 52% of detectable virus within 48 hours of a patient’s exposure to oseltamivir. Phylogenetic analysis and data gathered by pyrosequencing and cloning directly on clinical samples suggest that the mutant emerged de novo.

  11. Pandemic Influenza A (H1N1): knowledge among senior health ...

    African Journals Online (AJOL)

    Objective: This study was conducted to assess the level of knowledge of influenza A (H1N1) infection among health care workers in a secondary health care facility in Osogbo, Southwest Nigeria. Methods: A structured questionnaire assessing participants'knowledge of swine influenza viruses, mode of transmission, clinical ...

  12. Early experience of the pandemic influenza H1N1 2009 epidemic in Taiwan

    Directory of Open Access Journals (Sweden)

    Tzong-Hann Yang

    2011-07-01

    Conclusion: When a patient presents with influenza-like acute febrile respiratory illness symptoms and is young in age, has a travel history involving an affected area, and is suffering from myalgia or leukopenia, physicians should be alerted to the possibility of novel H1N1 virus infection.

  13. Development of a diagnostic kit for Tamiflu-resistant influenza A (H1N1)

    International Nuclear Information System (INIS)

    Jung, I. L.; Hong, S. W.

    2012-01-01

    Swine influenza A, which has been pandemic worldwide since 2009, is a new type virus derived from A type influenza. Although some drugs against the contageous disease, such as relenza and tamiflu, have been commercialized, those drug resistant viruses could be also followed by the wide usage of drugs. For examples, Tamiflu-resistant viruses, the mutant type viruses, can not be cured by the treatment of tamiflu anymore. Thus, a quick diagnosis for the wild type (tamiflu-sensitive) and mutant (tamiflu-resistant) virus would be essential in order to prevent the wide spread of viruses. In spite of that, unfortunately, very few studies have been conducted until now. If we could tell the differences between tamiflu-resistant and -sensitive patients using by the proper diagnostic kit, not only patient specific treatment would be possible, but also the spread of viruses would be effectively prevented. Currently used detection methods for the swine influenza A H1N1, which were originated from CDC, USA, can not detect the tamiflu-resistant swine influenza A H1N1, but only can detect tamiflu-sensitive wine influenza A H1N1. In this study, all the primers for the detection of swInfA, swH1, MP and NA (neuraminidase) have been developed in order to detect both tamiflu-resistant and tamiflu-sensitive swine influenza A H1N1s simultaneously, and then, new multiplex RT-PCR methods has been established

  14. Pandemic infl uenza A (H1N1) 2009: a case series from intensive ...

    African Journals Online (AJOL)

    This article presents a series of seven ventilator-dependent patients with pandemic in. uenza A (H1N1) 2009 and one with seasonal in. uenza at two hospitals – a government regional hospital and a private hospital – in the Ugu District, KwaZulu-Natal. The clinical features of these patients are described, and an attempt is ...

  15. Development of a diagnostic kit for Tamiflu-resistant influenza A (H1N1)

    Energy Technology Data Exchange (ETDEWEB)

    Jung, I. L.; Hong, S. W.

    2012-01-15

    Swine influenza A, which has been pandemic worldwide since 2009, is a new type virus derived from A type influenza. Although some drugs against the contageous disease, such as relenza and tamiflu, have been commercialized, those drug resistant viruses could be also followed by the wide usage of drugs. For examples, Tamiflu-resistant viruses, the mutant type viruses, can not be cured by the treatment of tamiflu anymore. Thus, a quick diagnosis for the wild type (tamiflu-sensitive) and mutant (tamiflu-resistant) virus would be essential in order to prevent the wide spread of viruses. In spite of that, unfortunately, very few studies have been conducted until now. If we could tell the differences between tamiflu-resistant and -sensitive patients using by the proper diagnostic kit, not only patient specific treatment would be possible, but also the spread of viruses would be effectively prevented. Currently used detection methods for the swine influenza A H1N1, which were originated from CDC, USA, can not detect the tamiflu-resistant swine influenza A H1N1, but only can detect tamiflu-sensitive wine influenza A H1N1. In this study, all the primers for the detection of swInfA, swH1, MP and NA (neuraminidase) have been developed in order to detect both tamiflu-resistant and tamiflu-sensitive swine influenza A H1N1s simultaneously, and then, new multiplex RT-PCR methods has been established.

  16. Serological Evidence of Influenza A virus serotypes (H1 N1 and H5 ...

    African Journals Online (AJOL)

    Keywords: H1N1 and H5N1 influenza A, chicken Sera, Nigeria. One hundred sera samples from chicken flocks showing respiratory distress but failed to respond to treatment against chronic respiratory disease (CRD) were tested for avian influenza virus antibodies. The sera samples were collected from 5, 32, and 21 weeks ...

  17. Ethnic differences in susceptibilities to A(H1N1) flu: An epidemic ...

    African Journals Online (AJOL)

    The current A(H1N1) flu has showed sub-population dependent susceptibility and fatality as early as April and May of 2009 in its first wave of spreading. After the pandemic outbreak spreads globally for more than seven months, the subpopulation dependence of this flu, including ethnicity, age and gender selectivity, has ...

  18. Genetic Characterization of Influenza A (H1N1) Pandemic 2009 Virus Isolates from Mumbai.

    Science.gov (United States)

    Gohil, Devanshi; Kothari, Sweta; Shinde, Pramod; Meharunkar, Rhuta; Warke, Rajas; Chowdhary, Abhay; Deshmukh, Ranjana

    2017-08-01

    Pandemic influenza A (H1N1) 2009 virus was first detected in India in May 2009 which subsequently became endemic in many parts of the country. Influenza A viruses have the ability to evade the immune response through its ability of antigenic variations. The study aims to characterize influenza A (H1N1) pdm 09 viruses circulating in Mumbai during the pandemic and post-pandemic period. Nasopharyngeal swabs positive for influenza A (H1N1) pdm 09 viruses were inoculated on Madin-Darby canine kidney cell line for virus isolation. Molecular and phylogenetic analysis of influenza A (H1N1) pdm 09 isolates was conducted to understand the evolution and genetic diversity of the strains. Nucleotide and amino acid sequences of the HA gene of Mumbai isolates when compared to A/California/07/2009-vaccine strain revealed 14 specific amino acid differences located at the antigenic sites. Amino acid variations in HA and NA gene resulted in changes in the N-linked glycosylation motif which may lead to immune evasion. Phylogenetic analysis of the isolates revealed their evolutionary position with vaccine strain A/California/07/2009 but had undergone changes gradually. The findings in the present study confirm genetic variability of influenza viruses and highlight the importance of continuous surveillance during influenza outbreaks.

  19. Imaging findings of severe and critical severe pulmonary infections with A H1N1 influenza

    International Nuclear Information System (INIS)

    Chen Feng; Zhao Dawei; Wen Shuo; Li Hongjun; Wang Wei; He Ning; Zhang Ruichi; Song Wenyan

    2010-01-01

    Objective: To evaluate the pulmonary imaging features in patients with severe or critical severe A H1N1 influenza. Methods: Clinical and imaging findings of 18 cases with H1N1 pneumonia were retrospectively analyzed. These patients were divided into 2 groups including severe group (n=11) and critical group (n=7). Results: Among the severe group, bilateral ill-defined nodules and patch shadows were found in 8 cases, local ill-defined patchy was shown in 3 cases, and consolidation of right inferior lung was demonstrated by CT scan in 1 case. Among the critical group, diffuse ground-glass attenuation with partial consolidation were found in bilateral lungs of 4 cases, subcutaneous emphysema was observed in 1 case. CT showed diffuse ground-glass attenuation and nodular like consolidation in bilateral inferior lungs in 1 case, and other 3 cases showed diffuse consolidation of bilateral lungs. Conclusions: The radiologic findings of severe and critical severe pulmonary infections with H1N1 include ill-defined nodules and patch shadows of bilateral lung in sever patients, diffuse peribronchial ground-glass opacity and multifocal consolidation in critical severe patients. The radiologists should learn the features of H1N1 pneumonia on thoracic plain film and CTT to make diagnosis in time. (authors)

  20. Rural Responses to H1N1: A Flexible Model for Community Collaboration

    Science.gov (United States)

    O'Farrell, Denise; Aubrey, Debra Larsen

    2010-01-01

    This paper examines a regional 2009 H1N1 rural response model, which utilises community partnerships with local government, county emergency management, public health, private healthcare, Medical Reserve Corps volunteers, and other organisations in rural Southeast Idaho. Unique aspects of the collaborative use of federal, state, county, and…

  1. Information Entropy Analysis of the H1N1 Genetic Code

    Science.gov (United States)

    Martwick, Andy

    2010-03-01

    During the current H1N1 pandemic, viral samples are being obtained from large numbers of infected people world-wide and are being sequenced on the NCBI Influenza Virus Resource Database. The information entropy of the sequences was computed from the probability of occurrence of each nucleotide base at every position of each set of sequences using Shannon's definition of information entropy, [ H=∑bpb,2( 1pb ) ] where H is the observed information entropy at each nucleotide position and pb is the probability of the base pair of the nucleotides A, C, G, U. Information entropy of the current H1N1 pandemic is compared to reference human and swine H1N1 entropy. As expected, the current H1N1 entropy is in a low entropy state and has a very large mutation potential. Using the entropy method in mature genes we can identify low entropy regions of nucleotides that generally correlate to critical protein function.

  2. H1N1 Preventive Health Behaviors in a University Setting

    Science.gov (United States)

    Katz, Rebecca; May, Larissa; Sanza, Megan; Johnston, Lindsay; Petinaux, Bruno

    2012-01-01

    Background: When H1N1 emerged in 2009, institutions of higher education were immediately faced with questions about how best to protect their community from the virus, yet limited information existed to help predict student preventive behaviors. Methods: The authors surveyed students at a large urban university in November 2009 to better…

  3. Assessment of H1N1 influenza: A swine flu vaccination in Kumasi ...

    African Journals Online (AJOL)

    This study was carried out to assess H1N1 vaccination in the Kumasi metropolis of the Ashanti Region of Ghana. Questionnaires on the subject were administered to 504 individuals compris-ing of 254 health personnel and 250 from the general public (in a cross-sectional survey) after an initial interview of 1,686 individuals.

  4. Influenza A(H1N1)pdm09 Virus Infection in Giant Pandas, China

    OpenAIRE

    Li, Desheng; Zhu, Ling; Cui, Hengmin; Ling, Shanshan; Fan, Shengtao; Yu, Zhijun; Zhou, Yuancheng; Wang, Tiecheng; Qian, Jun; Xia, Xianzhu; Xu, Zhiwen; Gao, Yuwei; Wang, Chengdong

    2014-01-01

    We confirmed infection with influenza A(H1N1)pdm09 in giant pandas in China during 2009 by using virus isolation and serologic analysis methods. This finding extends the host range of influenza viruses and indicates a need for increased surveillance for and control of influenza viruses among giant pandas.

  5. Influenza A(H1N1)pdm09 virus infection in giant pandas, China.

    Science.gov (United States)

    Li, Desheng; Zhu, Ling; Cui, Hengmin; Ling, Shanshan; Fan, Shengtao; Yu, Zhijun; Zhou, Yuancheng; Wang, Tiecheng; Qian, Jun; Xia, Xianzhu; Xu, Zhiwen; Gao, Yuwei; Wang, Chengdong

    2014-03-01

    We confirmed infection with influenza A(H1N1)pdm09 in giant pandas in China during 2009 by using virus isolation and serologic analysis methods. This finding extends the host range of influenza viruses and indicates a need for increased surveillance for and control of influenza viruses among giant pandas.

  6. Immunization-Safety Monitoring Systems for the 2009 H1N1 Monovalent Influenza Vaccination Program

    NARCIS (Netherlands)

    Salmon, Daniel A.; Akhtar, Aysha; Mergler, Michelle J.; Vannice, Kirsten S.; Izurieta, Hector; Ball, Robert; Lee, Grace M.; Vellozzi, Claudia; Garman, Patrick; Cunningham, Francesca; Gellin, Bruce; Koh, Howard; Lurie, Nicole

    The effort to vaccinate the US population against the 2009 H1N1 influenza virus hinged, in part, on public confidence in vaccine safety. Early in the vaccine program, >20% of parents reported that they would not vaccinate their children. Concerns about the safety of the vaccines were reported by

  7. Neurologic complications and outcomes of pandemic (H1N1) 2009 in Korean children.

    Science.gov (United States)

    Kwon, Soonhak; Kim, Saeyoon; Cho, Min-hyun; Seo, Hyeeun

    2012-04-01

    Neurologic complications of children with influenza A H1N1 2009 pandemic, diagnosed in two consecutive influenza seasons were retrospectively reviewed to seek better outcomes in future outbreaks. Patient demographics, clinical manifestations and neurologic outcomes were reviewed. A total of 1,389 children were diagnosed with influenza A H1N1 by real-time reverse transcriptase-polymerase chain reaction. Of these, 23 (1.7%) patients had neurologic involvement. Their mean age was 5.9 ± 3.6 yr (range, 6 months to 11 yr) and 16 (69.9%) were boys. None of the 23 patients had been vaccinated for influenza A H1N1 and seasonal influenzas. Twenty-two of the 23 patients presented with seizures. Clinical features included febrile convulsion (n = 19), afebrile convulsion (n = 1), aseptic meningitis (n = 1), encephalopathy (n = 1), and acute necrotizing encephalopathy (n = 1). They all were treated with Oseltamivir twice daily for 5 days immediately after nasal and throat swab testing. Twenty-one of the subjects recovered fully, but the youngest two infants experienced severe neurological sequelae. The results indicate that neurologic complications associated with influenza A H1N1 2009 pandemic were mostly mild, but rarely were serious. Prompt intervention leads to a better outcome and vaccination may prevent the disease, thus staving off serious neurological complications following influenza, especially in young infants.

  8. French experience of 2009 A/H1N1v influenza in pregnant women.

    Directory of Open Access Journals (Sweden)

    Grégory Dubar

    Full Text Available BACKGROUND: The first reports on the pandemic influenza 2009 A/H1N1v from the USA, Mexico, and Australia indicated that this disease was associated with a high mortality in pregnant women. The aim of this study was to describe and compare the characteristics of severe critically ill and non-severe pregnant women with 2009 A/H1N1v-related illness in France. METHODOLOGY/PRINCIPAL FINDINGS: A national registry was created to screen pregnant women with laboratory-confirmed 2009 A/H1N1v influenza. Three hundred and fifteen patients from 46 French hospitals were included: 40 patients were admitted to intensive care units (severe outcomes, 111 were hospitalized in obstetric or medical wards (moderate outcomes, and 164 were outpatients (mild outcomes. The 2009 A/H1N1v influenza illness occurred during all pregnancy trimesters, but most women (54%, notably the severe patients (70%, were in the third trimester. Among the severe patients, twenty (50% underwent mechanical ventilation, and eleven (28% were treated with extracorporeal membrane oxygenation. Three women died from A/H1N1v influenza. We found a strong association between the development of a severe outcome and both co-existing illnesses (adjusted odds ratio [OR], 5.1; 95% confidence interval [CI], 2.2-11.8 and a delay in oseltamivir treatment after the onset of symptoms (>3 or 5 days (adjusted OR, 4.8; 95% CI, 1.9-12.1 and 61.2, 95% CI; 14.4-261.3, respectively. Among the 140 deliveries after 22 weeks of gestation known to date, 19 neonates (14% were admitted to a neonatal intensive care unit, mainly for preterm delivery, and two neonates died. None of these neonates developed 2009 A/H1N1v infection. CONCLUSIONS: This series confirms the high incidence of complications in pregnant women infected with pandemic A/H1N1v observed in other countries but depicts a lower overall maternal and neonatal mortality and morbidity than indicated in the USA or Australia. Moreover, our data demonstrate the

  9. Positive Selection on Hemagglutinin and Neuraminidase Genes of H1N1 Influenza Viruses

    LENUS (Irish Health Repository)

    Li, Wenfu

    2011-04-21

    Abstract Background Since its emergence in March 2009, the pandemic 2009 H1N1 influenza A virus has posed a serious threat to public health. To trace the evolutionary path of these new pathogens, we performed a selection-pressure analysis of a large number of hemagglutinin (HA) and neuraminidase (NA) gene sequences of H1N1 influenza viruses from different hosts. Results Phylogenetic analysis revealed that both HA and NA genes have evolved into five distinct clusters, with further analyses indicating that the pandemic 2009 strains have experienced the strongest positive selection. We also found evidence of strong selection acting on the seasonal human H1N1 isolates. However, swine viruses from North America and Eurasia were under weak positive selection, while there was no significant evidence of positive selection acting on the avian isolates. A site-by-site analysis revealed that the positively selected sites were located in both of the cleaved products of HA (HA1 and HA2), as well as NA. In addition, the pandemic 2009 strains were subject to differential selection pressures compared to seasonal human, North American swine and Eurasian swine H1N1 viruses. Conclusions Most of these positively and\\/or differentially selected sites were situated in the B-cell and\\/or T-cell antigenic regions, suggesting that selection at these sites might be responsible for the antigenic variation of the viruses. Moreover, some sites were also associated with glycosylation and receptor-binding ability. Thus, selection at these positions might have helped the pandemic 2009 H1N1 viruses to adapt to the new hosts after they were introduced from pigs to humans. Positive selection on position 274 of NA protein, associated with drug resistance, might account for the prevalence of drug-resistant variants of seasonal human H1N1 influenza viruses, but there was no evidence that positive selection was responsible for the spread of the drug resistance of the pandemic H1N1 strains.

  10. Calculating the potential for within-flight transmission of influenza A (H1N1

    Directory of Open Access Journals (Sweden)

    Blower Sally

    2009-12-01

    Full Text Available Abstract Background Clearly air travel, by transporting infectious individuals from one geographic location to another, significantly affects the rate of spread of influenza A (H1N1. However, the possibility of within-flight transmission of H1N1 has not been evaluated; although it is known that smallpox, measles, tuberculosis, SARS and seasonal influenza can be transmitted during commercial flights. Here we present the first quantitative risk assessment to assess the potential for within-flight transmission of H1N1. Methods We model airborne transmission of infectious viral particles of H1N1 within a Boeing 747 using methodology from the field of quantitative microbial risk assessment. Results The risk of catching H1N1 will essentially be confined to passengers travelling in the same cabin as the source case. Not surprisingly, we find that the longer the flight the greater the number of infections that can be expected. We calculate that H1N1, even during long flights, poses a low to moderate within-flight transmission risk if the source case travels First Class. Specifically, 0-1 infections could occur during a 5 hour flight, 1-3 during an 11 hour flight and 2-5 during a 17 hour flight. However, within-flight transmission could be significant, particularly during long flights, if the source case travels in Economy Class. Specifically, two to five infections could occur during a 5 hour flight, 5-10 during an 11 hour flight and 7-17 during a 17 hour flight. If the aircraft is only partially loaded, under certain conditions more infections could occur in First Class than in Economy Class. During a 17 hour flight, a greater number of infections would occur in First Class than in Economy if the First Class Cabin is fully occupied, but Economy class is less than 30% full. Conclusions Our results provide insights into the potential utility of air travel restrictions on controlling influenza pandemics in the winter of 2009/2010. They show travel by one

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

    Directory of Open Access Journals (Sweden)

    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

  12. Epidemiological characteristics of novel influenza A (H1N1 in antiviral drug users in Korea.

    Directory of Open Access Journals (Sweden)

    Kyunghi Choi

    Full Text Available Soon after the first novel influenza A (H1N1 death was documented in Korea on August 15, 2009, prompt treatment with antiviral drugs was recommended when an infection was suspected. Free antiviral drugs were distributed to patients who met the case definition in the treatment guidelines, and patients prescribed the antiviral drugs were included in the Antiviral Drug Surveillance System (ADSS. A total of 2,825,821 patients were reported to the ADSS from September 1 to December 31, 2009. Odds ratios were calculated to compare the risks of severe diseases, as indicated by general hospital admissions or intensive care unit (ICU admissions according to demographic characteristics, underlying medical conditions, and behavioral factors. Approximately 6% of the total population received antiviral drugs during the study period. Of these, 2,709,611 (95.9% were outpatients, 114,840 (4.06% were hospitalized, and 1,370 (0.05% were admitted to the ICU. Children aged 0-9 yr accounted for 33.94% of all reported cases, whereas only 3.89% of the patients were ≥ 60 yr. The estimated incidence of novel influenza A (H1N1 during the pandemic was 5.68/100 of all reported cases. Mortality due to influenza A (H1N1 during the pandemic was 0.33/100,000, with the highest mortality of 1.31/100,000 for patients aged ≥ 60 years. Severe pandemic H1N1 influenza was associated with the presence of one or more underlying medical conditions in elderly aged ≥ 60 years and with lower economic status. Moreover, influenza A (H1N1 appeared to be age-specific in terms of mortality. Although the incidence and admission rates of influenza A (H1N1 were higher in younger age groups, fatal cases were much more likely to occur in the elderly (≥ 60 years. In contrast to earlier influenza A (H1N1 reports, the risks of a severe outcome were elevated among those who were underweight (body mass index < 18.5 kg/m(2.

  13. Airport arrivals screening during pandemic (H1N1) 2009 influenza in New South Wales, Australia.

    Science.gov (United States)

    Gunaratnam, Praveena J; Tobin, Sean; Seale, Holly; Marich, Andrew; McAnulty, Jeremy

    2014-03-17

    To examine the effectiveness of airport screening in New South Wales during pandemic (H1N1) 2009 influenza. Analysis of data collected at clinics held at Sydney Airport, and of all notified cases of influenza A(H1N1)pdm09, between 28 April 2009 and 18 June 2009. Case detection rate per 100,000 passengers screened, sensitivity, positive predictive value and specificity of airport screening. The proportion of all cases in the period detected at airport clinics was compared with the proportion detected in emergency departments and general practice. Of an estimated 625,147 passenger arrivals at Sydney Airport during the period, 5845 (0.93%) were identified as being symptomatic or febrile, and three of 5845 were subsequently confirmed to have influenza A(H1N1)pdm09, resulting in a detection rate of 0.05 per 10,000 screened (95% CI, 0.02-1.14 per 10,000). Forty-five patients with overseas-acquired influenza A(H1N1)pdm09 in NSW would have probably passed through the airport during this time, giving airport screening a sensitivity of 6.67% (95% CI, 1.40%-18.27%). Positive predictive value was 0.05% (95% CI, 0.02%-0.15%) and specificity 99.10% (95% CI, 99.00%-100.00%). Of the 557 confirmed cases across NSW during the period, 290 (52.1%) were detected at emergency departments and 135 (24.2%) at general practices, compared with three (0.5%) detected at the airport. Airport screening was ineffective in detecting cases of influenza A(H1N1)pdm09 in NSW. Its future use should be carefully considered against potentially more effective interventions, such as contact tracing in the community.

  14. Inside the outbreak of the 2009 influenza A (H1N1)v virus in Mexico.

    Science.gov (United States)

    Zepeda-Lopez, Hector M; Perea-Araujo, Lizbeth; Miliar-García, Angel; Dominguez-López, Aarón; Xoconostle-Cázarez, Beatriz; Lara-Padilla, Eleazar; Ramírez Hernandez, Jorge A; Sevilla-Reyes, Edgar; Orozco, Maria Esther; Ahued-Ortega, Armando; Villaseñor-Ruiz, Ignacio; Garcia-Cavazos, Ricardo J; Teran, Luis M

    2010-10-08

    Influenza viruses pose a threat to human health because of their potential to cause global disease. Between mid March and mid April a pandemic influenza A virus emerged in Mexico. This report details 202 cases of infection of humans with the 2009 influenza A virus (H1N1)v which occurred in Mexico City as well as the spread of the virus throughout the entire country. From May 1st to May 5th nasopharyngeal swabs, derived from 751 patients, were collected at 220 outpatient clinics and 28 hospitals distributed throughout Mexico City. Analysis of samples using real time RT-PCR revealed that 202 patients out of the 751 subjects (26.9%) were confirmed to be infected with the new virus. All confirmed cases of human infection with the strain influenza (H1N1)v suffered respiratory symptoms. The greatest number of confirmed cases during the outbreak of the 2009 influenza A (H1N1)v were seen in neighbourhoods on the northeast side of Mexico City including Iztapalapa, Gustavo A. Madero, Iztacalco, and Tlahuac which are the most populated areas in Mexico City. Using these data, together with data reported by the Mexican Secretariat of Health (MSH) to date, we plot the course of influenza (H1N1)v activity throughout Mexico. Our data, which is backed up by MSH data, show that the greatest numbers of the 2009 influenza A (H1N1) cases were seen in the most populated areas. We speculate on conditions in Mexico which may have sparked this flu pandemic, the first in 41 years. We accept the hypothesis that high population density and a mass gathering which took in Iztapalapa contributed to the rapid spread of the disease which developed in three peaks of activity throughout the Country.

  15. Inside the outbreak of the 2009 influenza A (H1N1v virus in Mexico.

    Directory of Open Access Journals (Sweden)

    Hector M Zepeda-Lopez

    Full Text Available BACKGROUND: Influenza viruses pose a threat to human health because of their potential to cause global disease. Between mid March and mid April a pandemic influenza A virus emerged in Mexico. This report details 202 cases of infection of humans with the 2009 influenza A virus (H1N1v which occurred in Mexico City as well as the spread of the virus throughout the entire country. METHODOLOGY AND FINDINGS: From May 1st to May 5th nasopharyngeal swabs, derived from 751 patients, were collected at 220 outpatient clinics and 28 hospitals distributed throughout Mexico City. Analysis of samples using real time RT-PCR revealed that 202 patients out of the 751 subjects (26.9% were confirmed to be infected with the new virus. All confirmed cases of human infection with the strain influenza (H1N1v suffered respiratory symptoms. The greatest number of confirmed cases during the outbreak of the 2009 influenza A (H1N1v were seen in neighbourhoods on the northeast side of Mexico City including Iztapalapa, Gustavo A. Madero, Iztacalco, and Tlahuac which are the most populated areas in Mexico City. Using these data, together with data reported by the Mexican Secretariat of Health (MSH to date, we plot the course of influenza (H1N1v activity throughout Mexico. CONCLUSIONS: Our data, which is backed up by MSH data, show that the greatest numbers of the 2009 influenza A (H1N1 cases were seen in the most populated areas. We speculate on conditions in Mexico which may have sparked this flu pandemic, the first in 41 years. We accept the hypothesis that high population density and a mass gathering which took in Iztapalapa contributed to the rapid spread of the disease which developed in three peaks of activity throughout the Country.

  16. Serosurveillance for pandemic influenza A (H1N1) 2009 virus infection in domestic elephants, Thailand.

    Science.gov (United States)

    Paungpin, Weena; Wiriyarat, Witthawat; Chaichoun, Kridsada; Tiyanun, Ekasit; Sangkachai, Nareerat; Changsom, Don; Poltep, Kanaporn; Ratanakorn, Parntep; Puthavathana, Pilaipan

    2017-01-01

    The present study conducted serosurveillance for the presence of antibody to pandemic influenza A (H1N1) 2009 virus (H1N1pdm virus) in archival serum samples collected between 2009 and 2013 from 317 domestic elephants living in 19 provinces situated in various parts of Thailand. To obtain the most accurate data, hemagglutination-inhibition (HI) assay was employed as the screening test; and sera with HI antibody titers ≥20 were further confirmed by other methods, including cytopathic effect/hemagglutination based-microneutralization (microNT) and Western blot (WB) assays using H1N1pdm matrix 1 (M1) or hemagglutinin (HA) recombinant protein as the test antigen. Conclusively, the appropriate assays using HI in conjunction with WB assays for HA antibody revealed an overall seropositive rate of 8.5% (27 of 317). The prevalence of antibody to H1N1pdm virus was 2% (4/172) in 2009, 32% (17/53) in 2010, 9% (2/22) in 2011, 12% (1/8) in 2012, and 5% (3/62) in 2013. Notably, these positive serum samples were collected from elephants living in 7 tourist provinces of Thailand. The highest seropositive rate was obtained from elephants in Phuket, a popular tourist beach city. Young elephants had higher seropositive rate than older elephants. The source of H1N1pdm viral infection in these elephants was not explored, but most likely came from close contact with the infected mahouts or from the infected tourists who engaged in activities such as elephant riding and feeding. Nevertheless, it could not be excluded that elephant-to-elephant transmission did occur.

  17. Serosurveillance for pandemic influenza A (H1N1 2009 virus infection in domestic elephants, Thailand.

    Directory of Open Access Journals (Sweden)

    Weena Paungpin

    Full Text Available The present study conducted serosurveillance for the presence of antibody to pandemic influenza A (H1N1 2009 virus (H1N1pdm virus in archival serum samples collected between 2009 and 2013 from 317 domestic elephants living in 19 provinces situated in various parts of Thailand. To obtain the most accurate data, hemagglutination-inhibition (HI assay was employed as the screening test; and sera with HI antibody titers ≥20 were further confirmed by other methods, including cytopathic effect/hemagglutination based-microneutralization (microNT and Western blot (WB assays using H1N1pdm matrix 1 (M1 or hemagglutinin (HA recombinant protein as the test antigen. Conclusively, the appropriate assays using HI in conjunction with WB assays for HA antibody revealed an overall seropositive rate of 8.5% (27 of 317. The prevalence of antibody to H1N1pdm virus was 2% (4/172 in 2009, 32% (17/53 in 2010, 9% (2/22 in 2011, 12% (1/8 in 2012, and 5% (3/62 in 2013. Notably, these positive serum samples were collected from elephants living in 7 tourist provinces of Thailand. The highest seropositive rate was obtained from elephants in Phuket, a popular tourist beach city. Young elephants had higher seropositive rate than older elephants. The source of H1N1pdm viral infection in these elephants was not explored, but most likely came from close contact with the infected mahouts or from the infected tourists who engaged in activities such as elephant riding and feeding. Nevertheless, it could not be excluded that elephant-to-elephant transmission did occur.

  18. Illinois department of public health H1N1/A pandemic communications evaluation survey.

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, D.; Decision and Information Sciences

    2010-09-16

    Because of heightened media coverage, a 24-hour news cycle and the potential miscommunication of health messages across all levels of government during the onset of the H1N1 influenza outbreak in spring 2009, the Illinois Department of Public Health (IDPH) decided to evaluate its H1N1 influenza A communications system. IDPH wanted to confirm its disease information and instructions were helping stakeholders prepare for and respond to a novel influenza outbreak. In addition, the time commitment involved in preparing, issuing, monitoring, updating, and responding to H1N1 federal guidelines/updates and media stories became a heavy burden for IDPH staff. The process and results of the H1N1 messaging survey represent a best practice that other health departments and emergency management agencies can replicate to improve coordination efforts with stakeholder groups during both emergency preparedness and response phases. Importantly, the H1N1 survey confirmed IDPH's messages were influencing stakeholders decisions to activate their pandemic plans and initiate response operations. While there was some dissatisfaction with IDPH's delivery of information and communication tools, such as the fax system, this report should demonstrate to IDPH that its core partners believe it has the ability and expertise to issue timely and accurate instructions that can help them respond to a large-scale disease outbreak in Illinois. The conclusion will focus on three main areas: (1) the survey development process, (2) survey results: best practices and areas for improvement and (3) recommendations: next steps.

  19. Asymptomatic ratio for seasonal H1N1 influenza infection among schoolchildren in Taiwan.

    Science.gov (United States)

    Hsieh, Ying-Hen; Tsai, Chen-An; Lin, Chien-Yu; Chen, Jin-Hua; King, Chwan-Chuen; Chao, Day-Yu; Cheng, Kuang-Fu

    2014-02-12

    Studies indicate that asymptomatic infections do indeed occur frequently for both seasonal and pandemic influenza, accounting for about one-third of influenza infections. Studies carried out during the 2009 pH1N1 pandemic have found significant antibody response against seasonal H1N1 and H3N2 vaccine strains in schoolchildren receiving only pandemic H1N1 monovalent vaccine, yet reported either no symptoms or only mild symptoms. Serum samples of 255 schoolchildren, who had not received vaccination and had pre-season HI Ab serotiters highest correlation with infection, as defined by 4-fold rise in HI titer. We estimate the asymptomatic ratio, or the proportion of asymptomatic infections, for schoolchildren during the 2005-6 influenza season when this vaccine strain was found to be antigenically related to the circulating H1N1 strain. Fever has the highest correlation with the 2005-06 seasonal influenza A(H1N1) infection, followed by headache, cough, vomiting, and sore throat. Asymptomatic ratio for the schoolchildren is found to range between 55.6% (95% CI: 44.7-66.4)-77.9% (68.8-87.0) using different sets of predictive symptoms. Moreover, the asymptomatic ratio was 66.9% (56.6-77.2) when using US-CDC criterion of fever + (cough/sore throat), and 73.0 (63.3-82.8) when under Taiwan CDC definition of Fever + (cough or sore throat or nose) + ( headache or pain or fatigue). Asymptomatic ratio for children is found to be substantially higher than that of the general population in literature. In providing reasonable quantification of the asymptomatic infected children spreading pathogens to others in a seasonal epidemic or a pandemic, our estimates of symptomatic ratio of infected children has important clinical and public health implications.

  20. Initial human transmission dynamics of the pandemic (H1N1) 2009 virus in North America

    Science.gov (United States)

    Pourbohloul, Babak; Ahued, Armando; Davoudi, Bahman; Meza, Rafael; Meyers, Lauren A.; Skowronski, Danuta M.; Villaseñor, Ignacio; Galván, Fernando; Cravioto, Patricia; Earn, David J. D.; Dushoff, Jonathan; Fisman, David; Edmunds, W. John; Hupert, Nathaniel; Scarpino, Samuel V.; Trujillo, Jesús; Lutzow, Miguel; Morales, Jorge; Contreras, Ada; Chávez, Carolina; Patrick, David M.; Brunham, Robert C.

    2009-01-01

    Background  Between 5 and 25 April 2009, pandemic (H1N1) 2009 caused a substantial, severe outbreak in Mexico, and subsequently developed into the first global pandemic in 41 years. We determined the reproduction number of pandemic (H1N1) 2009 by analyzing the dynamics of the complete case series in Mexico City during this early period. Methods  We analyzed three mutually exclusive datasets from Mexico City Distrito Federal which constituted all suspect cases from 15 March to 25 April: confirmed pandemic (H1N1) 2009 infections, non‐pandemic influenza A infections and patients who tested negative for influenza. We estimated the initial reproduction number from 497 suspect cases identified prior to 20 April, using a novel contact network methodology incorporating dates of symptom onset and hospitalization, variation in contact rates, extrinsic sociological factors, and uncertainties in underreporting and disease progression. We tested the robustness of this estimate using both the subset of laboratory‐confirmed pandemic (H1N1) 2009 infections and an extended case series through 25 April, adjusted for suspected ascertainment bias. Results  The initial reproduction number (95% confidence interval range) for this novel virus is 1·51 (1·32–1·71) based on suspected cases and 1·43 (1·29–1·57) based on confirmed cases before 20 April. The longer time series (through 25 April) yielded a higher estimate of 2·04 (1·84–2·25), which reduced to 1·44 (1·38–1·51) after correction for ascertainment bias. Conclusions  The estimated transmission characteristics of pandemic (H1N1) 2009 suggest that pharmaceutical and non‐pharmaceutical mitigation measures may appreciably limit its spread prior the development of an effective vaccine. PMID:19702583

  1. Dynamic gene expression analysis in a H1N1 influenza virus mouse pneumonia model.

    Science.gov (United States)

    Bao, Yanyan; Gao, Yingjie; Shi, Yujing; Cui, Xiaolan

    2017-06-01

    H1N1, a major pathogenic subtype of influenza A virus, causes a respiratory infection in humans and livestock that can range from a mild infection to more severe pneumonia associated with acute respiratory distress syndrome. Understanding the dynamic changes in the genome and the related functional changes induced by H1N1 influenza virus infection is essential to elucidating the pathogenesis of this virus and thereby determining strategies to prevent future outbreaks. In this study, we filtered the significantly expressed genes in mouse pneumonia using mRNA microarray analysis. Using STC analysis, seven significant gene clusters were revealed, and using STC-GO analysis, we explored the significant functions of these seven gene clusters. The results revealed GOs related to H1N1 virus-induced inflammatory and immune functions, including innate immune response, inflammatory response, specific immune response, and cellular response to interferon-beta. Furthermore, the dynamic regulation relationships of the key genes in mouse pneumonia were revealed by dynamic gene network analysis, and the most important genes were filtered, including Dhx58, Cxcl10, Cxcl11, Zbp1, Ifit1, Ifih1, Trim25, Mx2, Oas2, Cd274, Irgm1, and Irf7. These results suggested that during mouse pneumonia, changes in the expression of gene clusters and the complex interactions among genes lead to significant changes in function. Dynamic gene expression analysis revealed key genes that performed important functions. These results are a prelude to advancements in mouse H1N1 influenza virus infection biology, as well as the use of mice as a model organism for human H1N1 influenza virus infection studies.

  2. Impact of obesity in patients infected with 2009 influenza A(H1N1).

    Science.gov (United States)

    Díaz, Emili; Rodríguez, Alejandro; Martin-Loeches, Ignacio; Lorente, Leonardo; Del Mar Martín, María; Pozo, Juan Carlos; Montejo, Juan Carlos; Estella, Angel; Arenzana, Ángel; Rello, Jordi

    2011-02-01

    A large proportion of patients infected with 2009 influenza A(H1N1) (A[H1N1]) are obese. Obesity has been proposed as a risk factor influencing outcome in these patients. However, its role remains unclear. We evaluate the outcome of patients who are obese and infected with A(H1N1) in the ICU, determining whether obesity is a risk factor for mortality. This was a prospective, observational, and multicenter study performed in 144 ICUs in Spain. Data were obtained from the Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTEI/SEMICYUC) registry. Adult patients with A(H1N1) that was confirmed by real-time polymerase chain reaction were included in the analysis. Patients who were obese (BMI > 30) were compared with patients who were nonobese. Cox regression analysis was used to determine adjusted mortality. Differences of P 40). Mechanical ventilation (MV) was more frequently applied in patients who were obese (64% vs 52.4%, P < .01) Patients with obesity remained on MV longer than patients who were nonobese (6.5 ± 10.3 days vs 9.3 ± 9.7 days, P = .02), had longer ICU length of stay (10.8 ± 12.1 days vs 13.7 ± 11.7 days, P = .03), and had longer hospitalization (18.2 ± 14.6 days vs 22.2 ± 16.5 days, P = .02). Mortality adjusted by severity and potential confounders identified that obesity was not significantly associated with ICU mortality (hazard ratio, 1.1; 95% CI, 0.69-1.75; P = .68). In our cohort, patients who were obese and infected with A(H1N1) did not have increased mortality. However, there was an association between obesity and higher ICU resource consumption.

  3. 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

    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. 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. 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.

  4. Identification of hemagglutinin structural domain and polymorphisms which may modulate swine H1N1 interactions with human receptor

    OpenAIRE

    Perovic Vladimir; Veljkovic Nevena; Glisic Sanja; Niman Henry L; Veljkovic Veljko; Muller Claude P

    2009-01-01

    Abstract Background The novel A/H1N1 influenza virus, which recently emerged in North America is most closely related to North American H1N1/N2 swine viruses. Until the beginning of 2009, North American swine H1N1/N2 viruses have only sporadically infected humans as dead-end hosts. In 2009 the A/H1N1 virus acquired the capacity to spread efficiently by human to human transmission. The novel A/H1N1 influenza virus has struck thousands of people in more than 70 countries and killed more than 14...

  5. Critically Ill patients with 2009 influenza A(H1N1) in Mexico.

    Science.gov (United States)

    Domínguez-Cherit, Guillermo; Lapinsky, Stephen E; Macias, Alejandro E; Pinto, Ruxandra; Espinosa-Perez, Lourdes; de la Torre, Alethse; Poblano-Morales, Manuel; Baltazar-Torres, Jose A; Bautista, Edgar; Martinez, Abril; Martinez, Marco A; Rivero, Eduardo; Valdez, Rafael; Ruiz-Palacios, Guillermo; Hernández, Martín; Stewart, Thomas E; Fowler, Robert A

    2009-11-04

    In March 2009, novel 2009 influenza A(H1N1) was first reported in the southwestern United States and Mexico. The population and health care system in Mexico City experienced the first and greatest early burden of critical illness. To describe baseline characteristics, treatment, and outcomes of consecutive critically ill patients in Mexico hospitals that treated the majority of such patients with confirmed, probable, or suspected 2009 influenza A(H1N1). Observational study of 58 critically ill patients with 2009 influenza A(H1N1) at 6 hospitals between March 24 and June 1, 2009. Demographic data, symptoms, comorbid conditions, illness progression, treatments, and clinical outcomes were collected using a piloted case report form. The primary outcome measure was mortality. Secondary outcomes included rate of 2009 influenza (A)H1N1-related critical illness and mechanical ventilation as well as intensive care unit (ICU) and hospital length of stay. Critical illness occurred in 58 of 899 patients (6.5%) admitted to the hospital with confirmed, probable, or suspected 2009 influenza (A)H1N1. Patients were young (median, 44.0 [range, 10-83] years); all presented with fever and all but 1 with respiratory symptoms. Few patients had comorbid respiratory disorders, but 21 (36%) were obese. Time from hospital to ICU admission was short (median, 1 day [interquartile range {IQR}, 0-3 days]), and all patients but 2 received mechanical ventilation for severe acute respiratory distress syndrome and refractory hypoxemia (median day 1 ratio of Pao(2) to fraction of inspired oxygen, 83 [IQR, 59-145] mm Hg). By 60 days, 24 patients had died (41.4%; 95% confidence interval, 28.9%-55.0%). Patients who died had greater initial severity of illness, worse hypoxemia, higher creatine kinase levels, higher creatinine levels, and ongoing organ dysfunction. After adjusting for a reduced opportunity of patients dying early to receive neuraminidase inhibitors, neuraminidase inhibitor treatment (vs

  6. Cytokine profile of bronchoalveolar lavage fluid from a mouse model of bronchial asthma during seasonal H1N1 infection.

    Science.gov (United States)

    Hasegawa, Shunji; Wakiguchi, Hiroyuki; Okada, Seigo; Gui Kang, Yu; Fujii, Nao; Hasegawa, Masanari; Hasegawa, Hideki; Ainai, Akira; Atsuta, Ryo; Shirabe, Komei; Toda, Shoichi; Wakabayashi-Takahara, Midori; Morishima, Tsuneo; Ichiyama, Takashi

    2014-10-01

    Several studies support the role of viral infections in the pathogenesis of asthma exacerbation. However, several pediatricians believe that influenza virus infection does not exacerbate bronchial asthma, except for influenza A H1N1 2009 pandemic [A(H1N1)pdm09] virus infection. We previously reported that A(H1N1)pdm09 infection possibly induces severe pulmonary inflammation or severe asthmatic attack in a mouse model of bronchial asthma and in asthmatic children. However, the ability of seasonal H1N1 influenza (H1N1) infection to exacerbate asthmatic attacks in bronchial asthma patients has not been previously reported, and the differences in the pathogenicity profiles, such as cytokine profiles, remains unclear in bronchial asthma patients after A(H1N1)pdm09 and H1N1 infections. The cytokine levels and viral titers in the bronchoalveolar lavage (BAL) fluid from mice with and without asthma after H1N1 infection (A/Yamagata and A/Puerto Rico strains) were compared. The interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, IL-5, interferon (IFN)-α, IFN-β, and IFN-γ levels were significantly higher in the BAL fluids from the control/H1N1 mice than from the asthmatic/H1N1 mice. The viral titers in the BAL fluid were also significantly higher in the control/H1N1mice than in the asthmatic/H1N1 mice infected with either A/Yamagata or A/Puerto Rico. A(H1N1)pdm09 infection, but not H1N1 infection, can induce severe pulmonary inflammation through elevated cytokine levels in a mouse model of asthma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. The Genomic Contributions of Avian H1N1 Influenza A Viruses to the Evolution of Mammalian Strains

    Science.gov (United States)

    Wu, Gang; Zhang, Jinghui; Webster, Robert G.

    2015-01-01

    Among the influenza A viruses (IAVs) in wild aquatic birds, only H1, H2, and H3 subtypes have caused epidemics in humans. H1N1 viruses of avian origin have also caused 3 of 5 pandemics. To understand the reappearance of H1N1 in the context of pandemic emergence, we investigated whether avian H1N1 IAVs have contributed to the evolution of human, swine, and 2009 pandemic H1N1 IAVs. On the basis of phylogenetic analysis, we concluded that the polymerase gene segments (especially PB2 and PA) circulating in North American avian H1N1 IAVs have been reintroduced to swine multiple times, resulting in different lineages that led to the emergence of the 2009 pandemic H1N1 IAVs. Moreover, the similar topologies of hemagglutinin and nucleoprotein and neuraminidase and matrix gene segments suggest that each surface glycoprotein coevolved with an internal gene segment within the H1N1 subtype. The genotype of avian H1N1 IAVs of Charadriiformes origin isolated in 2009 differs from that of avian H1N1 IAVs of Anseriformes origin. When the antigenic sites in the hemagglutinin of all 31 North American avian H1N1 IAVs were considered, 60%-80% of the amino acids at the antigenic sites were identical to those in 1918 and/or 2009 pandemic H1N1 viruses. Thus, although the pathogenicity of avian H1N1 IAVs could not be inferred from the phylogeny due to the small dataset, the evolutionary process within the H1N1 IAV subtype suggests that the circulation of H1N1 IAVs in wild birds poses a continuous threat for future influenza pandemics in humans. PMID:26208281

  8. Early outbreak of 2009 influenza A (H1N1 in Mexico prior to identification of pH1N1 virus.

    Directory of Open Access Journals (Sweden)

    Ying-Hen Hsieh

    Full Text Available 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.

  9. 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

  10. Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series.

    Science.gov (United States)

    Noriega, Luis Miguel; Verdugo, Renato J; Araos, Rafael; Munita, José Manuel; Díaz, Violeta; Marcotti, Alejandra; Perez, Jorge; Gonzalez, Patricia; Thompson, Luis; Canals, Magdalena; Hoppe, Arnold; Mounts, Anthony W; Vial, Pablo A

    2010-05-01

    Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009. Description of case series using hospital records. Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza-like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission. This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear.

  11. Computed tomography findings in patients with H1N1 influenza A infection

    Directory of Open Access Journals (Sweden)

    Viviane Brandao Amorim

    2013-09-01

    Full Text Available The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their nonspecificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease.

  12. Nosocomial Pandemic (H1N1) 2009, United Kingdom, 2009–2010

    Science.gov (United States)

    Myles, Puja R.; Openshaw, Peter J.M.; Gadd, Elaine M.; Lim, Wei Shen; Semple, Malcolm G.; Read, Robert C.; Taylor, Bruce L.; McMenamin, James; Armstrong, Colin; Bannister, Barbara; Nicholson, Karl G.; Nguyen-Van-Tam, Jonathan S.

    2011-01-01

    To determine clinical characteristics of patients hospitalized in the United Kingdom with pandemic (H1N1) 2009, we studied 1,520 patients in 75 National Health Service hospitals. We characterized patients who acquired influenza nosocomially during the pandemic (H1N1) 2009 outbreak. Of 30 patients, 12 (80%) of 15 adults and 14 (93%) of 15 children had serious underlying illnesses. Only 12 (57%) of 21 patients who received antiviral therapy did so within 48 hours after symptom onset, but 53% needed escalated care or mechanical ventilation; 8 (27%) of 30 died. Despite national guidelines and standardized infection control procedures, nosocomial transmission remains a problem when influenza is prevalent. Health care workers should be routinely offered influenza vaccine, and vaccination should be prioritized for all patients at high risk. Staff should remain alert to the possibility of influenza in patients with complex clinical problems and be ready to institute antiviral therapy while awaiting diagnosis during influenza outbreaks. PMID:21470446

  13. Bilateral Pulmonary Thromboembolism: An Unusual Presentation of Infection with Influenza A (H1N1 Virus

    Directory of Open Access Journals (Sweden)

    Parviz Saleh

    2010-06-01

    Full Text Available AbstractSwine flue is a highly contagious acute respiratory diseasecaused by a subtype of influenza A virus. Herein we presentthree patients with H1N1 infection complicated with pulmonarythromboembolism. The patients had chest pain and unexplaineddyspnea. Imaging studies showed bilateral hilar predominance.Computed tomographic angiography confirmed bilateral thromboembolism(an unusual presentation of H1N1 infection. We didnot find any predisposing factor including endothelial damage,stasis, or hypercoagulable state in these patients. They did notreceive any medication. After anticoagulation and treatment withoseltamivir, all the patients were discharged in good condition.To the best of our knowledge bilateral pulmonary thromboembolismhas not been reported in English language literature inpatients with swine flu infection. Appropriate diagnosis andtreatment will be life saving in this condition.Iran J Med Sci 2010; 35(2: 149-153.

  14. Acute necrotizing encephalopathy in a child with H1N1 influenza infection

    International Nuclear Information System (INIS)

    Lyon, Jane B.; Remigio, Cheryl; Milligan, Thomas; Deline, Carol

    2010-01-01

    Since the World Health Organization declared a global pandemic of novel influenza A H1N1 in June 2009, there has been a sustained rise in the number of cases of this strain of influenza. Although most cases are mild with complete and uneventful recovery, multiple cases of severe infection with complications including death have been reported. To the best of our knowledge, the majority of fatal outcomes in the United States have been related to pulmonary complications. We report a 12-year-old girl infected with influenza A H1N1 whose clinical course was complicated by rapid progressive neurologic deterioration and striking CT and MRI findings consistent with acute necrotizing encephalopathy (ANE). To our knowledge this has not been reported in the pediatric radiology literature. We hope this case will alert radiologists to this complication and familiarize radiologists with imaging findings that herald ANE. (orig.)

  15. Computed tomography findings in patients with H1N1 influenza A infection

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Zanetti, Glaucia [Faculdade de Medicina de Petropolis (FMP), RJ (Brazil)

    2013-09-15

    The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their non specificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease. (author)

  16. Computed tomography findings in patients with H1N1 influenza A infection

    International Nuclear Information System (INIS)

    Amorim, Viviane Brandao; Rodrigues, Rosana Souza; Barreto, Miriam Menna; Marchiori, Edson; Zanetti, Glaucia

    2013-01-01

    The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their non specificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease. (author)

  17. H1N1 influenza ('swine 'flu') in the paediatric ICU in South Africa

    African Journals Online (AJOL)

    Schoub B. Swine flu – implications for South Africa. Communicable Diseases Surveillance. Bulletin 2009;7(3):5-7. 5. Ahrens JO, Morrow BM, Argent AC. Influenza A(H1N1)pdm09 in critically ill children admitted to a paediatric intensive care unit, South Africa. S Afr J Crit Care 2015;31(1):4-7. 6. Cox CM, Blanton L, Dhara R, ...

  18. Intravenous Ketamine for Refractory Bronchospasm Precipitated by H1N1 Infection

    OpenAIRE

    Agrawal, Amit; Shrivastava, Jyotsna

    2014-01-01

    Acute severe bronchospasm is an emergency situation and sometimes these children may fail to respond to conventional treatment and deteriorate rapidly to respiratory failure requiring mechanical ventilation. We present a case of 2-year-old girl, who presented with severe bronchospasm resulting in respiratory failure not responding to conventional management including mechanical ventilation and was found to be H1N1 positive. She was treated with ketamine infusion, which led to prompt improveme...

  19. Intravenous Ketamine for Refractory Bronchospasm Precipitated by H1N1 Infection.

    Science.gov (United States)

    Agrawal, Amit; Shrivastava, Jyotsna

    2014-01-01

    Acute severe bronchospasm is an emergency situation and sometimes these children may fail to respond to conventional treatment and deteriorate rapidly to respiratory failure requiring mechanical ventilation. We present a case of 2-year-old girl, who presented with severe bronchospasm resulting in respiratory failure not responding to conventional management including mechanical ventilation and was found to be H1N1 positive. She was treated with ketamine infusion, which led to prompt improvement in airway obstruction.

  20. Pandemic A/H1N1 influenza: transmission of the first cases in Spain.

    Science.gov (United States)

    Català, Laura; Rius, Cristina; García de Olalla, Patricia; Nelson, Jeanne L; Alvarez, Josep; Minguell, Sofía; Camps, Neus; Sala, María Rosa; Arias, Carlos; Barrabeig, Irene; Carol, Mónica; Torra, Roser; Cardeñosa, Neus; Pumarola, Tomas; Caylà, Joan A

    2012-02-01

    Pandemic A/H1N1 influenza emerged in Mexico at the end of March 2009. Since then, it is still important to provide evidences that contributed to the international spread of the virus and to ascertain the attack rate of this new strain of influenza among the first cases in Spain that led to identify the first transmission in Europe. Three pandemic A/H1N1 influenza groups related to an overseas flight were studied: 71 student group, 94 remaining passengers, and 68 contacts of confirmed cases. The attack rate with their 95% confidence interval (CI) among the student group and contacts was calculated. On April 26th, when the first cases were notified, strong preventive measures were implemented among the student group and the contacts of the confirmed cases. On 27th April, the first pandemic A/H1N1 influenza cases confirmed in Spain were three students that came back from Mexico by airplane. A student generated the first native case in Spain and one of the first cases in Europe. Similar attack rates were found between the student group (14.1%; CI: 12.1-16.1) and their contacts (13.2%; CI: 4.4-22.0), but no cases among remaining passengers were detected, suggesting low transmission risk during air travel. The first cases of pandemic A/H1N1 influenza in Spain were imported by airplane from Mexico. Preventive efforts to reduce the impact of the influenza influenced that primary and secondary rates were lower than first estimations by WHO. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  1. A candidate H1N1 pandemic influenza vaccine elicits protective immunity in mice.

    Directory of Open Access Journals (Sweden)

    Julia Steitz

    2010-05-01

    Full Text Available In 2009 a new pandemic disease appeared and spread globally. The recent emergence of the pandemic influenza virus H1N1 first isolated in Mexico and USA raised concerns about vaccine availability. We here report our development of an adenovirus-based influenza H1N1 vaccine tested for immunogenicity and efficacy to confer protection in animal model.We generated two adenovirus(Ad5-based influenza vaccine candidates encoding the wildtype or a codon-optimized hemagglutinin antigen (HA from the recently emerged swine influenza isolate A/California/04/2009 (H1N1pdm. After verification of antigen expression, immunogenicity of the vaccine candidates were tested in a mouse model using dose escalations for subcutaneous immunization. Sera of immunized animals were tested in microneutalization and hemagglutination inhibition assays for the presence of HA-specific antibodies. HA-specific T-cells were measured in IFNgamma Elispot assays. The efficiency of the influenza vaccine candidates were evaluated in a challenge model by measuring viral titer in lung and nasal turbinate 3 days after inoculation of a homologous H1N1 virus.A single immunization resulted in robust cellular and humoral immune response. Remarkably, the intensity of the immune response was substantially enhanced with codon-optimized antigen, indicating the benefit of manipulating the genetic code of HA antigens in the context of recombinant influenza vaccine design. These results highlight the value of advanced technologies in vaccine development and deployment in response to infections with pandemic potential. Our study emphasizes the potential of an adenoviral-based influenza vaccine platform with the benefits of speed of manufacture and efficacy of a single dose immunization.

  2. Modeling of the influence of humidity on H1N1 flu in China

    Science.gov (United States)

    PEI, Y.; Tian, H.; Xu, B.

    2015-12-01

    In 2009, a heavy Flu hit the whole world. It was caused by the virus H1N1. The influenza first broke out in Mexico in March and the United States in April, 2009. The World Health Organization (WHO) announced that the H1N1 influenza became pandemic, alert to a warning phase of six. By the end of 2011, 181302 H1N1 cases were reported in mainland China. To improve our understanding on the impact of environmental factors on the disease transmission, we constructed an SIR (Susceptible - Infectious - Recovered) model incorporating environmental factors. It was found that the absolute humidity was a dominant environmental factor. The study interpolated the humidity data monitored with 340 weather stations from 1951 to 2011 in mainland China. First, the break point of the trend for the absolutely humidity was detected by the BFAST (Break For Additive Season and Trend) method. Then, the SIR model with and without the absolutely humidity incorporated in the model was built and tested. Finally, the results with the two scenarios were compared. Results indicate that lower absolutely humidity may promote the transmission of the H1N1 cases. The calculated basic reproductive number ranges from 1.65 to 3.66 with a changing absolute humidity. This is consistent with the former study result with basic reproductive number ranging from 2.03 to 4.18. The average recovery duration was estimated to be 5.7 days. The average duration to get immunity from the influenza is 399.02 days. A risk map is also produced to illustrate the model results.

  3. Use of Medical Care during Pandemic (H1N1) 2009, Navarre, Spain

    Science.gov (United States)

    Burgui, Rosana; Martínez-Baz, Iván; Guevara, Marcela; Carlos, Silvia

    2011-01-01

    Of 233 households with laboratory-confirmed pandemic (H1N1) 2009 in Navarre, Spain, only 64% (107/166) of contacts with influenza-like illness had sought medical care. This value was lower for adults (53%, 39/74) than for children <15 years of age (74%, 68/92), as well as for those with cases secondary to another household case (58%, 64/111). PMID:21801624

  4. Intravenous ketamine for refractory bronchospasm precipitated by H1N1 infection

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    Amit eAgrawal

    2014-04-01

    Full Text Available Acute severe bronchospasm is an emergency situation and sometimes these children may fail to respond to conventional treatment and deteriorate rapidly to respiratory failure requiring mechanical ventilation. We present a case of 2-year-old girl, who presented with severe bronchospasm resulting in respiratory failure not responding to conventional management including mechanical ventilation and was found to be H1N1 positive. She was treated with ketamine infusion, which led to prompt improvement in airway obstruction.

  5. Analysis of a pandemic in the Italian newspapers: the A(H1N1 experience

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    Alessandro Zanetti

    2012-06-01

    Full Text Available

    Background: in 2009 a novel infective agent, a(H1n1, was recognized by the World Health organization (WHo as a pandemic virus. Like most European countries, Italy experienced a single pandemic wave during fall-winter 2009. The objective of our study was to evaluate the news reports and the representation of the a(H1n1 pandemic in the Italian newspapers both quantitatively and qualitatively.

    Methods: from april 24th, 2009 to February 28th, 2010, seven national newspapers were monitored for the quantitative reporting of a(H1n1. In a three month sample period, reports were evaluated quali- tatively by considering their front page presence, tones used for headlines, and images and figures dedicated to the topic.

    Results: in a ten month window, a total of 1220 articles were published. The reporting period showed four peaks and one hollow, with a similar pattern for all the newspapers. during the three-month sample period, we found a total of 382 articles, 98.4% of which appeared on front pages, 33.8% of which contained headlines using alarming tones, and 47.8% which contained info-graphic elements.

    Conclusions: the a(H1n1 2009 pandemic in Italy was mild; nonetheless, newspapers devoted great attention to the new influenza and used alarmist tones. In similar situations, there are several areas where scientists should play a greater role. scientists should support journalists in understanding scientific issues and help them translate scientific information into news items. scientists should also help to contain the anxiety aroused in lay people by a pandemic, and support vaccination efforts dedicated to it....

  6. Screening for Influenza A(H1N1)pdm09, Auckland International Airport, New Zealand

    Science.gov (United States)

    Hale, Michael J.; Baker, Michael G.

    2012-01-01

    Entry screening for influenza A(H1N1)pdm09 at Auckland International Airport, New Zealand, detected 4 cases, which were later confirmed, among 456,518 passengers arriving April 27–June 22, 2009. On the basis of national influenza surveillance data, which suggest that ≈69 infected travelers passed through the airport, sensitivity for screening was only 5.8%. PMID:22516105

  7. Origins of the 2009 H1N1 influenza pandemic in swine in Mexico

    Science.gov (United States)

    Mena, Ignacio; Nelson, Martha I; Quezada-Monroy, Francisco; Dutta, Jayeeta; Cortes-Fernández, Refugio; Lara-Puente, J Horacio; Castro-Peralta, Felipa; Cunha, Luis F; Trovão, Nídia S; Lozano-Dubernard, Bernardo; Rambaut, Andrew; van Bakel, Harm; García-Sastre, Adolfo

    2016-01-01

    Asia is considered an important source of influenza A virus (IAV) pandemics, owing to large, diverse viral reservoirs in poultry and swine. However, the zoonotic origins of the 2009 A/H1N1 influenza pandemic virus (pdmH1N1) remain unclear, due to conflicting evidence from swine and humans. There is strong evidence that the first human outbreak of pdmH1N1 occurred in Mexico in early 2009. However, no related swine viruses have been detected in Mexico or any part of the Americas, and to date the most closely related ancestor viruses were identified in Asian swine. Here, we use 58 new whole-genome sequences from IAVs collected in Mexican swine to establish that the swine virus responsible for the 2009 pandemic evolved in central Mexico. This finding highlights how the 2009 pandemic arose from a region not considered a pandemic risk, owing to an expansion of IAV diversity in swine resulting from long-distance live swine trade. DOI: http://dx.doi.org/10.7554/eLife.16777.001 PMID:27350259

  8. Radiographic study of severe Influenza-A (H1N1) disease in children

    International Nuclear Information System (INIS)

    Zhao Cailei; Gan Yungen; Sun Jie

    2011-01-01

    Objective: To characterize the radiographic findings of pediatric patients with severe Influenza-A (H1N1) disease. Methods: A retrospective study of data from chest X-ray, CT and MRI exam of 29 pediatric patients treated in intensive care unit for severe Influenza-A (H1N1) disease. Results: Disease developed quickly at early stage. Here are four types of radiographic findings. The disease continued to progress for 2-3 days and X-ray showed that all 29 patients had increased solid lesions with the existence of interstitial lesions. Four days later, all lung lesions showed absorption to certain degree. Fifteen days later, X-ray and CT showed complete or significant absorption in 19 cases (85.5%); delayed recovery was identified in 8 cases (27.6%), pulmonary fibrosis was found in 3 cases (10.3%), and 3 patients (10.3%) died. But the latter identified more lesions. Cranial CT and MRI were performed for 8 patients who had neurological symptoms. Of them, 3 cases (10.3%) were abnormal, showed symmetrical long T1 and T2 signal shadow in bilateral thalamus and longer T1 and T2 signals in the between. 3 cases had autopsy completed. Conclusion: The severe Influenza-A (H1N1) among children progression was generally rapid in the first 3 days. The overall radiographic findings are similar to acute respiratory distress syndrome (ARDS). A small portion of the patients occurred acute necrotizing encephalopathy and plastic bronchitis.

  9. H1N1 Influenza Patient Saved by Extracorporeal Membrane Oxygenation: First Report from Iran

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    Alireza Jahangirifard

    2016-11-01

    Full Text Available Respiratory failure is a serious complication of H1N1 influenza that, if not properly managed, can cause death. When mechanical ventilation is not effective, the only way to save the patient’s life is extracorporeal membrane oxygenation (ECMO. A prolonged type of cardiopulmonary bypass, ECMO is a high-cost management modality compared to other conventional types and its maintenance requires skilled personnel. Such staff usually comprises the members of open-heart surgical teams.  Herein, we describe a patient with H1N1 influenza and severe respiratory failure not improved by mechanical ventilation who was admitted to Masih Daneshvari Medical Center in March 2015. She was placed on ECMO, from which she was successfully weaned 9 days later. The patient was discharged from the hospital after 52 days. Follow-up till 11 months after discharge revealed completely active life with no problem. There should be a close collaboration among infectious disease specialists, cardiac anesthetists, cardiac surgeons, and intensivists for the correct timing of ECMO placement, subsequent weaning, and care of the patient. This team work was the key to our success story. This is the first patient to survive H1N1 with the use of ECMO in Iran. 

  10. [Epidemiological profile of mortality due to human influenza A (H1N1) in Mexico].

    Science.gov (United States)

    Fajardo-Dolci, Germán E; Hernández-Torres, Francisco; Santacruz-Varela, Javier; Rodríguez-Suárez, Javier; Lamy, Philippe; Arboleya-Casanova, Heberto; Gutiérrez-Vega, Rafael; Manuell-Lee, Gabriel; Córdova-Villalobos, José Angel

    2009-01-01

    To carry out the epidemiological analysis of 122 influenza A (H1N1) deaths confirmed by laboratory and help to improve the diagnosis and timely managing of cases. A total of 122 clinical records were analyzed of patients with confirmed influenza A (H1N1) virus infection who died. Fifty-one percent of patients were female and 49% were male. A total of 45.l% who died were between 20 and 39 years old. Overall fatality was 2.2% and ranged between 0.3% for the l0 to l9 year-old group to 6.3% for the 50 to 59 year-old group. Forty-three percent of deaths were concentrated in only two of the thirty-two states and 5l% received medical attention in social security institutions. Only l7% received hospital attention within 72 hours and 42% died within 72 hours of hospital attention. Novel Influenza A (H1N1) virus produces higher mortality in young people whereas seasonal influenza has a greater impact on young children and older people. Delay in medical care and the associated morbidity were relevant factors for death.

  11. Origins of the 2009 H1N1 influenza pandemic in swine in Mexico.

    Science.gov (United States)

    Mena, Ignacio; Nelson, Martha I; Quezada-Monroy, Francisco; Dutta, Jayeeta; Cortes-Fernández, Refugio; Lara-Puente, J Horacio; Castro-Peralta, Felipa; Cunha, Luis F; Trovão, Nídia S; Lozano-Dubernard, Bernardo; Rambaut, Andrew; van Bakel, Harm; García-Sastre, Adolfo

    2016-06-28

    Asia is considered an important source of influenza A virus (IAV) pandemics, owing to large, diverse viral reservoirs in poultry and swine. However, the zoonotic origins of the 2009 A/H1N1 influenza pandemic virus (pdmH1N1) remain unclear, due to conflicting evidence from swine and humans. There is strong evidence that the first human outbreak of pdmH1N1 occurred in Mexico in early 2009. However, no related swine viruses have been detected in Mexico or any part of the Americas, and to date the most closely related ancestor viruses were identified in Asian swine. Here, we use 58 new whole-genome sequences from IAVs collected in Mexican swine to establish that the swine virus responsible for the 2009 pandemic evolved in central Mexico. This finding highlights how the 2009 pandemic arose from a region not considered a pandemic risk, owing to an expansion of IAV diversity in swine resulting from long-distance live swine trade.

  12. Transcription analysis on response of swine lung to H1N1 swine influenza virus.

    Science.gov (United States)

    Li, Yongtao; Zhou, Hongbo; Wen, Zhibin; Wu, Shujuan; Huang, Canhui; Jia, Guangmin; Chen, Huanchun; Jin, Meilin

    2011-08-08

    As a mild, highly contagious, respiratory disease, swine influenza always damages the innate immune systems, and increases susceptibility to secondary infections which results in considerable morbidity and mortality in pigs. Nevertheless, the systematical host response of pigs to swine influenza virus infection remains largely unknown. To explore it, a time-course gene expression profiling was performed for comprehensive analysis of the global host response induced by H1N1 swine influenza virus in pigs. At the early stage of H1N1 swine virus infection, pigs were suffering mild respiratory symptoms and pathological changes. A total of 268 porcine genes showing differential expression (DE) after inoculation were identified to compare with the controls on day 3 post infection (PID) (Fold change ≥ 2, p swine influenza virus infection in pigs. The observed gene expression profile could help to screen the potential host agents for reducing the prevalence of swine influenza virus and further understand the molecular pathogenesis associated with H1N1 infection in pigs.

  13. Fulminant hemophagocytic lymphohistiocytosis induced by pandemic A (H1N1 influenza: a case report

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    Wacrenier Agnès

    2011-07-01

    Full Text Available Abstract Introduction Hemophagocytic lymphohistiocytosis induced by viral diseases is a well recognized entity. Severe forms of H5N1 influenza are known to be associated with symptoms very similar to a reactive hemophagocytic syndrome. We report a case of fulminant lymphohistiocytosis associated with the pandemic A (H1N1 variant. Case presentation A 42-year-old Caucasian woman developed a syndrome of fatal hemophagocytic lymphohistiocytosis shortly after H1N1 influenza. Initial symptoms of the viral disease were unusual, with acute abdominal involvement. Our patient's course was complicated by diffuse skin rash and ileal ischemia. Our patient died of refractory shock and multi-organ failure. Skin, ileum and colon histology was consistent with an acute apoptosis combined with an increased cellular regeneration. Conclusions Influenza may be complicated by severe forms of hemophagocytic lymphohistiocytosis. To ensure early recognition and treatment, physicians should be aware of the possible induction of the syndrome by the novel H1N1 variant. The rapid occurrence of a multi-organ involvement with evocative biological features of macrophage activation should alert clinicians.

  14. Two Years after Pandemic Influenza A/2009/H1N1: What Have We Learned?

    Science.gov (United States)

    Cheng, Vincent C. C.; To, Kelvin K. W.; Tse, Herman; Hung, Ivan F. N.

    2012-01-01

    Summary: The world had been anticipating another influenza pandemic since the last one in 1968. The pandemic influenza A H1N1 2009 virus (A/2009/H1N1) finally arrived, causing the first pandemic influenza of the new millennium, which has affected over 214 countries and caused over 18,449 deaths. Because of the persistent threat from the A/H5N1 virus since 1997 and the outbreak of the severe acute respiratory syndrome (SARS) coronavirus in 2003, medical and scientific communities have been more prepared in mindset and infrastructure. This preparedness has allowed for rapid and effective research on the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the disease, with impacts on its control. A PubMed search using the keywords “pandemic influenza virus H1N1 2009” yielded over 2,500 publications, which markedly exceeded the number published on previous pandemics. Only representative works with relevance to clinical microbiology and infectious diseases are reviewed in this article. A significant increase in the understanding of this virus and the disease within such a short amount of time has allowed for the timely development of diagnostic tests, treatments, and preventive measures. These findings could prove useful for future randomized controlled clinical trials and the epidemiological control of future pandemics. PMID:22491771

  15. Meteorological Influence on the 2009 Influenza A (H1N1) Pandemic in Mainland China.

    Science.gov (United States)

    Zhao, X.; Cai, J.; Feng, D.; Bai, Y.; Xu, B.

    2015-12-01

    Since May 2009, a novel influenza A (H1N1) pandemic has spread rapidly in mainland China from Mexico. Although there has been substantial analysis of this influenza, reliable work estimating its spatial dynamics and determinants remain scarce. The survival and transmission of this pandemic virus not only depends on its biological properties, but also a correlation with external environmental factors. In this study, we collected daily influenza A (H1N1) cases and corresponding annual meteorological factors in mainland China from May 2009 to April 2010. By analyzing these data at county-level, a similarity index, which considered the spatio-temporal characteristics of the disease, was proposed to evaluate the role and lag time of meteorological factors in the influenza transmission. The results indicated that the influenza spanned a large geographical area, following an overall trend from east to west across the country. The spatio-temporal transmission of the disease was affected by a series of meteorological variables, especially absolute humidity with a 3-week lag. These findings confirmed that the absolute humidity and other meteorological variables contributed to the local occurrence and dispersal of influenza A (H1N1). The impact of meteorological variables and their lag effects could be involved in the improvement of effective strategies to control and prevent disease outbreaks.

  16. Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season

    Science.gov (United States)

    Lackenby, Angie; Hungnes, Olav; Lina, Bruno; van der Werf, Sylvie; Schweiger, Brunhilde; Opp, Matthias; Paget, John; van de Kassteele, Jan; Hay, Alan; Zambon, Maria

    2009-01-01

    In Europe, the 2007–08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity. PMID:19331731

  17. Narcolepsy with cataplexy and hyperthyroidism sudden appeared after H1N1 vaccination

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    Silvia Leiva

    Full Text Available Narcolepsy type 1 (NT1 is a chronic sleep disorder, characterized by excessive daytime sleepiness, cataplexy and fragmented nocturnal sleep. It is caused by a hypocretin deficiency due to a significant reduction of the neurons producing it. In the last years, it has been postulated that an autoimmune mechanism would be responsible for the destruction of these neurons in those genetically predisposed patients. The increased incidence of narcolepsy after the pandemic H1N1 influenza vaccination campaign in 2009-2010 is known. We present below the case of an adult patient who, 10 days after receiving H1N1 vaccination, suffers a traffic accident after falling asleep. Subsequent studies revealed hyperthyroidism due to Graves disease. In spite of the treatment, the patient persisted with daily and disabling daytime sleepiness, sleep attacks and episodes of generalized muscle atony with preservation of consciousness. A nocturnal polysomnography and multiple sleep latency test (MSLT were performed with a diagnosis of NT1. The particularity of this case is the presentation of 2 autoimmune diseases triggered by an H1N1 vaccine without adjuvant, so far there is only evidence of NT1 associated with vaccines with adjuvant and viral infection. The association of both entities has made us reflect on the autoimmune mechanism, reinforcing the theory of its role in the onset of the disease.

  18. Evolutionary pathways of the pandemic influenza A (H1N1 2009 in the UK.

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    Monica Galiano

    Full Text Available The emergence of the influenza (H1N1 2009 virus provided a unique opportunity to study the evolution of a pandemic virus following its introduction into the human population. Virological and clinical surveillance in the UK were comprehensive during the first and second waves of the pandemic in 2009, with extensive laboratory confirmation of infection allowing a detailed sampling of representative circulating viruses. We sequenced the complete coding region of the haemagglutinin (HA segment of 685 H1N1 pandemic viruses selected without bias during two waves of pandemic in the UK (April-December 2009. Phylogenetic analysis showed that although temporal accumulation of amino acid changes was observed in the HA sequences, the overall diversity was less than that typically seen for seasonal influenza A H1N1 or H3N2. There was co-circulation of multiple variants as characterised by signature amino acid changes in the HA. A specific substitution (S203T became predominant both in UK and global isolates. No antigenic drift occurred during 2009 as viruses with greater than four-fold reduction in their haemagglutination inhibition (HI titre ("low reactors" were detected in a low proportion (3% and occurred sporadically. Although some limited antigenic divergence in viruses with four-fold reduction in HI titre might be related to the presence of 203T, additional studies are needed to test this hypothesis.

  19. H1N1 in pregnancy: Experience in a tertiary care hospital

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    Tapasya Dhar

    2014-01-01

    Full Text Available Introduction: The serious complication of influenza infection during pregnancy has been recognised for over a century. Because it is associated with high morbidity and mortality, we decided to undertake this study. Objectives: To assess maternal and perinatal outcome in women with H1N1 infection in pregnancy. Materials and Methods: This was a 1-year retrospective study conducted in Christian Medical College (  CMC and Hospital, Ludhiana. All women infected with H1N1 virus anytime during pregnancy were included in the study. Results and Analysis: A total of 26 patients were included in our study. A majority of patients were in the age group of 20-25 years (84.61%. A total of 61.54% were primigravida and 69.23% were in the third trimester. Comorbidities like diabetes, asthma, and obesity were present in 19.23% patients. The commonest symptoms were cough (92.37%, sore throat, and breathlessness. The commonest maternal complication was preterm labor (30.76%, and fetal complication was intrauterine death (19.23%. The majority delivered vaginally (57.7%. There were seven maternal deaths in our study. Conclusions: H1N1 remains a grave risk in pregnancy, underlining the need for greater awareness, early diagnosis, and prompt treatment.

  20. Radiographic study of severe Influenza-A (H1N1) disease in children

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    Zhao Cailei, E-mail: zhaocailei197866@163.com [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China); Gan Yungen, E-mail: mickeyym@yahoo.cn [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China); Sun Jie, E-mail: sunxixi@21cn.com [Department of Radiology, Shenzhen Children' s Hospital, No. 7019, Yitian Road, Futian District, Shenzhen 518026 (China)

    2011-09-15

    Objective: To characterize the radiographic findings of pediatric patients with severe Influenza-A (H1N1) disease. Methods: A retrospective study of data from chest X-ray, CT and MRI exam of 29 pediatric patients treated in intensive care unit for severe Influenza-A (H1N1) disease. Results: Disease developed quickly at early stage. Here are four types of radiographic findings. The disease continued to progress for 2-3 days and X-ray showed that all 29 patients had increased solid lesions with the existence of interstitial lesions. Four days later, all lung lesions showed absorption to certain degree. Fifteen days later, X-ray and CT showed complete or significant absorption in 19 cases (85.5%); delayed recovery was identified in 8 cases (27.6%), pulmonary fibrosis was found in 3 cases (10.3%), and 3 patients (10.3%) died. But the latter identified more lesions. Cranial CT and MRI were performed for 8 patients who had neurological symptoms. Of them, 3 cases (10.3%) were abnormal, showed symmetrical long T1 and T2 signal shadow in bilateral thalamus and longer T1 and T2 signals in the between. 3 cases had autopsy completed. Conclusion: The severe Influenza-A (H1N1) among children progression was generally rapid in the first 3 days. The overall radiographic findings are similar to acute respiratory distress syndrome (ARDS). A small portion of the patients occurred acute necrotizing encephalopathy and plastic bronchitis.

  1. Imaging manifestation of A H1N1 influenza with pneumonia

    International Nuclear Information System (INIS)

    Yang Jun; Xu Yunliang; Lu Zhibin; Wang Xiaojie; Li Shuo; Du Lei; Guo Limin; Li Xingwang

    2010-01-01

    Objective: To evaluate the imaging features of pneumonia caused by A (H1N1) influenza virus. Methods: Imaging data of 51 patients with pneumonia caused by A H1N1 influenza were retrospectively reviewed. All patients underwent mobile chest radiographs and 44 patients underwent CT as well. On the basis of the lesion degree in the lung, the patients were classified into mild, moderate and serious types. Results: Mild type showed patchy consolidation at chest imaging in 4 patients. Moderate type demonstrated consolidation and (or) ground-glass opacities more than 2 lung fields in 33 patients, including 30 bilateral and 3 unilateral. Serious type displayed diffuse consolidation and ground-glass opacities, probably accompanying with interstitial lesions in the lungs in 14 patients, including 6 patients with ARDS, 2 with infection and 1 with cutaneous emphysema. Conclusion: The imaging features of pneumonia caused by A H1N1 influenza mainly manifest as consolidation and ground-glass opacities, probably accompanying with interstitial changes. The imaging findings show various in patients with infection. Some serious patients even develope to ARDS. (authors)

  2. Affective language during the H1N1 influenza health crisis

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    Morant Marco, Ricard

    2010-12-01

    Full Text Available In this article we analyze the effects that, as seen through the written press, the arrival of H1N1 had on certain affective behaviors in society. After the spread of H1N1, health authorities recommended maintaining physical distance in social settings and, among other measures, advised against kissing. At first, this show of affection became a victim of the pandemic, especially in certain activities and rituals. However, once the media impact of swine flu had subsided, kissing recovered its habitual place and frequency, demonstrating that customs which are socially and culturally entrenched are resistant to change.

    El presente artículo analiza los efectos que según la prensa escrita tuvo la llegada de la gripe A en ciertos comportamientos afectivos de la población. Las autoridades sanitarias, tras la expansión del virus H1N1, recomendaron aumentar la distancia social y aconsejaron, entre otras medidas, evitar los besos. Esta manifestación afectiva, en un primer momento, notó los efectos de la pandemia, sobre todo en ciertas actividades y rituales. Sin embargo, una vez pasado el impacto mediático de la gripe A, recuperó su uso y frecuencia habitual, demostrando que las costumbres fuertemente enraizadas se resisten a cambiar.

  3. Influenza pandêmica A (H1N1 2009: fatores de risco para o internamento Pandemic influenza A (H1N1 2009: risk factors for hospitalization

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    Luana Lenzi

    2012-02-01

    Full Text Available OBJETIVO: Avaliar os aspectos da influenza pandêmica A (H1N1 2009 em pacientes hospitalizados a fim de identificar os fatores de risco para o internamento e, consequentemente, para o agravamento da doença. MÉTODOS: Estudo observacional e retrospectivo realizado entre março e dezembro de 2010. Os dados foram coletados a partir do Sistema Nacional de Agravos de Notificação do Ministério da Saúde. Foram incluídos somente os pacientes hospitalizados e não hospitalizados com confirmação laboratorial da infecção durante o período de estudo. As variáveis referentes às características demográficas e clínicas foram avaliadas estatisticamente a fim de comparar as taxas de internamento na presença ou na ausência desses fatores. Os fatores de risco foram identificados por regressão logística. RESULTADOS: Foram incluídos no estudo 4.740 pacientes com confirmação laboratorial da infecção. Desses, 1.911 foram internados, e 258 (13,5% foram a óbito. Os fatores de risco para o internamento foram idade (faixa etária de 20 a 29 anos, etnia negra ou indígena, presença de algumas comorbidades (cardiopatias, pneumopatias, nefropatias, hemoglobinopatia, imunodepressão, diabetes, obesidade, puerpério e tabagismo, número alto de comorbidades associadas, e alguns sintomas (dispneia, diarreia, vômito, dor torácica, hemoptise, pneumonia e sibilos. Níveis maiores de escolaridade e uso precoce do oseltamivir foram relacionados a fatores de proteção. A hospitalização contribuiu para o aumento da sobrevida. CONCLUSÕES: O conhecimento das características epidemiológicas que podem estar associadas a internação, gravidade da doença e mortalidade podem ser úteis na adoção de medidas preventivas e no diagnóstico e tratamento precoce da doença, colaborando para a diminuição dos óbitos e da necessidade de hospitalização.OBJECTIVE: To evaluate pandemic influenza A (H1N1 2009 in hospitalized patients in order to identify risk

  4. Community responses to communication campaigns for influenza A (H1N1: a focus group study

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    Gray Lesley

    2012-03-01

    Full Text Available Abstract Background This research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand. Methods Qualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui is a culturally appropriate methodology. Results Thematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust. Conclusions The responses from all groups endorsed the need for community based risk management including information dissemination. Engaging

  5. Impact of H1N1 on socially disadvantaged populations: systematic review.

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    Andrea C Tricco

    Full Text Available The burden of H1N1 among socially disadvantaged populations is unclear. We aimed to synthesize hospitalization, severe illness, and mortality data associated with pandemic A/H1N1/2009 among socially disadvantaged populations.Studies were identified through searching MEDLINE, EMBASE, scanning reference lists, and contacting experts. Studies reporting hospitalization, severe illness, and mortality attributable to laboratory-confirmed 2009 H1N1 pandemic among socially disadvantaged populations (e.g., ethnic minorities, low-income or lower-middle-income economy countries [LIC/LMIC] were included. Two independent reviewers conducted screening, data abstraction, and quality appraisal (Newcastle Ottawa Scale. Random effects meta-analysis was conducted using SAS and Review Manager.Sixty-two studies including 44,777 patients were included after screening 787 citations and 164 full-text articles. The prevalence of hospitalization for H1N1 ranged from 17-87% in high-income economy countries (HIC and 11-45% in LIC/LMIC. Of those hospitalized, the prevalence of intensive care unit (ICU admission and mortality was 6-76% and 1-25% in HIC; and 30% and 8-15%, in LIC/LMIC, respectively. There were significantly more hospitalizations among ethnic minorities versus non-ethnic minorities in two studies conducted in North America (1,313 patients, OR 2.26 [95% CI: 1.53-3.32]. There were no differences in ICU admissions (n = 8 studies, 15,352 patients, OR 0.84 [0.69-1.02] or deaths (n = 6 studies, 14,757 patients, OR 0.85 [95% CI: 0.73-1.01] among hospitalized patients in HIC. Sub-group analysis indicated that the meta-analysis results were not likely affected by confounding. Overall, the prevalence of hospitalization, severe illness, and mortality due to H1N1 was high for ethnic minorities in HIC and individuals from LIC/LMIC. However, our results suggest that there were little differences in the proportion of hospitalization, severe illness, and mortality between

  6. Neutralization and Binding Profile of Monoclonal Antibodies Generated Against Influenza A H1N1 Viruses.

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    Shembekar, Nachiket; Mallajosyula, Vamsee V Aditya; Malik, Ankita; Saini, Ashok; Varadarajan, Raghavan; Gupta, Satish Kumar

    2016-08-01

    Monoclonal antibodies (MAbs) provide scope for the development of better therapeutics and diagnostic tools. Herein, we describe the binding and neutralization profile(s) for a panel of murine MAbs generated against influenza A H1N1 viruses elicited by immunization with pandemic H1 recombinant hemagglutinin (rHA)/whole virus or seasonal H1 rHA. Neutralizing MAbs, MA-2070 and MA-M, were obtained after pandemic A/California/07/2009 (H1N1) virus/rHA immunization(s). Both MAbs reacted specifically with rHA from A/California/07/2009 and A/England/195/2009 in ELISA. MA-2070 bound rHA of A/California/07/2009 with high affinity (KD = 51.36 ± 9.20 nM) and exhibited potent in vitro neutralization (IC50 = 2.50 μg/mL). MA-2070 bound within the stem domain of HA. MA-M exhibited both hemagglutination inhibition (HI, 1.50 μg/mL) and in vitro neutralization (IC50 = 0.66 μg/mL) activity against the pandemic A/California/07/2009 virus and showed higher binding affinity (KD = 9.80 ± 0.67 nM) than MA-2070. MAb, MA-H generated against the seasonal A/Solomon Islands/03/2006 (H1N1) rHA binds within the head domain and bound the seasonal H1N1 (A/Solomon Islands/03/2006 and A/New Caledonia/20/1990) rHAs with high affinity (KD; 0.72-8.23 nM). MA-H showed high HI (2.50 μg/mL) and in vitro neutralization (IC50 = 2.61 μg/mL) activity against the A/Solomon Islands/03/2006 virus. All 3 MAbs failed to react in ELISA with rHA from various strains of H2N2, H3N2, H5N1, H7N9, and influenza virus B, suggesting their specificity for either pandemic or seasonal H1N1 influenza virus. The MAbs reported here may be useful in developing diagnostic assays.

  7. The H1N1 pandemic: media frames, stigmatization and coping.

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    McCauley, Michael; Minsky, Sara; Viswanath, Kasisomayajula

    2013-12-03

    Throughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak's alleged origin in Mexican pig farms. In this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors. Twelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups. Participants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses

  8. Pandemic H1N1 2009 ('swine flu'): diagnostic and other challenges.

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    Burkardt, Hans-Joachim

    2011-01-01

    Pandemic H1N1 2009 ('swine flu') virus was 'the virus of the year 2009' because it affected the lives of many people in this year. H1N1 was first described in California in April 2009 and spread very rapidly all over the globe. The fast global penetration of the swine flu caused the WHO in Geneva to call the infection with H1N1 a new pandemic with a rapid escalation of the different pandemic phases that ended on 11 June 2009, with the declaration of phase 6 (full-blown pandemic). This had far-reaching consequences for the local health authorities in the different affected countries and created awareness in the public and fear in the experts and even more so in many lay people. The consequences were: setting up reliable diagnostic tests as soon as possible; enhanced production, distribution and stock creation of the few drugs that were available to treat newly infected persons; and development, production, distribution and stock creation of new and appropriate anti-H1N1 swine flu vaccines. This all resulted in enormous costs in the local healthcare systems and also required smart and diligent logistics, because demand for all this was, in most cases, much higher than availability. Fortunately, the pandemic ended quite quickly (there was no 'second wave' as had been anticipated by some experts) and the death toll was moderate, compared with other influenza pandemic in the past and even to the regular annual appearance of the seasonal flu. This favorable outcome, however, provoked some harsh criticism that the WHO and healthcare systems in general had over-reacted and by doing so, a lot of money was thrown out of the window. This article describes the history of the H1N1 pandemic, the diagnostic challenges and resolutions, touches on treatment and vaccination very briefly and also comments on the criticism and arguments that came up immediately at the end and following the termination of the pandemic situation.

  9. Pandemic influenza A/H1N1pdm in Italy: age, risk and population susceptibility.

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    Stefano Merler

    Full Text Available BACKGROUND: A common pattern emerging from several studies evaluating the impact of the 2009 A/H1N1 pandemic influenza (A/H1N1pdm conducted in countries worldwide is the low attack rate observed in elderly compared to that observed in children and young adults. The biological or social mechanisms responsible for the observed age-specific risk of infection are still to be deeply investigated. METHODS: The level of immunity against the A/H1N1pdm in pre and post pandemic sera was determined using left over sera taken for diagnostic purposes or routine ascertainment obtained from clinical laboratories. The antibody titres were measured by the haemagglutination inhibition (HI assay. To investigate whether certain age groups had higher risk of infection the presence of protective antibody (≥1∶40, was calculated using exact binomial 95% CI on both pre- and post- pandemic serological data in the age groups considered. To estimate age-specific susceptibility to infection we used an age-structured SEIR model. RESULTS: By comparing pre- and post-pandemic serological data in Italy we found age- specific attack rates similar to those observed in other countries. Cumulative attack rate at the end of the first A/H1N1pdm season in Italy was estimated to be 16.3% (95% CI 9.4%-23.1%. Modeling results allow ruling out the hypothesis that only age-specific characteristics of the contact network and levels of pre-pandemic immunity are responsible for the observed age-specific risk of infection. This means that age-specific susceptibility to infection, suspected to play an important role in the pandemic, was not only determined by pre-pandemic levels of H1N1pdm antibody measured by HI. CONCLUSIONS: Our results claim for new studies to better identify the biological mechanisms, which might have determined the observed pattern of susceptibility with age. Moreover, our results highlight the need to obtain early estimates of differential susceptibility with age in

  10. Early recognition of the 2009 pandemic influenza A (H1N1) pneumonia by chest ultrasound.

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    Testa, Americo; Soldati, Gino; Copetti, Roberto; Giannuzzi, Rosangela; Portale, Grazia; Gentiloni-Silveri, Nicolò

    2012-02-17

    The clinical picture of the pandemic influenza A (H1N1)v ranges from a self-limiting afebrile infection to a rapidly progressive pneumonia. Prompt diagnosis and well-timed treatment are recommended. Chest radiography (CRx) often fails to detect the early interstitial stage. The aim of this study was to evaluate the role of bedside chest ultrasonography (US) in the early management of the 2009 influenza A (H1N1)v infection. 98 patients who arrived in the Emergency Department complaining of influenza-like symptoms were enrolled in the study. Patients not displaying symptoms of acute respiratory distress were discharged without further investigations. Among patients with clinical suggestion of a community-acquired pneumonia, cases encountering other diagnoses or comorbidities were excluded from the study. Clinical history, laboratory tests, CRx, and computed tomography (CT) scan, if indicated, contributed to define the diagnosis of pneumonia in the remaining patients. Chest US was performed by an emergency physician, looking for presence of interstitial syndrome, alveolar consolidation, pleural line abnormalities, and pleural effusion, in 34 patients with a final diagnosis of pneumonia, in 16 having normal initial CRx, and in 33 without pneumonia, as controls. Chest US was carried out without discomfort in all subjects, requiring a relatively short time (9 minutes; range, 7 to 13 minutes). An abnormal US pattern was detected in 32 of 34 patients with pneumonia (94.1%). A prevalent US pattern of interstitial syndrome was depicted in 15 of 16 patients with normal initial CRx, of whom 10 (62.5%) had a final diagnosis of viral (H1N1) pneumonia. Patients with pneumonia and abnormal initial CRx, of whom only four had a final diagnosis of viral (H1N1) pneumonia (22.2%; PUS pattern of alveolar consolidation. Finally, a positive US pattern of interstitial syndrome was found in five of 33 controls (15.1%). False negatives were found in two (5.9%) of 34 cases, and false

  11. Streptococcus pneumoniae coinfection is correlated with the severity of H1N1 pandemic influenza.

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    Gustavo Palacios

    2009-12-01

    Full Text Available Initial reports in May 2009 of the novel influenza strain H1N1pdm estimated a case fatality rate (CFR of 0.6%, similar to that of seasonal influenza. In July 2009, however, Argentina reported 3056 cases with 137 deaths, representing a CFR of 4.5%. Potential explanations for increased CFR included virus reassortment or genetic drift, or infection of a more vulnerable population. Virus genomic sequencing of 26 Argentinian samples representing both severe and mild disease indicated no evidence of reassortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence. Furthermore, no evidence was found for increased frequency of risk factors for H1N1pdm disease.We examined nasopharyngeal swab samples (NPS from 199 cases of H1N1pdm infection from Argentina with MassTag PCR, testing for 33 additional microbial agents. The study population consisted of 199 H1N1pdm-infected subjects sampled between 23 June and 4 July 2009. Thirty-nine had severe disease defined as death (n = 20 or hospitalization (n = 19; 160 had mild disease. At least one additional agent of potential pathogenic importance was identified in 152 samples (76%, including Streptococcus pneumoniae (n = 62; Haemophilus influenzae (n = 104; human respiratory syncytial virus A (n = 11 and B (n = 1; human rhinovirus A (n = 1 and B (n = 4; human coronaviruses 229E (n = 1 and OC43 (n = 2; Klebsiella pneumoniae (n = 2; Acinetobacter baumannii (n = 2; Serratia marcescens (n = 1; and Staphylococcus aureus (n = 35 and methicillin-resistant S. aureus (MRSA, n = 6. The presence of S. pneumoniae was strongly correlated with severe disease. S. pneumoniae was present in 56.4% of severe cases versus 25% of mild cases; more than one-third of H1N1pdm NPS with S. pneumoniae were from subjects with severe disease (22 of 62 S. pneumoniae-positive NPS, p = 0.0004. In subjects 6 to 55 years of age, the adjusted odds ratio (OR of severe disease in the presence of

  12. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

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    Yun, Tae Jin (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)); Park, Chang Min; Choi, Seung Hong; Lee, Hyun Ju; Goo, Jin Mo (Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: cmpark@radiol.snu.ac.kr; Kwon, Gu Jin (Dept. of Family Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Family Medicine, Gangneung Asan Hospital, Gangneung (Korea, Republic of)); Woo, Sung Koo (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of)); Park, Seung Hoon (Dept. of Internal Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of))

    2011-05-15

    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  13. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

    International Nuclear Information System (INIS)

    Yun, Tae Jin; Park, Chang Min; Choi, Seung Hong; Lee, Hyun Ju; Goo, Jin Mo; Kwon, Gu Jin; Woo, Sung Koo; Park, Seung Hoon

    2011-01-01

    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  14. Illness representation on H1N1 influenza and preventive behaviors in the Hong Kong general population.

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    Mo, Phoenix K H; Lau, Joseph T F

    2015-12-01

    This study examined illness representations of new influenza Human Swine Influenza A (H1N1) and association with H1N1 preventive behaviors among 300 Chinese adults using a population-based randomized telephone survey. Results showed that relatively few participants thought H1N1 would have serious consequences (12%-15.7%) and few showed negative emotional responses toward H1N1 (9%-24.7%). The majority of the participants thought H1N1 could be controlled by treatment (70.4%-72.7%). Multiple logistic regression analyses showed that treatment control (odds ratio = 1.78) and psychological attribution (odds ratio = .75) were associated with intention to take up influenza vaccination. Emotional representations were associated with lower likelihood of wearing face mask (odds ratio = .77) and hand washing (odds ratio = .67). Results confirm that illness representation variables are associated with H1N1 preventive behaviors. © The Author(s) 2014.

  15. Phylodynamics of H1N1/2009 influenza reveals the transition from host adaptation to immune-driven selection

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    Su, Yvonne C. F.; Bahl, Justin; Joseph, Udayan; Butt, Ka Man; Peck, Heidi A.; Koay, Evelyn S. C.; Oon, Lynette L. E.; Barr, Ian G.; Vijaykrishna, Dhanasekaran; Smith, Gavin J. D.

    2015-01-01

    Influenza A H1N1/2009 virus that emerged from swine rapidly replaced the previous seasonal H1N1 virus. Although the early emergence and diversification of H1N1/2009 is well characterized, the ongoing evolutionary and global transmission dynamics of the virus remain poorly investigated. To address this we analyse >3,000 H1N1/2009 genomes, including 214 full genomes generated from our surveillance in Singapore, in conjunction with antigenic data. Here we show that natural selection acting on H1N1/2009 directly after introduction into humans was driven by adaptation to the new host. Since then, selection has been driven by immunological escape, with these changes corresponding to restricted antigenic diversity in the virus population. We also show that H1N1/2009 viruses have been subject to regular seasonal bottlenecks and a global reduction in antigenic and genetic diversity in 2014. PMID:26245473

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

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    Esposito Susanna

    2011-12-01

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

  17. ‘Presenting CXR phenotype of H1N1’ flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks’

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    Minns, F.C., E-mail: Fiona.Minns@nhslothian.scot.nhs.uk [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Nimhuineachain, A, E-mail: draideen@gmail.com [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Beek, E.J.R. van, E-mail: Edwin-vanbeek@ed.ac.uk [Clinical Research Imaging Centre, University of Edinburgh, 47 Little France Crescent, Edinburgh, Midlothian EH16 4TJ (United Kingdom); Ritchie, G., E-mail: drgillritchie@hotmail.com [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom); Hill, A., E-mail: adam.hill318@nhs.net [Department of Respiratory Medicine, New Royal Infirmary, Edinburgh (United Kingdom); Murchison, J.T., E-mail: john.murchison@nhslothian.scot.nhs.uk [Department of Radiology, New Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA (United Kingdom)

    2015-09-15

    Highlights: • Patients with H1N1 pneumonia demonstrated more opacified zones on chest x-ray than patients with non-H1N1 pneumonias. • A particular ‘phenotype’ of chest x-ray changes was identified in H1N1 patients. • This H1N1 ‘phenotype’ was the same for the two evaluated ‘flu seasons, during both pandemic and post pandemic stages. - Abstract: Aims: To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). Methods: We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were ‘blinded’ to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Results: Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p = 0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p = 0.001). H1N1 radiographs were more likely to be ‘patchy’ versus ‘confluent’ changes of non-H1N1 CAP (p = 0.03) and more often demonstrated peripheral distribution (p = 0.01). H1N1 patients tended to stay in hospital longer (not significant; p = 0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p = 0.02). The findings were the same for the two evaluated seasons. Conclusion: H1N1 patients demonstrated more extensive disease, which was more likely bilateral, ‘patchy’, and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients

  18. ‘Presenting CXR phenotype of H1N1’ flu compared with contemporaneous non-H1N1, community acquired pneumonia, during pandemic and post-pandemic outbreaks’

    International Nuclear Information System (INIS)

    Minns, F.C.; Nimhuineachain, A; Beek, E.J.R. van; Ritchie, G.; Hill, A.; Murchison, J.T.

    2015-01-01

    Highlights: • Patients with H1N1 pneumonia demonstrated more opacified zones on chest x-ray than patients with non-H1N1 pneumonias. • A particular ‘phenotype’ of chest x-ray changes was identified in H1N1 patients. • This H1N1 ‘phenotype’ was the same for the two evaluated ‘flu seasons, during both pandemic and post pandemic stages. - Abstract: Aims: To review, phenotype and assess potential prognostic value of initial chest X-ray findings in patients with H1N1 influenza during seasonal outbreaks of 2009 and 2010, in comparison with non-H1N1, community acquired pneumonia (CAP). Methods: We retrospectively identified 72 patients admitted to hospital with pneumonia during the seasons of 2009 and 2010. H1N1 cases were confirmed by virology PCR. Presenting chest X-rays were jointly read by 2 radiologists, who were ‘blinded’ to further patient details and divided into 6 zones. Total number of opacified zones, the pattern and distribution of changes and length of hospital stay were recorded. Results: Patients with H1N1 demonstrated more opacified zones (mean of 2.9 compared with 2.0; p = 0.006), which were bilateral in two-thirds compared with a quarter of those with non-H1N1 CAP (p = 0.001). H1N1 radiographs were more likely to be ‘patchy’ versus ‘confluent’ changes of non-H1N1 CAP (p = 0.03) and more often demonstrated peripheral distribution (p = 0.01). H1N1 patients tended to stay in hospital longer (not significant; p = 0.08). A positive correlation existed between number of affected zones and length of inpatient stay, which was statistically significant for the cohorts combined (p = 0.02). The findings were the same for the two evaluated seasons. Conclusion: H1N1 patients demonstrated more extensive disease, which was more likely bilateral, ‘patchy’, and peripheral in distribution. With increasing global cases of H1N1, knowledge of the typical findings of the H1N1 presenting chest X-ray may assist with early triage of patients

  19. Who got vaccinated against H1N1 pandemic influenza? A longitudinal study in four U.S. cities.

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    Li, Meng; Chapman, Gretchen B; Ibuka, Yoko; Meyers, Lauren Ancel; Galvani, Alison

    2012-01-01

    The recent H1N1 pandemic influenza stimulated numerous studies into the attitudes and intentions about the H1N1 vaccine. However, no study has investigated prospective predictors of vaccination behaviour. We conducted a two-wave longitudinal study among residents in four U.S. cities during the course of the H1N1 outbreak, using Internet surveys to assess demographic, cognitive and emotional predictors of H1N1 vaccination behaviour. Surveys were conducted at two time points, before (Time 1) and after (Time 2) the H1N1 vaccine was widely available to the public. Results show that Time 2 vaccination rates, but not Time 1 vaccination intentions, tracked H1N1 prevalence across the four cities. Receipt of seasonal influenza vaccine in the previous year, worry, compliance with recommended interventions, household size and education assessed at Time 1 were significant prospective predictors of vaccination behaviour. Perception of the H1N1 vaccine, social influence and prioritised vaccine recipient status assessed at Time 2 also predicted vaccination behaviour. Critically, worry about H1N1 mediated the effects of both objective risk (prevalence at the city level) and perceived risk on vaccination behaviour. These results suggest that H1N1 vaccination behaviour appropriately reflected objective risk across regions, and worry acted as the mechanism by which vaccination behaviour followed objective risk.

  20. Twin Peaks: A/H1N1 Pandemic Influenza Virus Infection and Vaccination in Norway, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Thierry Van Effelterre

    Full Text Available Vaccination campaigns against A/H1N1 2009 pandemic influenza virus (A/H1N1p began in autumn 2009 in Europe, after the declaration of the pandemic at a global level. This study aimed to estimate the proportion of individuals vaccinated against A/H1N1p in Norway who were already infected (asymptomatically or symptomatically by A/H1N1p before vaccination, using a mathematical model.A dynamic, mechanistic, mathematical model of A/H1N1p transmission was developed for the Norwegian population. The model parameters were estimated by calibrating the model-projected number of symptomatic A/H1N1p cases to the number of laboratory-confirmed A/H1N1p cases reported to the surveillance system, accounting for potential under-reporting. It was assumed in the base case that the likelihood of vaccination was independent of infection/disease state. A sensitivity analysis explored the effects of four scenarios in which current or previous symptomatic A/H1N1p infection would influence the likelihood of being vaccinated.The number of model-projected symptomatic A/H1N1p cases by week during the epidemic, accounting for under-reporting and timing, closely matched that of the laboratory-confirmed A/H1N1p cases reported to the surveillance system. The model-projected incidence of symptomatic A/H1N1p infection was 27% overall, 55% in people <10 years old and 41% in people 10-20 years old. The model-projected percentage of individuals vaccinated against A/H1N1p who were already infected with A/H1N1p before being vaccinated was 56% overall, 62% in people <10 years old and 66% in people 10-20 years old. The results were sensitive to assumptions about the independence of vaccination and infection; however, even when current or previous symptomatic A/H1N1p infection was assumed to reduce the likelihood of vaccination, the estimated percentage of individuals who were infected before vaccination remained at least 32% in all age groups.This analysis suggests that over half the

  1. Twin Peaks: A/H1N1 Pandemic Influenza Virus Infection and Vaccination in Norway, 2009-2010.

    Science.gov (United States)

    Van Effelterre, Thierry; Dos Santos, Gaël; Shinde, Vivek

    2016-01-01

    Vaccination campaigns against A/H1N1 2009 pandemic influenza virus (A/H1N1p) began in autumn 2009 in Europe, after the declaration of the pandemic at a global level. This study aimed to estimate the proportion of individuals vaccinated against A/H1N1p in Norway who were already infected (asymptomatically or symptomatically) by A/H1N1p before vaccination, using a mathematical model. A dynamic, mechanistic, mathematical model of A/H1N1p transmission was developed for the Norwegian population. The model parameters were estimated by calibrating the model-projected number of symptomatic A/H1N1p cases to the number of laboratory-confirmed A/H1N1p cases reported to the surveillance system, accounting for potential under-reporting. It was assumed in the base case that the likelihood of vaccination was independent of infection/disease state. A sensitivity analysis explored the effects of four scenarios in which current or previous symptomatic A/H1N1p infection would influence the likelihood of being vaccinated. The number of model-projected symptomatic A/H1N1p cases by week during the epidemic, accounting for under-reporting and timing, closely matched that of the laboratory-confirmed A/H1N1p cases reported to the surveillance system. The model-projected incidence of symptomatic A/H1N1p infection was 27% overall, 55% in people <10 years old and 41% in people 10-20 years old. The model-projected percentage of individuals vaccinated against A/H1N1p who were already infected with A/H1N1p before being vaccinated was 56% overall, 62% in people <10 years old and 66% in people 10-20 years old. The results were sensitive to assumptions about the independence of vaccination and infection; however, even when current or previous symptomatic A/H1N1p infection was assumed to reduce the likelihood of vaccination, the estimated percentage of individuals who were infected before vaccination remained at least 32% in all age groups. This analysis suggests that over half the people vaccinated

  2. An Experimental Investigation of the Performance of a Collison Nebulizer Generating H1N1 Influenza Aerosols

    Science.gov (United States)

    2015-04-04

    of the performance of a collison nebulizer generating H1N1 influenza aerosols E.A. Ibrahim*, D.A. Harnish%, K. Kinney%, B.K. Heimbuch%, and J.D... H1N1 influenza aerosols was assessed in terms of particle size distribution (PSD) and survivability of the virus upon generation. An H1N1 influenza...stresses imparted on components by the Collison nebulizer. The possible slight loss in H1N1 influenza viability over the course of 60 min of continuous

  3. Twin Peaks: A/H1N1 Pandemic Influenza Virus Infection and Vaccination in Norway, 2009–2010

    Science.gov (United States)

    Van Effelterre, Thierry; Dos Santos, Gaël; Shinde, Vivek

    2016-01-01

    Background Vaccination campaigns against A/H1N1 2009 pandemic influenza virus (A/H1N1p) began in autumn 2009 in Europe, after the declaration of the pandemic at a global level. This study aimed to estimate the proportion of individuals vaccinated against A/H1N1p in Norway who were already infected (asymptomatically or symptomatically) by A/H1N1p before vaccination, using a mathematical model. Methods A dynamic, mechanistic, mathematical model of A/H1N1p transmission was developed for the Norwegian population. The model parameters were estimated by calibrating the model-projected number of symptomatic A/H1N1p cases to the number of laboratory-confirmed A/H1N1p cases reported to the surveillance system, accounting for potential under-reporting. It was assumed in the base case that the likelihood of vaccination was independent of infection/disease state. A sensitivity analysis explored the effects of four scenarios in which current or previous symptomatic A/H1N1p infection would influence the likelihood of being vaccinated. Results The number of model-projected symptomatic A/H1N1p cases by week during the epidemic, accounting for under-reporting and timing, closely matched that of the laboratory-confirmed A/H1N1p cases reported to the surveillance system. The model-projected incidence of symptomatic A/H1N1p infection was 27% overall, 55% in people <10 years old and 41% in people 10–20 years old. The model-projected percentage of individuals vaccinated against A/H1N1p who were already infected with A/H1N1p before being vaccinated was 56% overall, 62% in people <10 years old and 66% in people 10–20 years old. The results were sensitive to assumptions about the independence of vaccination and infection; however, even when current or previous symptomatic A/H1N1p infection was assumed to reduce the likelihood of vaccination, the estimated percentage of individuals who were infected before vaccination remained at least 32% in all age groups. Conclusion This analysis

  4. An influenza A/H1N1/2009 hemagglutinin vaccine produced in Escherichia coli.

    Directory of Open Access Journals (Sweden)

    José M Aguilar-Yáñez

    2010-07-01

    Full Text Available The A/H1N1/2009 influenza pandemic made evident the need for faster and higher-yield methods for the production of influenza vaccines. Platforms based on virus culture in mammalian or insect cells are currently under investigation. Alternatively, expression of fragments of the hemagglutinin (HA protein in prokaryotic systems can potentially be the most efficacious strategy for the manufacture of large quantities of influenza vaccine in a short period of time. Despite experimental evidence on the immunogenic potential of HA protein constructs expressed in bacteria, it is still generally accepted that glycosylation should be a requirement for vaccine efficacy.We expressed the globular HA receptor binding domain, referred to here as HA(63-286-RBD, of the influenza A/H1N1/2009 virus in Escherichia coli using a simple, robust and scalable process. The recombinant protein was refolded and purified from the insoluble fraction of the cellular lysate as a single species. Recombinant HA(63-286-RBD appears to be properly folded, as shown by analytical ultracentrifugation and bio-recognition assays. It binds specifically to serum antibodies from influenza A/H1N1/2009 patients and was found to be immunogenic, to be capable of triggering the production of neutralizing antibodies, and to have protective activity in the ferret model.Projections based on our production/purification data indicate that this strategy could yield up to half a billion doses of vaccine per month in a medium-scale pharmaceutical production facility equipped for bacterial culture. Also, our findings demonstrate that glycosylation is not a mandatory requirement for influenza vaccine efficacy.

  5. Brotes escolares de gripe (H1N1 2009 en Cataluña

    Directory of Open Access Journals (Sweden)

    Nuria Torner

    2011-01-01

    Full Text Available A pesar de los avances en el conocimiento del virus de la gripe (H1N1 2009, la eficacia de su transmision entre contactos, asi como la eficacia de las intervenciones no farmacologicas es poco conocida. El objetivo de este trabajo es caracterizar la ocurrencia de brotes confirmados de virus (H1N1 2009 en Cataluna en el ambito escolar durante el periodo pandemico y evaluar las actuaciones llevadas a cabo para su control. Metodos: Se estudio la incidencia de brotes de VGA(H1N12009 de mayo a diciembre 2009. Se calcularon las tasas de ataque en funcion de emision de recomendaciones preventivas y ejecucion de intervenciones. La asociacion entre variables se calculo mediante ¿Ô2, comparacion de medias mediante t-Student y comparacion de proporciones mediante estadistico z , estableciendo el grado de significacion estadistica en ¿¿=0,05. Resultados: En total se notificaron 238 brotes. La TA global fue del 15,5%. Del total de brotes solo se conoce la tasa de ataque de 173 (72,7%, de los cuales 142 (82,1%; p<0,001 tuvieron una TA inferior al 25%. El principal ambito de transmision fue el escolar, donde se produjeron 209 (88%; p<0,001 brotes, de los cuales 187 (78,6%; p<0,001 correspondian a centros educativos. La duracion media de los brotes fue significativamente menor en funcion de la emision de recomendaciones (p=0,04. Conclusiones: El estudio de los brotes de gripe A/H1N1 2009 permite evidenciar que la adopcion de medidas preventivas y de higiene es de vital importancia para el control de la transmision en centros educativos.

  6. Antigenic cartography of H1N1 influenza viruses using sequence-based antigenic distance calculation.

    Science.gov (United States)

    Anderson, Christopher S; McCall, Patrick R; Stern, Harry A; Yang, Hongmei; Topham, David J

    2018-02-12

    The ease at which influenza virus sequence data can be used to estimate antigenic relationships between strains and the existence of databases containing sequence data for hundreds of thousands influenza strains make sequence-based antigenic distance estimates an attractive approach to researchers. Antigenic mismatch between circulating strains and vaccine strains results in significantly decreased vaccine effectiveness. Furthermore, antigenic relatedness between the vaccine strain and the strains an individual was originally primed with can affect the cross-reactivity of the antibody response. Thus, understanding the antigenic relationships between influenza viruses that have circulated is important to both vaccinologists and immunologists. Here we develop a method of mapping antigenic relationships between influenza virus stains using a sequence-based antigenic distance approach (SBM). We used a modified version of the p-all-epitope sequence-based antigenic distance calculation, which determines the antigenic relatedness between strains using influenza hemagglutinin (HA) genetic coding sequence data and provide experimental validation of the p-all-epitope calculation. We calculated the antigenic distance between 4838 H1N1 viruses isolated from infected humans between 1918 and 2016. We demonstrate, for the first time, that sequence-based antigenic distances of H1N1 Influenza viruses can be accurately represented in 2-dimenstional antigenic cartography using classic multidimensional scaling. Additionally, the model correctly predicted decreases in cross-reactive antibody levels with 87% accuracy and was highly reproducible with even when small numbers of sequences were used. This work provides a highly accurate and precise bioinformatics tool that can be used to assess immune risk as well as design optimized vaccination strategies. SBM accurately estimated the antigenic relationship between strains using HA sequence data. Antigenic maps of H1N1 virus strains reveal

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

    Directory of Open Access Journals (Sweden)

    Andrew eMcNeill

    2016-02-01

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

  8. Twitter Influence on UK Vaccination and Antiviral Uptake during the 2009 H1N1 Pandemic.

    Science.gov (United States)

    McNeill, Andrew; Harris, Peter R; Briggs, Pam

    2016-01-01

    Information exchange via Twitter and other forms of social media make public health communication more complex as citizens play an increasingly influential role in shaping acceptable or desired health behaviors. Taking the case of the 2009-2010 H1N1 pandemic, we explore in detail the dissemination of H1N1-related advice in the UK through Twitter to see how it was used to discourage or encourage vaccine and antiviral uptake. In three stages we conducted (1) an analysis of general content, retweeting patterns, and URL sharing, (2) a discourse analysis of the public evaluation of press releases and (3) a template analysis of conversations around vaccine and antiviral uptake, using Protection Motivation Theory (PMT) as a way of understanding how the public weighed the costs and benefits. Network analysis of retweets showed that information from official sources predominated. Analysing the spread of significant messages through Twitter showed that most content was descriptive but there was some criticism of health authorities. A detailed analysis of responses to press releases revealed some scepticism over the economic beneficiaries of vaccination, that served to undermine public trust. Finally, the conversational analysis showed the influence of peers when weighing up the risks and benefits of medication. Most tweets linked to reliable sources, however Twitter was used to discuss both individual and health authority motivations to vaccinate. The PMT framework describes the ways individuals assessed the threat of the H1N1 pandemic, weighing this against the perceived cost of taking medication. These findings offer some valuable insights for social media communication practices in future pandemics.

  9. Long-term respiratory follow-up of H1N1 infection

    Directory of Open Access Journals (Sweden)

    Kerenidi Theodora

    2011-06-01

    Full Text Available Abstract Background The first case of 2009 pandemic influenza A (H1N1 virus infection was documented in our Hospital on 10th August 2009. Metdods and findings Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR testing was used to confirm the diagnosis. All patients were treated with oseltamivir from the first day of hospitalization. Upon admission 12/44 had local patchy shadowing in their chest x-ray and additionally antibiotic regimen was added to these patients as pneumonia was suspected based on clinical evidence. In total 44 patients were hospitalized 15/44 had asthma, 6/44 COPD, 5/44 leukemia. Lung function was evaluated with forced vital capacity, forced expiratory volume in 1 sec and diffused carbon monoxide upon discharge and every 3 months, until 6 months of observation was completed after discharge. The purpose of this retrospective cohort study was to evaluate whether influenza A (H1N1 had an impact on the respiratory capacity of the infected patients. Conclusions An improvement of pulmonary function tests was observed between the first two measurements, implicating an inflammatory pathogenesis of influenza A (H1N1 to the respiratory tract. This inflammation was not associated with the severity or clinical outcome of the patients. All patients had a mild clinical course and their respiratory capacity was stable between the second and third measurement, suggesting that the duration of respiratory inflammation was two months. Early treatment with antiviral agents and vaccination represent the mainstay of management.

  10. Pandemic 2009 H1N1 virus infection associated with purpuric skin lesions: a case report

    Directory of Open Access Journals (Sweden)

    Biagioli Daniele

    2011-04-01

    Full Text Available Abstract Introduction The influenza virus infection may be severe in non-immune people. Common complications of influenza virus include upper and lower respiratory tract infections, otitis media, myocarditis, acute respiratory distress syndrome and multi-organ failure. There have been cases of vasculitis following influenza vaccination, and rash and acute purpura may occur in certain viral infections. To the best of our knowledge, there are no reports concerning cases of systemic vasculitis associated with pandemic 2009 (H1N1 infection. Case presentation A 23-year-old Caucasian woman was hospitalized at the "L. Spallanzani" National Institute for Infectious Diseases in Rome, Italy. Clinical and radiological features including laboratory findings of this case are illustrated. Notably, the patient had fever, severe abdominal pain, hematuria, arthritis, and purpuric manifestations associated with a normal platelet count. Nasopharyngeal and rectal swabs revealed pandemic 2009 (H1N1 virus by reverse-transcriptase-polymerase-chain-reaction assay. Routine laboratory analyses showed elevated inflammatory parameters. The autoimmune panel tests were normal. Steroid therapy associated with oseltamivir achieved an evident and rapid improvement. On day seven the patient chose to leave the hospital against medical advice. Conclusion Complications related to influenza infection can be life threatening, particularly in immunocompromised patients. Henoch-Schönlein purpura triggered by the novel influenza virus infection could be an attractive pathogenetic hypothesis. We have discussed both the diagnosis and the challenge of therapy protocols. Steroid therapy is part of the management of severe vasculitis. Our case suggests that steroid therapy associated with antivirals can prevent the risk of further complications such as hemorrhage and multi-organ failure during severe vasculitis, without enhancing the virulence of the influenza virus. The possible role of

  11. Imaging Findings in Patients With H1N1 Influenza A Infection

    International Nuclear Information System (INIS)

    Bakhshayeshkaram, Mehrdad; Saidi, Bahareh; Tabarsi, Payam; Zahirifard, Soheila; Ghofrani, Mishka

    2011-01-01

    Swine influenza (H1N1) is a very contagious respiratory infection and World Health Organization (WHO) has raised the alert level to phase 6 (pandemic). The study of clinical and laboratory manifestations as well as radiologic imaging findings helps in its early diagnosis. The aim of this study was to evaluate the imaging findings of patients with documented H1N1 infection referred to our center. Thirty-one patients (16 men) with documented H1N1 infection were included in our study. The initial radiography obtained from the patients was reviewed regarding pattern (consolidation, ground glass, nodules and reticulation), distribution (focal, multifocal, and diffuse) and the lung zones involved. Computed tomography (CT) scans were also reviewed for the same abnormalities. The patient files were studied for their possible underlying diseases. The mean age was 37.97 ± 13.9 years. Seventeen (54.8%) patients had co-existing condition (eight respiratory, five cardiovascular, two immunodeficiency, two cancer, four others). Twelve (38.7%) patients required intensive care unit (ICU) admission. Five (16.1%) patients died. (25.8%) had normal initial radiographs. The most common abnormality was consolidation (12/31; 38.7%) in the peripheral region (11/31; 35.5%) followed by peribronchovascular areas (10/31; 32.3%) which was most commonly observed in the lower zone. The patients admitted to the ICU were more likely to have two or more lung zones involved (P = 0.005). In patients with the novel swine flu infection, the most common radiographic abnormality observed was consolidation in the lower lung zones. Patients admitted to ICU were more likely to have two or more lung zones involved

  12. Extreme evolutionary conservation of functionally important regions in H1N1 influenza proteome.

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    Samantha Warren

    Full Text Available The H1N1 subtype of influenza A virus has caused two of the four documented pandemics and is responsible for seasonal epidemic outbreaks, presenting a continuous threat to public health. Co-circulating antigenically divergent influenza strains significantly complicates vaccine development and use. Here, by combining evolutionary, structural, functional, and population information about the H1N1 proteome, we seek to answer two questions: (1 do residues on the protein surfaces evolve faster than the protein core residues consistently across all proteins that constitute the influenza proteome? and (2 in spite of the rapid evolution of surface residues in influenza proteins, are there any protein regions on the protein surface that do not evolve? To answer these questions, we first built phylogenetically-aware models of the patterns of surface and interior substitutions. Employing these models, we found a single coherent pattern of faster evolution on the protein surfaces that characterizes all influenza proteins. The pattern is consistent with the events of inter-species reassortment, the worldwide introduction of the flu vaccine in the early 80's, as well as the differences caused by the geographic origins of the virus. Next, we developed an automated computational pipeline to comprehensively detect regions of the protein surface residues that were 100% conserved over multiple years and in multiple host species. We identified conserved regions on the surface of 10 influenza proteins spread across all avian, swine, and human strains; with the exception of a small group of isolated strains that affected the conservation of three proteins. Surprisingly, these regions were also unaffected by genetic variation in the pandemic 2009 H1N1 viral population data obtained from deep sequencing experiments. Finally, the conserved regions were intrinsically related to the intra-viral macromolecular interaction interfaces. Our study may provide further insights

  13. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, S.-Y. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, J.H., E-mail: jhkate@skku.ed [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Y.-J. [Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  14. H1N1 influenza infection in children: Frequency, pattern, and outcome of chest radiographic abnormalities

    International Nuclear Information System (INIS)

    Yoo, S.-Y.; Kim, J.H.; Eo, H.; Jeon, T.Y.; Shin, K.E.; Shin, W.S.; Jung, H.N.; Kim, Y.-J.

    2011-01-01

    Aim: To describe the frequency, pattern, and outcome of chest radiographic abnormalities in children with H1N1 influenza infection. Materials and methods: Three hundred and fourteen paediatric patients with confirmed H1N1 influenza infection who underwent chest radiography at presentation at a single institution during the outbreak in 2009 were retrospectively reviewed. Abnormal chest radiographic findings related to acute infection were analysed in terms of frequency, pattern, and distribution. Medical records and follow-up radiographs were also reviewed to assess clinical features and outcomes. Results: Chest lesions suggesting acute infection were identified in 49 (16%) patients (mean age 8.2 years, range approximately 1.8-18.5 years). The most common finding was prominent peribronchial marking (71%), followed by air-space opacity (51%) with or without volume decrease, generalized hyperinflation (24%), and pleural effusion (20%). Other minor findings included pneumomediastinum (n = 2) and a nodule (n = 1). Distributions were bilateral (55%) or unilateral (45%) with frequent involvement of lower (78%), and middle (59%) lung zones. Thirty-nine patients (80%) were hospitalized and six (12%) required mechanical ventilation, followed by recovery. Thirty-one out of the 33 patients that underwent follow-up radiography showed marked resolution of all radiographic abnormalities. Conclusion: The frequency of a chest radiographic abnormality was found to be low in children with H1N1 influenza infection. Although typical radiographic findings of a viral lower respiratory infection were more common, unilateral involvement and air-space opacity were common, often with pleural effusion. Furthermore, pulmonary lesions showed near complete resolution on follow-up radiographs in the majority of patients.

  15. Duration of viral shedding in hospitalized patients infected with pandemic H1N1

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    Petrosillo Nicola

    2011-05-01

    Full Text Available Abstract Background The first influenza pandemic of the 21th century was ignited by a new strain of influenza A virus (A/H1N1pdm. Specific patient groups, including those with comorbidities, pregnant women, young children, older and immunocompromised patients, are at increased risk for serious influenza-related disease. This study was aimed at investigating the influence of clinical presentation, antiviral treatment and possible drug resistance-associated mutations, on the extent and duration of viral shedding in patients infected with A/H1N1pdm. Methods An observational study was performed, based on retrospective review of clinical and laboratory records of patients who were hospitalized for A/H1N1pdm infection at the National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy, between April 24 and December 31, 2009. Among 119 hospitalized patients, 39 were selected for a post hoc analysis, based on the availability of serial nasopharyngeal swabs samples and related information. Results Eleven out of the 39 study patients (28.2% presented with pneumonia; 29 (74.4% received antiviral treatment. Patients with pneumonia were significantly older than patients without pneumonia. The mean values of viral RNA concentration were not significantly increased in patients with pneumonia, but a significant increase in the duration of viral shedding was observed as compared to patients without pneumonia. In patients receiving antivirals, the viral RNA concentration was significantly reduced in comparison to untreated patients at days 4-5 after symptom onset, while the overall duration of viral shedding was only marginally affected. A significant correlation between duration of viral shedding and time elapsed between symptom onset and therapy start was observed, with a significant reduction of days of viral shedding when therapy was initiated within 2 days of symptoms appearance. No known drug resistance mutations were detected in patients with

  16. Milk-Alkali syndrome induced by H1N1 influenza vaccine

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    Abdullah K Al-Hwiesh

    2017-01-01

    Full Text Available Milk-Alkali syndrome (MAS consists of a triad of hypercalcemia, metabolic alkalosis, and acute renal failure. We hereby report a 75-year-old Indian gentleman who presented to our emergency department with a history of generalized weakness and easy fatigability. Investigations were consistent with MAS secondary to calcium carbonate and calcitriol treatment to prevent osteoporosis, aggravated by H1N1 influenza vaccine. The patient was treated with hemodialysis and zoledronate. To our knowledge, this is the first reported case of such association in the literature.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  18. VIGILANCIA EPIDEMIOLÓGICA DE LA GRIPE (H1N1 2009 SIN RED CENTINELA

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    Alberto Malvar Pintos

    2010-01-01

    Full Text Available Fundamento: En Galicia no existe red centinela de vigilancia epidemiológica por lo que se utilizan sistemas alternativos de vigilancia. El objetivo de este trabajo es describirlos y presentar los resultados observados durante la pandemia de gripe (H1N1 2009. Métodos: Los sistemas utilizados fueron llamadas recibidas por gripe (H1N1 2009 e infección respiratoria aguda en el 061, sistema de notificación de enfermedades obligatorias (SXNOE, vigilancia virológica, registros de atención primaria e ingresos hospitalarios. Los datos se analizaron con Excell. Resultados: La primera onda por virus A(H1N1v se registró a través del 061 entre las semanas 39/2009 y 49/2009, alcanzando el pico en la 44/2009 con la mayor tasa de llamadas acumuladas en el grupo de 5-19 años. SXNOE proporcionó una onda (semanas 39/2009 a 49/2009 con pico en la 44/2009. Microbiológicamente se estudiaron con RT-PRC 6.181 muestras (31% positivas y pico en la semana 44/2009. Los registros de Atención Primaria proporcionaron una onda (semanas 39/2009 a 49/2009 con pico en la semana 44/2009 con la mayor tasa de consultas para los de 5-19 años. Entre las semanas 26/2009 y 17/2010, ingresaron 698 personas con gripe (H1N1 2009, con mayor número de hospitalizaciones en la 44/2009. Conclusiones: Los sistemas descritos quedan avalados por la homogeneidad de los resultados, ya que dibujan la misma onda (semanas 39/2009 a 49/2009 y coinciden en el pico (semana 44/2009 donde se observa la mayor tasa de consultas entre 5-19 años. El 061 aparece como el sistema más operativo al proporcionar datos diarios.

  19. Identification of the First Chinese Cases of H1N1 Flu

    Centers for Disease Control (CDC) Podcasts

    2009-08-04

    In this podcast, Dr. Scott Dowell discusses the first cases of the new H1N1 influenza virus in China in May 2009, which occurred in three students who had been studying in North America during the early days of the pandemic and returned home to visit their friends and family. Chinese health officials acted swiftly to investigate and determine whether the students had spread their illness to others. The article, which appears in the September 2009 issue of Emerging Infectious Diseases, details what they found.  Created: 8/4/2009 by Emerging Infectious Diseases.   Date Released: 8/4/2009.

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

    International Nuclear Information System (INIS)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis

    2010-01-01

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

  1. Inactivation of H1N1 viruses exposed to acidic ozone water

    Science.gov (United States)

    Uhm, Han S.; Lee, Kwang H.; Seong, Baik L.

    2009-10-01

    The inactivation of H1N1 viruses upon exposure to acidic ozone water was investigated using chicken allantoic fluids of different dilutions, pH values, and initial ozone concentrations. The inactivation effect of the acidic ozone water was found to be stronger than the inactivation effect of the ozone water combined with the degree of acidity, indicating a synergic effect of acidity on ozone decay in water. It is also shown that acidic ozone water with a pH value of 4 or less is very effective means of virus inactivation if provided in conjunction with an ozone concentration of 20 mg/l or higher.

  2. Development of a diagnostic kit for Tamiflu-resistant influenze A (H1N1)

    Energy Technology Data Exchange (ETDEWEB)

    Jung, I. L.

    2012-12-15

    Using by pre-developed multiplex RT-PCR kit that is able to diagnosis Tamiflu-sensitive and -resistant Swine Influenza A (H1N1) in the 1st research year, reproducibility and sentitivity of the kit has been investigated in this year. The optimum concentration of reverse transcriptase has also been determined and the economic evaluation has been carried out in this year. Based on the results, a international patent has been applied and a domestic patent has been registered in this year.

  3. Development of a diagnostic kit for Tamiflu-resistant influenze A (H1N1)

    International Nuclear Information System (INIS)

    Jung, I. L.

    2012-12-01

    Using by pre-developed multiplex RT-PCR kit that is able to diagnosis Tamiflu-sensitive and -resistant Swine Influenza A (H1N1) in the 1st research year, reproducibility and sentitivity of the kit has been investigated in this year. The optimum concentration of reverse transcriptase has also been determined and the economic evaluation has been carried out in this year. Based on the results, a international patent has been applied and a domestic patent has been registered in this year

  4. GM-CSF increases mucosal and systemic immunogenicity of an H1N1 influenza DNA vaccine administered into the epidermis of non-human primates.

    Directory of Open Access Journals (Sweden)

    Peter T Loudon

    2010-06-01

    Full Text Available The recent H5N1 avian and H1N1 swine-origin influenza virus outbreaks reaffirm that the threat of a world-wide influenza pandemic is both real and ever-present. Vaccination is still considered the best strategy for protection against influenza virus infection but a significant challenge is to identify new vaccine approaches that offer accelerated production, broader protection against drifted and shifted strains, and the capacity to elicit anti-viral immune responses in the respiratory tract at the site of viral entry. As a safe alternative to live attenuated vaccines, the mucosal and systemic immunogenicity of an H1N1 influenza (A/New Caledonia/20/99 HA DNA vaccine administered by particle-mediated epidermal delivery (PMED or gene gun was analyzed in rhesus macaques.Macaques were immunized at weeks 0, 8, and 16 using a disposable single-shot particle-mediated delivery device designed for clinical use that delivers plasmid DNA directly into cells of the epidermis. Significant levels of hemagglutination inhibiting (HI antibodies and cytokine-secreting HA-specific T cells were observed in the periphery of macaques following 1-3 doses of the PMED HA DNA vaccine. In addition, HA DNA vaccination induced detectable levels of HA-specific mucosal antibodies and T cells in the lung and gut-associated lymphoid tissues of vaccinated macaques. Importantly, co-delivery of a DNA encoding the rhesus macaque GM-CSF gene was found to significantly enhance both the systemic and mucosal immunogenicity of the HA DNA vaccine.These results provide strong support for the development of a particle-mediated epidermal DNA vaccine for protection against respiratory pathogens such as influenza and demonstrate, for the first time, the ability of skin-delivered GM-CSF to serve as an effective mucosal adjuvant for vaccine induction of immune responses in the gut and respiratory tract.

  5. Oseltamivir-resistant influenza A(H1N1) viruses detected in Europe during season 2007-8 had epidemiologic and clinical characteristics similar to co-circulating susceptible A(H1N1) viruses.

    NARCIS (Netherlands)

    Ciancio B.C.; Meerhoff, T.J.; Kramarz, P.; Bonmarin, I.; Borgen, K.; Boucher, C.A.; Buchholz, U.; Buda, S.; Dijkstra, F.; Dudman, S.; Duwe, S.; Hauge, S.H.; Hungnes, O.; Meijer, A.; Mossong, J.; Paget, W.J.; Phin, N.; Sande, M. van der; Schweiger, B.; Nicoll, A.

    2009-01-01

    During the 2007-08 influenza season, high levels of oseltamivir resistance were detected among influenza A(H1N1) viruses in a number of European countries. We used surveillance data to describe influenza A(H1N1) cases for whom antiviral resistance testing was performed. We pooled data from national

  6. Severity of pneumonia due to new H1N1 influenza virus in ferrets is intermediate between that due to seasonal H1N1 virus and highly pathogenic avian influenza H5N1 virus

    NARCIS (Netherlands)

    J.M.A. van den Brand (Judith); K.J. Stittelaar (Koert); G. van Amerongen (Geert); G.F. Rimmelzwaan (Guus); J.H. Simon (James); E. de Wit (Emmie); V.J. Munster (Vincent); T.M. Bestebroer (Theo); R.A.M. Fouchier (Ron); T. Kuiken (Thijs); A.D.M.E. Osterhaus (Albert)

    2010-01-01

    textabstractBackground. The newly emerged influenza A(H1N1) virus (new H1N1 virus) is causing the first influenza pandemic of this century. Three influenza pandemics of the previous century caused variable mortality, which largely depended on the development of severe pneumonia. However, the ability

  7. Assessing Google flu trends performance in the United States during the 2009 influenza virus A (H1N1 pandemic.

    Directory of Open Access Journals (Sweden)

    Samantha Cook

    Full Text Available BACKGROUND: Google Flu Trends (GFT uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1 pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet. For each GFT model we calculated the correlation and RMSE (root mean square error between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009-Dec 2009. We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively. The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. CONCLUSIONS: Internet search behavior changed during pH1N1, particularly in the categories "influenza complications" and "term for influenza." The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1

  8. Identification of hemagglutinin structural domain and polymorphisms which may modulate swine H1N1 interactions with human receptor

    Directory of Open Access Journals (Sweden)

    Perovic Vladimir

    2009-09-01

    Full Text Available Abstract Background The novel A/H1N1 influenza virus, which recently emerged in North America is most closely related to North American H1N1/N2 swine viruses. Until the beginning of 2009, North American swine H1N1/N2 viruses have only sporadically infected humans as dead-end hosts. In 2009 the A/H1N1 virus acquired the capacity to spread efficiently by human to human transmission. The novel A/H1N1 influenza virus has struck thousands of people in more than 70 countries and killed more than 140, representing a public health emergency of international concern. Here we have studied properties of hemagglutinin of A/H1N1 which may modulate virus/receptor interaction. Results Analyses by ISM bioinformatics platform of the HA1 protein of North American swine H1N1/N2 viruses and the new A/H1N1 showed that both groups of viruses differed in conserved characteristics that reflect a distinct propensity of these viruses to undergo a specific interaction with swine or human host proteins or receptors. Swine H1N1/N2 viruses that sporadically infected humans featured both the swine and the human interaction pattern. Substitutions F71S, T128S, E302K, M314L in HA1 of swine H1N1 viruses from North America are identified as critical for the human interaction pattern of A/H1N1 and residues D94, D196 and D274 are predicted to be "hot-spots" for polymorphisms which could increase infectivity of A/H1N1 virus. At least one of these residues has already emerged in the A/H1N1 isolates from Spain, Italy and USA. The domain 286-326 was identified to be involved in virus/receptor interaction. Conclusion Our results (i contribute to better understanding of the origin of the novel A/H1N1 influenza virus, (ii provide a tool for monitoring its molecular evolution (iii predicts hotspots associated with enhanced infectivity in humans and (iv identify therapeutic and diagnostic targets for prevention and treatment of A/H1N1 infection.

  9. Assessing Google Flu Trends Performance in the United States during the 2009 Influenza Virus A (H1N1) Pandemic

    Science.gov (United States)

    Cook, Samantha; Conrad, Corrie; Fowlkes, Ashley L.; Mohebbi, Matthew H.

    2011-01-01

    Background Google Flu Trends (GFT) uses anonymized, aggregated internet search activity to provide near-real time estimates of influenza activity. GFT estimates have shown a strong correlation with official influenza surveillance data. The 2009 influenza virus A (H1N1) pandemic [pH1N1] provided the first opportunity to evaluate GFT during a non-seasonal influenza outbreak. In September 2009, an updated United States GFT model was developed using data from the beginning of pH1N1. Methodology/Principal Findings We evaluated the accuracy of each U.S. GFT model by comparing weekly estimates of ILI (influenza-like illness) activity with the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet). For each GFT model we calculated the correlation and RMSE (root mean square error) between model estimates and ILINet for four time periods: pre-H1N1, Summer H1N1, Winter H1N1, and H1N1 overall (Mar 2009–Dec 2009). We also compared the number of queries, query volume, and types of queries (e.g., influenza symptoms, influenza complications) in each model. Both models' estimates were highly correlated with ILINet pre-H1N1 and over the entire surveillance period, although the original model underestimated the magnitude of ILI activity during pH1N1. The updated model was more correlated with ILINet than the original model during Summer H1N1 (r = 0.95 and 0.29, respectively). The updated model included more search query terms than the original model, with more queries directly related to influenza infection, whereas the original model contained more queries related to influenza complications. Conclusions Internet search behavior changed during pH1N1, particularly in the categories “influenza complications” and “term for influenza.” The complications associated with pH1N1, the fact that pH1N1 began in the summer rather than winter, and changes in health-seeking behavior each may have played a part. Both GFT models performed well prior to and during pH1N1

  10. Initial psychological responses to Influenza A, H1N1 ("Swine flu"

    Directory of Open Access Journals (Sweden)

    Neto Felix

    2009-10-01

    Full Text Available Abstract Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork. We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu" in the six days following the WHO pandemic alert level 5, and regional differences in these responses. Methods 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180 or Europe (N = 148. Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

  11. Update: novel influenza A (H1N1) virus infection - Mexico, March-May, 2009.

    Science.gov (United States)

    2009-06-05

    On April 12, 2009, Mexico responded to a request for verification by the World Health Organization (WHO) of an outbreak of acute respiratory illness in the small community of La Gloria, Veracruz. During April 15-17, the Mexico Ministry of Health received informal notification of clusters of rapidly progressive severe pneumonia occurring mostly in Distrito Federal (metropolitan Mexico City) and San Luis Potosi. In response, on April 17, Mexico intensified national surveillance for acute respiratory illness and pneumonia. During April 22-24, novel influenza A (H1N1) virus infection, previously identified in two children in the United States, was confirmed in several patients. This report updates a previous report on the outbreak in Mexico and summarizes public health actions taken to date by Mexico to monitor and control the outbreak. During March 1-May 29, national surveillance identified 41,998 persons with acute respiratory illness; specimens from 25,127 (59.8%) patients were tested, of which 5,337 (21.2%) were positive for novel influenza A (H1N1) virus infection by real-time reverse transcription--polymerase chain reaction (rRT-PCR). As of May 29, 97 patients with laboratory-confirmed infection had died. Epidemiologic evidence to date suggests that the outbreak likely peaked nationally in late April, although localized cases continue to be identified.

  12. The knowledge of the importance on the influenza virus a (H1N1: experience report

    Directory of Open Access Journals (Sweden)

    Jaine Kareny da Silva

    2015-10-01

    Full Text Available Background and Objectives: Although infection rates by influenza A H1N1, present reduction since 2010 through immunization, it is still notorious some cases and outbreaks of the disease in the country. To minimize such cases it is important, among other measures, the qualification of the health worker. In this sense, the objective was to describe the level of awareness of nursing professionals in a hospital Bahia interior, on the transmission of the H1N1 virus, symptoms and what PPE is needed in assisting patients with suspected or diagnostic confirmation. Methods: This is an experience report experienced by nursing students at the State University of Bahia, who developed curricular component activities Caring Process: Rationale and practice in a public hospital in Bahia. The report data is from the collection conducted with the nurses, addressing aspects of symptoms, transmission and personal protective equipment. Each professional nursing spontaneously answered the questions and the end was discussed each item aiming answer questions by promoting thus an educational activity based on the knowledge of professionals. Results: Although most participants recognize the personal protective equipment and the symptoms of the viral disease, some are still unaware of the transmission routes. Most received no training on the subject. Conclusion: It is necessary to implement a Center for Continuing Education to answer questions about this and other topics, but are not limited to specific actions and seeking partnerships with higher education institutions. KEYWORDS: Education, Continuing. Education, Nursing. Disease Transmission, Infectious. Communicable Disease Control

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

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    Farooqui Amber

    2012-06-01

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

  14. Influenza preparedness and the bureaucratic reflex: anticipating and generating the 2009 H1N1 event.

    Science.gov (United States)

    Barker, Kezia

    2012-07-01

    This paper draws together work on the event to problematise the generative implications of anticipatory governance in the management of emerging infectious disease. Through concerns for preparedness, the need to anticipate outbreaks of disease has taken on a new urgency. With the identification of the H1N1 virus circulating amongst human populations in 2009, public health measures and security practices at regional, national and international levels were rapidly put into play. However, as the ensuing event demonstrated, the social, political and economic disruptions of emerging infectious diseases can be matched by those of anticipatory actions. I argue that the event-making potential of surveillance practices and the pre-determined arrangements of influenza preparedness planning, when triggered by the H1N1 virus, caused an event acceleration through the hyper-sensitised global health security architecture. In the UK, this led to a bureaucratic reflex, a security response event that overtook the present actualities of the disease. This raises questions about the production of forms of insecurity by the security apparatus itself. Copyright © 2012. Published by Elsevier Ltd.

  15. Profile of Brazilian scientific production on A/H1N1 pandemic influenza.

    Science.gov (United States)

    Luchs, Adriana

    2012-06-01

    In the last few years, bibliometric studies have proliferated, seeking to provide data on world research. This study analyzes the profile of the Brazilian scientific production in the A (H1N1) influenza field between 2009 and 2011. The research was conducted in MEDLINE, SciELO and LILACS databases, selecting papers in which the term "H1N1" and "Brazil" were defined as the main topics. The data were analyzed taking into consideration the Brazilian state and institution in which the articles were produced, the impact factor of the journal and the language. The research revealed 40 documents (27 from MEDLINE, 16 from SciELO and 24 from LILACS). The journal impact factor ranged from 0.0977 to 8.1230. A similar amount of articles were written in English and Portuguese and São Paulo was the most productive state in the country, with 95% of the Brazilian production originating from the Southern and Southeastern regions. Linguistic data indicate that previous efforts made in order to improve the scientific production of Brazilian researchers making their observations attain a broader scientific audience produced results. It is necessary to assess the scientific studies, especially those conducted with public funds, in order to ensure that the results will benefit society.

  16. Inhibition of influenza A virus (H1N1 fusion by benzenesulfonamide derivatives targeting viral hemagglutinin.

    Directory of Open Access Journals (Sweden)

    Lei Zhu

    Full Text Available Hemagglutinin (HA of the influenza virus plays a crucial role in the early stage of the viral life cycle by binding to sialic acid on the surface of host epithelial cells and mediating fusion between virus envelope and endosome membrane for the release of viral genomes into the cytoplasm. To initiate virus fusion, endosome pH is lowered by acidification causing an irreversible conformational change of HA, which in turn results in a fusogenic HA. In this study, we describe characterization of an HA inhibitor of influenza H1N1 viruses, RO5464466. One-cycle time course study in MDCK cells showed that this compound acted at an early step of influenza virus replication. Results from HA-mediated hemolysis of chicken red blood cells and trypsin sensitivity assay of isolated HA clearly showed that RO5464466 targeted HA. In cell-based assays involving multiple rounds of virus infection and replication, RO5464466 inhibited an established influenza infection. The overall production of progeny viruses, as a result of the compound's inhibitory effect on fusion, was dramatically reduced by 8 log units when compared with a negative control. Furthermore, RO5487624, a close analogue of RO5464466, with pharmacokinetic properties suitable for in vivo efficacy studies displayed a protective effect on mice that were lethally challenged with influenza H1N1 virus. These results might benefit further characterization and development of novel anti-influenza agents by targeting viral hemagglutinin.

  17. 2009 pandemic influenza A (H1N1) in pregnancy: a systematic review of the literature.

    Science.gov (United States)

    Mosby, Laura G; Rasmussen, Sonja A; Jamieson, Denise J

    2011-07-01

    To summarize the literature regarding 2009 H1N1 influenza A during pregnancy, we conducted a systematic literature review using a PubMed search and other strategies. Studies were included if they reported 2009 H1N1 influenza in pregnant women as original data. In all, 2153 abstracts were reviewed, and a total of 120 studies were included. Data were extracted regarding number of cases, additional risk factors for influenza-associated complications, treatment, and maternal and pregnancy outcomes. Authors were contacted to determine the extent of overlap when it was suspected. Pregnancy was associated with increased risk of hospital and intensive care unit admission and of death. Pregnant women who received delayed treatment with neuraminidase inhibitors or who had additional risk factors were more likely to develop severe disease. Preterm and emergency cesarean deliveries were frequently reported. These results reinforce the importance of early identification and treatment of suspected influenza in this high-risk population. Published by Mosby, Inc.

  18. The economic impact of H1N1 on Mexico's tourist and pork sectors.

    Science.gov (United States)

    Rassy, Dunia; Smith, Richard D

    2013-07-01

    By examining tourist arrivals and pork output and trade statistics, this analysis estimates the economic impact to the Mexican tourism and pork sectors because of the H1N1 influenza pandemic. It also assesses the role of the international response in the context of this economic impact. For tourism, losing almost a million overseas visitors translated into losses of around $US2.8bn, which extended over a five-month period, mostly because of the slow return of European travellers. For the pork industry, temporal decreases in output were observed in most of the country and related to H1N1 incidence (p = 0.048, r = 0.37). By the end of 2009, Mexico had a pork trade deficit of $US27m. The losses derived from this pandemic were clearly influenced by the risk perception created in tourist-supplying and pork trade partners. Results suggest that the wider economic implications of health-related emergencies can be significant and need to be considered in preparedness planning. For instance, more effective surveillance and data gathering would enable policy to target emergency funding to the sectors and regions hardest hit. These results also stress the importance of being familiar with trade networks so as to be able to anticipate the international response and respond accordingly. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Fatal H1N1-Related Acute Necrotizing Encephalopathy in an Adult

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    Yu-Jin Lee

    2011-01-01

    Full Text Available Acute necrotizing encephalopathy (ANE is a severe neurological complication of influenza infection, including H1N1 influenza. Many cases of ANE have been reported in the pediatric literature, but very few cases have been described in adults. The cause of ANE remains unknown—the influenza virus is not known to be neurotropic, and evidence of direct viral involvement of the central nervous system (CNS has not been demonstrated in the limited cases of ANE in which pathological specimens have been obtained. Here we report a fatal case of ANE from H1N1 influenza infection in an adult. Neuroimaging and postmortem analysis both showed widespread brain edema, necrosis, and hemorrhage, but molecular studies and postmortem pathology revealed no evidence of direct viral involvement of the CNS. This case of fatal ANE in an adult is consistent with the hypothesis generated from pediatric cases that the host immune response, and not direct viral invasion of the CNS, is responsible for pathogenesis of ANE.

  20. Recurrent Spontaneous Pneumothorax during the Recovery Phase of ARDS Due to H1N1 Infection

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    Canan Bor

    2013-03-01

    Full Text Available The pregnant patients are prone to influenza A (H1N1 virus infection, which may rapidly progress to lower respiratory tract infection and subsequent respiratory failure and acute respiratory distress syndrome (ARDS. Pneumothorax might develop in ARDS under mechanical ventilation. But post-ARDS pneumothorax in spontaneously breathing patient has not been reported in the literature. We report a 31-year old pregnant woman infected with influenza A (H1N1 virus and progressed to ARDS. Mechanical ventilation with high PEEP improved patient's gas exchange parameters within 3 weeks. However spontaneous pneumothorax was developed one week after she weaned off the ventilator. After successful drainage therapy, the patient was discharged. However she re-admitted to the hospital because of a recurrent pneumothorax one week later. She was discharged in good health after being treated with negative continuous pleural aspiration for 10 days. Influenza might cause severe pulmonary infection and death. In addition to diffuse alveolar damage, sub-pleural and intrapulmonary air cysts might occur in influenza-related ARDS and may lead to spontaneous pneumothorax. This complication should always be considered during the recovery period of ARDS and a long-term close follow-up is necessary.

  1. Economic Evaluation of Individual School Closure Strategies: The Hong Kong 2009 H1N1 Pandemic.

    Directory of Open Access Journals (Sweden)

    Zoie Shui-Yee Wong

    Full Text Available School closures as a means of containing the spread of disease have received considerable attention from the public health community. Although they have been implemented during previous pandemics, the epidemiological and economic effects of the closure of individual schools remain unclear.This study used data from the 2009 H1N1 pandemic in Hong Kong to develop a simulation model of an influenza pandemic with a localised population structure to provide scientific justifications for and economic evaluations of individual-level school closure strategies.The estimated cost of the study's baseline scenario was USD330 million. We found that the individual school closure strategies that involved all types of schools and those that used a lower threshold to trigger school closures had the best performance. The best scenario resulted in an 80% decrease in the number of cases (i.e., prevention of about 830,000 cases, and the cost per case prevented by this intervention was USD1,145; thus, the total cost was USD1.28 billion.This study predicts the effects of individual school closure strategies on the 2009 H1N1 pandemic in Hong Kong. Further research could determine optimal strategies that combine various system-wide and district-wide school closures with individual school triggers across types of schools. The effects of different closure triggers at different phases of a pandemic should also be examined.

  2. Control of H1N1 influenza outbreak: A study conducted in a naval warship

    Directory of Open Access Journals (Sweden)

    Arun Gupta

    2017-01-01

    Full Text Available Introduction: In confined afloat settings, the threat of an acceleration of the Influenza outbreak is substantial, causing high morbidity of the personnel on board, disrupting daily activities, and leading to low crew morale. In this study, H1N1 Influenza outbreak in a Naval Warship and its control measures are described. Materials and Methods: It is a study of 21 clinically suspected cases of H1N1 Influenza. Cases were reported within 3 weeks from a ship company, all of whom were susceptible. They have been described on the basis of demography, clinical features, recent travel history, and history of contact. Results: Mean age of the clinically suspected cases was 26.71 years. Of 21 suspected cases, 14 were found positive for the disease. Nine cases were admitted to the hospital and two developed complications. Attack rate of the disease was 4.83%. Conclusion: In confined afloat settings, prompt public health measures of active case finding, strict isolation, and adherence to hand hygiene, following cough etiquettes and disinfection enhancement, can effectively mitigate the outbreak. Vaccination may not have a role to play if preventive measures are instituted effectively.

  3. Antiviral activity of silver nanoparticle/chitosan composites against H1N1 influenza A virus

    Science.gov (United States)

    Mori, Yasutaka; Ono, Takeshi; Miyahira, Yasushi; Nguyen, Vinh Quang; Matsui, Takemi; Ishihara, Masayuki

    2013-02-01

    Silver nanoparticle (Ag NP)/chitosan (Ch) composites with antiviral activity against H1N1 influenza A virus were prepared. The Ag NP/Ch composites were obtained as yellow or brown floc-like powders following reaction at room temperature in aqueous medium. Ag NPs (3.5, 6.5, and 12.9 nm average diameters) were embedded into the chitosan matrix without aggregation or size alternation. The antiviral activity of the Ag NP/Ch composites was evaluated by comparing the TCID50 ratio of viral suspensions treated with the composites to untreated suspensions. For all sizes of Ag NPs tested, antiviral activity against H1N1 influenza A virus increased as the concentration of Ag NPs increased; chitosan alone exhibited no antiviral activity. Size dependence of the Ag NPs on antiviral activity was also observed: antiviral activity was generally stronger with smaller Ag NPs in the composites. These results indicate that Ag NP/Ch composites interacting with viruses exhibit antiviral activity.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    BACKGROUND: Pregnant women were suspected to be at particular risk when H1N1pnd09 influenza became pandemic in 2009. Our primary objective was to compare the immune responses conferred by MF59®-adjuvanted vaccine (Focetria®) in H1N1pnd09-naïve pregnant and non-pregnant women. The secondary aims...... were to compare influences of dose and adjuvant on the immune response. METHODS: The study was nested in the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010) pregnancy cohort in 2009-2010 and conducted as a single-blinded block-randomised [1∶1∶1] controlled clinical trial in pregnant...... at baseline, 3 weeks, 3 and 10 months after vaccination, adverse events were recorded prospectively. RESULTS: 58 pregnant women were allocated to Pa7.5 µg and 149 non-pregnant women were recruited to NPa7.5 µg. The sero-conversion rate was significantly increased in non-pregnant (NPa7.5 µg) compared...

  5. Streptococcus pneumoniae Coinfection Is Correlated with the Severity of H1N1 Pandemic Influenza

    Science.gov (United States)

    Cisterna, Daniel; Savji, Nazir; Bussetti, Ana Valeria; Kapoor, Vishal; Hui, Jeffrey; Tokarz, Rafal; Briese, Thomas; Baumeister, Elsa; Lipkin, W. Ian

    2009-01-01

    Background Initial reports in May 2009 of the novel influenza strain H1N1pdm estimated a case fatality rate (CFR) of 0.6%, similar to that of seasonal influenza. In July 2009, however, Argentina reported 3056 cases with 137 deaths, representing a CFR of 4.5%. Potential explanations for increased CFR included virus reassortment or genetic drift, or infection of a more vulnerable population. Virus genomic sequencing of 26 Argentinian samples representing both severe and mild disease indicated no evidence of reassortment, mutations associated with resistance to antiviral drugs, or genetic drift that might contribute to virulence. Furthermore, no evidence was found for increased frequency of risk factors for H1N1pdm disease. Methods/Principal Findings We examined nasopharyngeal swab samples (NPS) from 199 cases of H1N1pdm infection from Argentina with MassTag PCR, testing for 33 additional microbial agents. The study population consisted of 199 H1N1pdm-infected subjects sampled between 23 June and 4 July 2009. Thirty-nine had severe disease defined as death (n = 20) or hospitalization (n = 19); 160 had mild disease. At least one additional agent of potential pathogenic importance was identified in 152 samples (76%), including Streptococcus pneumoniae (n = 62); Haemophilus influenzae (n = 104); human respiratory syncytial virus A (n = 11) and B (n = 1); human rhinovirus A (n = 1) and B (n = 4); human coronaviruses 229E (n = 1) and OC43 (n = 2); Klebsiella pneumoniae (n = 2); Acinetobacter baumannii (n = 2); Serratia marcescens (n = 1); and Staphylococcus aureus (n = 35) and methicillin-resistant S. aureus (MRSA, n = 6). The presence of S. pneumoniae was strongly correlated with severe disease. S. pneumoniae was present in 56.4% of severe cases versus 25% of mild cases; more than one-third of H1N1pdm NPS with S. pneumoniae were from subjects with severe disease (22 of 62 S. pneumoniae-positive NPS, p = 0

  6. H1N1, H3N2 et B à Abidjan, Côte d'Ivoire

    African Journals Online (AJOL)

    English Title: Comparative analysis of the epidemiological and clinical profiles of influenza infection due to 2009 pH1N1, H1N1, H3N2 and B viruses in Abidjan, Cote d'Ivoire. English Abstract. Influenza can have various epidemiological and clinical characteristics. This study compares the epidemio-clinical profiles of ...

  7. Increased Extent of and Risk Factors for Pandemic (H1N1) 2009 and Seasonal Influenza among Children, Israel

    Science.gov (United States)

    Bromberg, Michal; Averbuch, Diana; Tenenbaum, Ariel; Goldmann, Daniele; Kunin, Marina; Shmueli, Einat; Yatsiv, Ido; Weintraub, Michael; Mandelboim, Michal; Strauss-Liviatan, Nurith; Anis, Emilia; Mendelson, Ella; Shohat, Tamy; Wolf, Dana G.; Shapiro, Mervyn; Grotto, Itamar

    2011-01-01

    During the pandemic (H1N1) 2009 outbreak in Israel, incidence rates among children were 2× higher than that of the previous 4 influenza seasons; hospitalization rates were 5× higher. Children hospitalized for pandemic (H1N1) 2009 were older and had more underlying chronic diseases than those hospitalized for seasonal influenza. PMID:21888809

  8. Pandemic H1N1 (2009) and renal failure: the experience of the Irish national tertiary referral centre.

    LENUS (Irish Health Repository)

    O Brien, F J

    2011-03-01

    H1N1 influenza A, was first described in April 2009. A significant cohort of patients from this outbreak developed acute respiratory distress syndrome or pneumonia. H1N1 has since been transmitted across the world. Little has been described on the renal complications of this illness.

  9. Continual re-introduction of human pandemic H1N1 influenza A viruses into US swine, 2009-2014

    Science.gov (United States)

    Human-to-swine transmission of pandemic H1N1 influenza viruses (pH1N1) increased the genetic diversity of influenza A viruses in swine (swIAVs) globally and is linked to the emergence of new pandemic threats, including H3N2v variants. Through phylogenetic analysis of contemporary swIAVs in the Unit...

  10. Effectiveness of A(H1N1)pdm09 influenza vaccine in adults recommended for annual influenza vaccination

    NARCIS (Netherlands)

    Gefenaite, G.; Tacken, M.A.; Bos, J.; Stirbu-Wagner, I.; Korevaar, J.C.; Stolk, R.P.; Wolters, B.; Bijl, M. van der; Postma, M.J.; Wilschut, J.; Nichol, K.L.; Hak, E.

    2013-01-01

    INTRODUCTION: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness. METHODS: VE against influenza and/or pneumonia was

  11. Effectiveness of A(H1N1)pdm09 influenza vaccine in adults recommended for annual influenza vaccination.

    NARCIS (Netherlands)

    Gefenaite, G.; Tacken, M.; Bos, J.; Stirbu-Wagner, I.; Korevaar, J.C.; Stolk, R.P.; Wolters, B.; Bijl, M.; Postma, M.J.; Wilschut, J.; Nichol, K.L.; Hak, E.

    2013-01-01

    Introduction: Because of variability in published A(H1N1)pdm09 influenza vaccine effectiveness estimates, we conducted a study in the adults belonging to the risk groups to assess the A(H1N1)pdm09 MF59-adjuvanted influenza vaccine effectiveness. Methods: VE against influenza and/or pneumonia was

  12. Correlates of 2009 Pandemic H1N1 Influenza Vaccine Acceptance among Middle and High School Teachers in Rural Georgia

    Science.gov (United States)

    Gargano, Lisa M.; Painter, Julia E.; Sales, Jessica M.; Morfaw, Christopher; Jones, LaDawna M.; Weiss, Paul; Murray, Dennis; DiClemente, Ralph J.; Hughes, James M.

    2011-01-01

    Background: Teachers play an essential role in the school community, and H1N1 vaccination of teachers is critical to protect not only themselves but also adolescents they come in contact within the classroom through herd immunity. School-aged children have a greater risk of developing H1N1 disease than seasonal influenza. The goal of this study…

  13. Possible basis for the emergence of H1N1 viruses with pandemic potential from avian hosts.

    Science.gov (United States)

    Koçer, Zeynep A; Krauss, Scott; Zanin, Mark; Danner, Angela; Gulati, Shelly; Jones, Jeremy C; Friedman, Kimberly; Graham, Allison; Forrest, Heather; Seiler, Jon; Air, Gillian M; Webster, Robert G

    2015-07-01

    Influenza A viruses of the H1N1 subtype have emerged from the avian influenza gene pool in aquatic birds and caused human pandemics at least twice during the past century. Despite this fact, surprisingly little is known about the H1N1 gene pool in the aquatic bird reservoir. A preliminary study showed that an H1N1 virus from a shorebird of the Charadriiformes order was transmitted between animals through the airborne route of infection, whereas an H1N1 virus from a bird of the Anseriformes order was not. Here we show that two of the three H1N1 viruses isolated from Charadriiformes species in 2009 were transmitted between animals through the airborne route of infection, and five H1N1 isolates from Anseriformes species were not. The one H1N1 virus from a Charadriiformes species that failed to transmit through the airborne route was a reassortant possessing multiple internal gene segments from Anseriformes species. The molecular differences between the airborne-transmissible and non-airborne-transmissible H1N1 viruses were multigenic, involving the selection of virus with human-like receptor-binding specificity (α2-6 sialic acid) and multiple differences in the polymerase complex, mainly in the PB2, PB1-F2, and nonstructural genes.

  14. Novel triple-reassortant H1N1 swine influenza viruses in pigs in Tianjin, Northern China.

    Science.gov (United States)

    Sun, Ying-Feng; Wang, Xiu-Hui; Li, Xiu-Li; Zhang, Li; Li, Hai-Hua; Lu, Chao; Yang, Chun-Lei; Feng, Jing; Han, Wei; Ren, Wei-Ke; Tian, Xiang-Xue; Tong, Guang-Zhi; Wen, Feng; Li, Ze-Jun; Gong, Xiao-Qian; Liu, Xiao-Min; Ruan, Bao-Yang; Yan, Ming-Hua; Yu, Hai

    2016-02-01

    Pigs are susceptible to both human and avian influenza viruses and therefore have been proposed to be mixing vessels for the generation of pandemic influenza viruses through reassortment. In this study, for the first time, we report the isolation and genetic analyses of three novel triple-reassortant H1N1 swine influenza viruses from pigs in Tianjin, Northern China. Phylogenetic analysis showed that these novel viruses contained genes from the 2009 pandemic H1N1 (PB2, PB1, PA and NP), Eurasian swine (HA, NA and M) and triple-reassortant swine (NS) lineages. This indicated that the reassortment among the 2009 pandemic H1N1, Eurasian swine and triple-reassortant swine influenza viruses had taken place in pigs in Tianjin and resulted in the generation of new viruses. Furthermore, three human-like H1N1, two classical swine H1N1 and two Eurasian swine H1N1 viruses were also isolated during the swine influenza virus surveillance from 2009 to 2013, which indicated that multiple genetic lineages of swine H1N1 viruses were co-circulating in the swine population in Tianjin, China. The emergence of novel triple-reassortant H1N1 swine influenza viruses may be a potential threat to human health and emphasizes the importance of further continuous surveillance. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. High rate of A(H1N1pdm09 infections among rural Thai villagers, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Benjawan Khuntirat

    Full Text Available Pandemic influenza A(H1N1pdm09 emerged in Thailand in 2009. A prospective longitudinal adult cohort and household transmission study of influenza-like illness (ILI was ongoing in rural Thailand at the time of emergence. Symptomatic and subclinical A(H1N1pdm09 infection rates in the cohort and among household members were evaluated.A cohort of 800 Thai adults underwent active community-based surveillance for ILI from 2008-2010. Acute respiratory samples from ILI episodes were tested for A(H1N1pdm09 by qRT-PCR; acute and 60-day convalescent blood samples were tested by A(H1N1pdm09 hemagglutination inhibition assay (HI. Enrollment, 12-month and 24-month follow-up blood samples were tested for A(H1N1pdm09 seroconversion by HI. Household members of influenza A-infected cohort subjects with ILI were enrolled in household transmission investigations in which day 0 and 60 blood samples and acute respiratory samples were tested by either qRT-PCR or HI for A(H1N1pdm09. Seroconversion between annual blood samples without A(H1N1pdm09-positive ILI was considered as subclinical infection.The 2-yr cumulative incidence of A(H1N1pdm09 infection in the cohort in 2009/2010 was 10.8% (84/781 with an annual incidence of 1.2% in 2009 and 9.7% in 2010; 83.3% of infections were subclinical (50% in 2009 and 85.9% in 2010. The 2-yr cumulative incidence was lowest (5% in adults born ≤ 1957. The A(H1N1pdm09 secondary attack rate among household contacts was 47.2% (17/36; 47.1% of these infections were subclinical. The highest A(H1N1pdm09 secondary attack rate among household contacts (70.6%, 12/17 occurred among children born between 1990 and 2003.Subclinical A(H1N1pdm09 infections in Thai adults occurred frequently and accounted for a greater proportion of all A(H1N1pdm09 infections than previously estimated. The role of subclinical infections in A(H1N1pdm09 transmission has important implications in formulating strategies to predict and prevent the spread of A(H1N1pdm

  16. Associations between health communication behaviors, neighborhood social capital, vaccine knowledge, and parents' H1N1 vaccination of their children.

    Science.gov (United States)

    Jung, Minsoo; Lin, Leesa; Viswanath, K

    2013-10-01

    During the H1N1 pandemic in 2009-10, the vaccination behavior of parents played a critical role in preventing and containing the spread of the disease and the subsequent health outcomes among children. Several studies have examined the relationship between parents' health communication behaviors and vaccinations for children in general. Little is known, however, about the link between parents' health communication behaviors and the vaccination of their children against the H1N1 virus, and their level of vaccine-related knowledge. We drew on a national survey among parents with at least one child less than 18 years of age (n=639) to investigate Parents' H1N1-related health communication behaviors including sources of information, media exposure, information-seeking behaviors, H1N1-related knowledge, and neighborhood social capital, as well as the H1N1 vaccination rates of their children. Findings showed that there is a significant association between the degree at which parents obtained H1N1 vaccination for their children and health communication variables: watching the national television news and actively seeking H1N1 information. And this association was moderated by the extent of the parents' H1N1-related knowledge. In addition, the parents' degree of neighborhood social capital mediated the association between H1N1 knowledge of the parents and H1N1 vaccination acceptance for their children. We found, compared to those with a low-level of neighborhood social capital, parents who have a high-level of neighborhood social capital are more likely to vaccinate their children. These findings suggest that it is necessary to design a strategic health communication campaign segmented by parent health communication behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Chowell, Gerardo; Echevarría-Zuno, Santiago; Viboud, Cécile; Simonsen, Lone; Tamerius, James; Miller, Mark A; Borja-Aburto, Víctor H

    2011-05-01

    Mexico's local and national authorities initiated an intense public health response during the early stages of the 2009 A/H1N1 pandemic. In this study we analyzed the epidemiological patterns of the pandemic during April-December 2009 in Mexico and evaluated the impact of nonmedical interventions, school cycles, and demographic factors on influenza transmission. We used influenza surveillance data compiled by the Mexican Institute for Social Security, representing 40% of the population, to study patterns in influenza-like illness (ILIs) hospitalizations, deaths, and case-fatality rate by pandemic wave and geographical region. We also estimated the reproduction number (R) on the basis of the growth rate of daily cases, and used a transmission model to evaluate the effectiveness of mitigation strategies initiated during the spring pandemic wave. A total of 117,626 ILI cases were identified during April-December 2009, of which 30.6% were tested for influenza, and 23.3% were positive for the influenza A/H1N1 pandemic virus. A three-wave pandemic profile was identified, with an initial wave in April-May (Mexico City area), a second wave in June-July (southeastern states), and a geographically widespread third wave in August-December. The median age of laboratory confirmed ILI cases was ∼ 18 years overall and increased to ∼ 31 years during autumn (pMexico City area was associated with a 29%-37% reduction in influenza transmission in spring 2009. In addition, an increase in R was observed in late May and early June in the southeast states, after mandatory school suspension resumed and before summer vacation started. State-specific fall pandemic waves began 2-5 weeks after school reopened for the fall term, coinciding with an age shift in influenza cases. We documented three spatially heterogeneous waves of the 2009 A/H1N1 pandemic virus in Mexico, which were characterized by a relatively young age distribution of cases. Our study highlights the importance of school

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

    Science.gov (United States)

    Chowell, Gerardo; Echevarría-Zuno, Santiago; Viboud, Cécile; Simonsen, Lone; Tamerius, James; Miller, Mark A.; Borja-Aburto, Víctor H.

    2011-01-01

    Background Mexico's local and national authorities initiated an intense public health response during the early stages of the 2009 A/H1N1 pandemic. In this study we analyzed the epidemiological patterns of the pandemic during April–December 2009 in Mexico and evaluated the impact of nonmedical interventions, school cycles, and demographic factors on influenza transmission. Methods and Findings We used influenza surveillance data compiled by the Mexican Institute for Social Security, representing 40% of the population, to study patterns in influenza-like illness (ILIs) hospitalizations, deaths, and case-fatality rate by pandemic wave and geographical region. We also estimated the reproduction number (R) on the basis of the growth rate of daily cases, and used a transmission model to evaluate the effectiveness of mitigation strategies initiated during the spring pandemic wave. A total of 117,626 ILI cases were identified during April–December 2009, of which 30.6% were tested for influenza, and 23.3% were positive for the influenza A/H1N1 pandemic virus. A three-wave pandemic profile was identified, with an initial wave in April–May (Mexico City area), a second wave in June–July (southeastern states), and a geographically widespread third wave in August–December. The median age of laboratory confirmed ILI cases was ∼18 years overall and increased to ∼31 years during autumn (ppandemic waves began 2–5 weeks after school reopened for the fall term, coinciding with an age shift in influenza cases. Conclusions We documented three spatially heterogeneous waves of the 2009 A/H1N1 pandemic virus in Mexico, which were characterized by a relatively young age distribution of cases. Our study highlights the importance of school cycles on the transmission dynamics of this pandemic influenza strain and suggests that school closure and other mitigation measures could be useful to mitigate future influenza pandemics. Please see later in the article for the Editors

  19. Causality assessment of serious neurologic adverse events following 2009 H1N1 vaccination.

    Science.gov (United States)

    Williams, S Elizabeth; Pahud, Barbara A; Vellozzi, Claudia; Donofrio, Peter D; Dekker, Cornelia L; Halsey, Neal; Klein, Nicola P; Baxter, Roger P; Marchant, Colin D; Larussa, Philip S; Barnett, Elizabeth D; Tokars, Jerome I; McGeeney, Brian E; Sparks, Robert C; Aukes, Laurie L; Jakob, Kathleen; Coronel, Silvia; Sejvar, James J; Slade, Barbara A; Edwards, Kathryn M

    2011-10-26

    Adverse events occurring after vaccination are routinely reported to the Vaccine Adverse Event Reporting System (VAERS). We studied serious adverse events (SAEs) of a neurologic nature reported after receipt of influenza A (H1N1) 2009 monovalent vaccine during the 2009-2010 influenza season. Investigators in the Clinical Immunization Safety Assessment (CISA) network sought to characterize these SAEs and to assess their possible causal relationship to vaccination. Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) physicians reviewed all SAE reports (as defined by the Code of Federal Regulations, 21CFR§314.80) after receipt of H1N1 vaccine reported to VAERS between October 1, 2009 and March 31, 2010. Non-fatal SAE reports with neurologic presentation were referred to CISA investigators, who requested and reviewed additional medical records and clinical information as available. CISA investigators assessed the causal relationship between vaccination and the event using modified WHO criteria as defined. 212 VAERS reports of non-fatal serious neurological events were referred for CISA review. Case reports were equally distributed by gender (50.9% female) with an age range of 6 months to 83 years (median 38 years). The most frequent diagnoses reviewed were: Guillain-Barré Syndrome (37.3%), seizures (10.8%), cranial neuropathy (5.7%), and acute disseminated encephalomyelitis (3.8%). Causality assessment resulted in classification of 72 events as "possibly" related (33%), 108 as "unlikely" related (51%), and 20 as "unrelated" (9%) to H1N1 vaccination; none were classified as "probable" or "definite" and 12 were unclassifiable (6%). The absence of a specific test to indicate whether a vaccine component contributes to the pathogenesis of an event occurring within a biologically plausible time period makes assessing causality difficult. The development of standardized protocols for providers to use in evaluation of adverse events

  20. Changes in the viral distribution pattern after the appearance of the novel influenza A H1N1 (pH1N1 virus in influenza-like illness patients in Peru.

    Directory of Open Access Journals (Sweden)

    Victor Alberto Laguna-Torres

    Full Text Available BACKGROUND: We describe the temporal variation in viral agents detected in influenza like illness (ILI patients before and after the appearance of the ongoing pandemic influenza A (H1N1 (pH1N1 in Peru between 4-January and 13-July 2009. METHODS: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chain-reaction (rRT-PCR. RESULTS: We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5% from EW 19-28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle cities during our study period. The city of Iquitos (Jungle had the highest number of influenza B cases and only one pH1N1 case. CONCLUSIONS: The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses.

  1. Changes in the viral distribution pattern after the appearance of the novel influenza A H1N1 (pH1N1) virus in influenza-like illness patients in Peru.

    Science.gov (United States)

    Laguna-Torres, Victor Alberto; Gómez, Jorge; Aguilar, Patricia V; Ampuero, Julia S; Munayco, Cesar; Ocaña, Víctor; Pérez, Juan; Gamero, María E; Arrasco, Juan Carlos; Paz, Irmia; Chávez, Edward; Cruz, Rollin; Chavez, Jaime; Mendocilla, Silvia; Gomez, Elizabeth; Antigoni, Juana; Gonzalez, Sofía; Tejada, Cesar; Chowell, Gerardo; Kochel, Tadeusz J

    2010-07-27

    We describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009. At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chain-reaction (rRT-PCR). We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW) 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5%) from EW 19-28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima) followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle) cities during our study period. The city of Iquitos (Jungle) had the highest number of influenza B cases and only one pH1N1 case. The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses.

  2. Assessment of the removal and inactivation of influenza viruses H5N1 and H1N1 by drinking water treatment.

    Science.gov (United States)

    Lénès, Dorothée; Deboosere, Nathalie; Ménard-Szczebara, Florence; Jossent, Jérôme; Alexandre, Virginie; Machinal, Claire; Vialette, Michèle

    2010-04-01

    Since 2003, there has been significant concern about the possibility of an outbreak of avian influenza virus subtype H5N1. Moreover, in the last few months, a pandemic of a novel swine-origin influenza A virus, namely A(H1N1), has already caused hundreds of thousands of human cases of illness and thousands of deaths. As those viruses could possibly contaminate water resources through wild birds excreta or through sewage, the aim of our work was to find out whether the treatment processes in use in the drinking water industry are suitable for eradicating them. The effectiveness of physical treatments (coagulation-flocculation-settling, membrane ultrafiltration and ultraviolet) was assessed on H5N1, and that of disinfectants (monochloramine, chlorine dioxide, chlorine, and ozone) was established for both the H5N1 and H1N1 viruses. Natural water samples were spiked with human H5N1/H1N1 viruses. For the coagulation-settling experiments, raw surface water was treated in jar-test pilots with 3 different coagulating agents (aluminum sulfate, ferric chloride, aluminum polychorosulfate). Membrane performance was quantified using a hollow-fiber ultrafiltration system. Ultraviolet irradiation experiments were conducted with a collimated beam that made it possible to assess the effectiveness of various UV doses (25-60 mJ/cm2). In the case of ozone, 0.5 mg/L and 1 mg/L residual concentrations were tested with a contact time of 10 min. Finally, for chlorine, chlorine dioxide and monochloramine treatments, several residual oxidant target levels were tested (from 0.3 to 3 mg/L) with contact times of 5-120 min. The infectivity of the H5N1 and H1N1 viruses in water samples was quantified in cell culture using a microtiter endpoint titration. The impact of coagulation-settling on the H5N1 subtype was quite low and variable. In contrast, ultrafiltration achieved more than a 3-log reduction (and more than a 4-log removal in most cases), and UV treatment was readily effective on its

  3. VIGILANCIA DE LA PANDEMIA DE GRIPE (H1N1) 2009 EN ESPAÑA

    OpenAIRE

    Amparo Larrauri Cámara; Silvia Jiménez-Jorge; Lorena Simón Méndez; Salvador de Mateo Ontañón

    2010-01-01

    Fundamento: España experimentó una circulación del nuevo virus de la gripe (H1N1)2009 durante el verano de 2009, que evolucionó de forma creciente hasta la presentación a principios del otoño de la primera onda pandémica por dicho virus. Los objetivos de este trabajo son describir la evolución de esta onda pandémica en nuestro país y evaluar su impacto en la morbilidad y mortalidad de la población española. Método: A partir de la información proporcionada por el Sistema de Vigilancia de la Gr...

  4. [Model to estimate epidemic patterns of influenza A (H1N1) in Mexico].

    Science.gov (United States)

    Navarro-Robles, Estela; Martínez-Matsushita, Louis; López-Molina, Rubén; Fritz-Hernández, Jimena; Flores-Aldana, Bárbara Aida; Mendoza-Pérez, Juan Carlos

    2012-04-01

    Apply a mathematical model to estimate the epidemic patterns of influenza A (H1N1) in Mexico during the stages of application and suspension of measures to mitigate the epidemic. The effective reproductive number (R) for each state of Mexico during and after the application of social distancing measures was estimated by the SIR model (susceptible, infected, and recovered individuals) based on data published by the Ministry of Health of Mexico. From the beginning of the outbreak until suspension of school activities (28 April-13 May 2009), the national median of R was 1.13. In the following period (14 May-17 July 2009) the national median of R decreased to 1.01. It was demonstrated that several epidemic scenarios occurred at the national level. It is suggested that heterogeneous patterns at the state level be taken into account in decision-making on the adoption of measures to mitigate influenza epidemics.

  5. Interpreting Google flu trends data for pandemic H1N1 influenza: the New Zealand experience.

    Science.gov (United States)

    Wilson, N; Mason, K; Tobias, M; Peacey, M; Huang, Q S; Baker, M

    2009-11-05

    For the period of the spread of pandemic H1N1 influenza in New Zealand during 2009, we compared results from Google Flu Trends with data from existing surveillance systems. The patterns from Google Flu Trends were closely aligned with (peaking a week before and a week after) two independent national surveillance systems for influenza-like illness (ILI) cases. It was much less congruent with (delayed by three weeks) data from ILI-related calls to a national free-phone Healthline and with media coverage of pandemic influenza. Some patterns were unique to Google Flu Trends and may not have reflected the actual ILI burden in the community. Overall, Google Flu Trends appears to provide a useful free surveillance system but it should probably be seen as supplementary rather than as an alternative.

  6. Epidemics and the politics of knowledge: contested narratives in Egypt's H1N1 response.

    Science.gov (United States)

    Leach, Melissa; Tadros, Mariz

    2014-01-01

    This article explores the politics of knowledge involved in understanding and responding to epidemics in an era of global health governance and biosecurity. It develops and applies an approach focused on how multiple, competing narratives about epidemics are constructed, mobilized and interact, and selectively justify pathways of intervention and response. A detailed ethnographic case study of national and local responses to H1N1 influenza, so-called swine flu, in Egypt reveals how global narratives were reworked by powerful actors in a particular political context, suppressing and delegitimizing the alternative narratives of the Zabaleen (Coptic Christian) people whose lives and livelihoods centered on raising pigs and working with them to control urban waste. The case study illustrates important ways in which geographies and politics of blame around epidemics emerge and are justified, their political contexts and consequences, and how they may feed back to shape the dynamics of disease itself.

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

    Science.gov (United States)

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

    2010-05-05

    Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors. To characterize this behavior, we surveyed students in grades 9-12 and parents of students in grades 5-8 about student activities during a week long closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students-though less interaction with other students than during school-with the level of interaction increasing with grade. Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact.

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

    Directory of Open Access Journals (Sweden)

    Joel C Miller

    Full Text Available BACKGROUND: Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors. METHODOLOGY/PRINCIPAL FINDINGS: To characterize this behavior, we surveyed students in grades 9-12 and parents of students in grades 5-8 about student activities during a week long closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students-though less interaction with other students than during school-with the level of interaction increasing with grade. CONCLUSIONS: Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact.

  9. Influenza A (H1N1: Past season’s wonder flu in Vojvodina

    Directory of Open Access Journals (Sweden)

    Joveš-Sević Biljana

    2012-01-01

    Full Text Available Background/Aim. Influenza A (H1N1 re-emerged in the human population during 2009. The aim of this study was to describe characteristics, laboratory findings, clinical presentation and treatment outcome among patients with influenza A (H1N1 infection. Methods. The study was performed at the Institute for Pulmonary Diseases of Vojvodina including all the patients hospitalized at the Intensive Care Unit or High Dependency Unit with confirmed, probable or suspected Influenza A (H1N1 infection between November 6th, 2009 and April 13th, 2010. Results. Among 64 patients Influenza A (H1N1 infection was confirmed by rt-PCR in 50, defined as probable in 7 and as suspected in 6 patients. There was an equal number of male and female patients. Their mean age was 46 years (SD ± 12.1. None of the patients were vaccinated against influenza. Comorbidities were present in 37 (58% patients. There were 29 (45% obese patients. Three patients were pregnant. The median time from symptom onset to hospital admission was 5 days (IQR 4-7. At admission, the median Modified Early Warning Score (MEWS was 4 (IQR 3-6. The most common presenting symptoms were cough (100% and fever (89%. The mean oxygen saturation at admission was 85.3% (SD 9.0. Auscultatory finding of wheesing in the absence of a chronic lung disease was found in 10 (15.6% patients. Leukopenia was noted in 23 (35.9% patients, and thrombocytopenia in 14 (21.9% patients. Aspartate aminotransferase values were elevated in 41 (64.1% patients, alanine aminotransferase in 32 (50% patients, and creatine kinase in 36 (56.2% patients. Opacities on an initial chest radiograph were predominantly patchy and the median number of the lung fields involved was 1 (IQR = 0-3. The non-survivors had statistically significantly higher MEWS at admission (p = 0.0001, lower oxygen saturation (p = 0.001, more lung fields involved on an initial chest radiograph (p = 0.006, wheezing in the absence of chronic lung disease (p = 0.02 and

  10. Assessment of epicutaneous testing of a monovalent Influenza A (H1N1 2009 vaccine in egg allergic patients

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    Pitt Tracy

    2011-02-01

    Full Text Available Abstract Background H1N1 is responsible for the first influenza pandemic in 41 years. In the fall of 2009, an H1N1 vaccine became available in Canada with the hopes of reducing the overall effect of the pandemic. The purpose of this study was to assess the safety of administering 2 different doses of a monovalent split virus 2009 H1N1 vaccine in egg allergic patients. Methods Patients were skin tested to the H1N1 vaccine in the outpatient paediatric and adult allergy and immunology clinics of the Health Sciences Centre and Children's Hospital of Winnipeg, Manitoba Canada. Individuals Results A total of 61 patients with egg allergy (history of an allergic reaction to egg with either positive skin test &/or specific IgE to egg >0.35 Ku/L were referred to our allergy clinics for skin testing to the H1N1 vaccine. 2 patients were excluded, one did not have a skin prick test to the H1N1 vaccine (only vaccine administration and the other passed an egg challenge during the study period. Ages ranged from 1 to 27 years (mean 5.6 years. There were 41(69.5% males and 18(30.5% females. All but one patient with a history of egg allergy, positive skin test to egg and/or elevated specific IgE level to egg had negative skin tests to the H1N1 vaccine. The 58 patients with negative skin testing to the H1N1 vaccine were administered the vaccine and observed for 30 minutes post vaccination with no adverse results. The patient with the positive skin test to the H1N1 vaccine was also administered the vaccine intramuscularly with no adverse results. Conclusions Despite concern regarding possible anaphylaxis to the H1N1 vaccine in egg allergic patients, in our case series 1/59(1.7% patients with sensitization to egg were also sensitized to the H1N1 vaccine. Administration of the H1N1 vaccine in egg allergic patients with negative H1N1 skin tests and observation is safe. Administering the vaccine in a 1 or 2 dose protocol without skin testing is a reasonable alternative

  11. Fitness of Pandemic H1N1 and Seasonal influenza A viruses during Co-infection: Evidence of competitive advantage of pandemic H1N1 influenza versus seasonal influenza.

    Science.gov (United States)

    Perez, Daniel Roberto; Sorrell, Erin; Angel, Matthew; Ye, Jianqiang; Hickman, Danielle; Pena, Lindomar; Ramirez-Nieto, Gloria; Kimble, Brian; Araya, Yonas

    2009-08-24

    On June 11, 2009 the World Health Organization (WHO) declared a new H1N1 influenza pandemic. This pandemic strain is as transmissible as seasonal H1N1 and H3N2 influenza A viruses. Major concerns facing this pandemic are whether the new virus will replace, co-circulate and/or reassort with seasonal H1N1 and/or H3N2 human strains. Using the ferret model, we investigated which of these three possibilities were most likely favored. Our studies showed that the current pandemic virus is more transmissible than, and has a biological advantage over, prototypical seasonal H1 or H3 strains.

  12. Exhaled aerosol transmission of pandemic and seasonal H1N1 influenza viruses in the ferret.

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    Frederick Koster

    Full Text Available Person-to-person transmission of influenza viruses occurs by contact (direct and fomites and non-contact (droplet and small particle aerosol routes, but the quantitative dynamics and relative contributions of these routes are incompletely understood. The transmissibility of influenza strains estimated from secondary attack rates in closed human populations is confounded by large variations in population susceptibilities. An experimental method to phenotype strains for transmissibility in an animal model could provide relative efficiencies of transmission. We developed an experimental method to detect exhaled viral aerosol transmission between unanesthetized infected and susceptible ferrets, measured aerosol particle size and number, and quantified the viral genomic RNA in the exhaled aerosol. During brief 3-hour exposures to exhaled viral aerosols in airflow-controlled chambers, three strains of pandemic 2009 H1N1 strains were frequently transmitted to susceptible ferrets. In contrast one seasonal H1N1 strain was not transmitted in spite of higher levels of viral RNA in the exhaled aerosol. Among three pandemic strains, the two strains causing weight loss and illness in the intranasally infected 'donor' ferrets were transmitted less efficiently from the donor than the strain causing no detectable illness, suggesting that the mucosal inflammatory response may attenuate viable exhaled virus. Although exhaled viral RNA remained constant, transmission efficiency diminished from day 1 to day 5 after donor infection. Thus, aerosol transmission between ferrets may be dependent on at least four characteristics of virus-host relationships including the level of exhaled virus, infectious particle size, mucosal inflammation, and viral replication efficiency in susceptible mucosa.

  13. Transmission of aerosolized seasonal H1N1 influenza A to ferrets.

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    Heather MacInnes

    Full Text Available Influenza virus is a major cause of morbidity and mortality worldwide, yet little quantitative understanding of transmission is available to guide evidence-based public health practice. Recent studies of influenza non-contact transmission between ferrets and guinea pigs have provided insights into the relative transmission efficiencies of pandemic and seasonal strains, but the infecting dose and subsequent contagion has not been quantified for most strains. In order to measure the aerosol infectious dose for 50% (aID(50 of seronegative ferrets, seasonal influenza virus was nebulized into an exposure chamber with controlled airflow limiting inhalation to airborne particles less than 5 µm diameter. Airborne virus was collected by liquid impinger and Teflon filters during nebulization of varying doses of aerosolized virus. Since culturable virus was accurately captured on filters only up to 20 minutes, airborne viral RNA collected during 1-hour exposures was quantified by two assays, a high-throughput RT-PCR/mass spectrometry assay detecting 6 genome segments (Ibis T5000™ Biosensor system and a standard real time RT-qPCR assay. Using the more sensitive T5000 assay, the aID(50 for A/New Caledonia/20/99 (H1N1 was approximately 4 infectious virus particles under the exposure conditions used. Although seroconversion and sustained levels of viral RNA in upper airway secretions suggested established mucosal infection, viral cultures were almost always negative. Thus after inhalation, this seasonal H1N1 virus may replicate less efficiently than H3N2 virus after mucosal deposition and exhibit less contagion after aerosol exposure.

  14. A cobertura da gripe A(H1N1 2009 pelo Fantástico

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    Flavia Natércia da Silva Medeiros

    Full Text Available A televisão é uma das principais fontes de informação sobre saúde tanto para o público geral quanto para os profissionais de saúde. O objetivo deste estudo é analisar a cobertura da gripe A(H1N1 2009 pelo Fantástico, conjugando uma análise de conteúdo com uma análise qualitativa sobre a forma como o programa apresentou a doença. Encontramos 16 matérias sobre o tema, veiculadas entre 26 de abril e 16 de agosto de 2009. A maioria teve como frame principal o alastramento da doença, mostrando dados epidemiológicos na forma de numeradores sem denominadores e falando em "alarde", "pânico" e "preocupação". As fontes mais frequentes foram representantes de governo e as vozes mais ouvidas foram cidadãos comuns. Medidas de contenção da gripe foram mencionadas com alta frequencia, com destaque para o uso de máscaras e a higienização das mãos. Também foram frequentes recomendações feitas por médicos e cerca de metade das matérias abordou os sintomas. Nossos resultados indicam que a cobertura do Fantástico optou por manter um tom de preocupação por meio das narrativas compostas e das imagens que acompanharam as matérias feitas sobre a gripe A(H1N1 2009.

  15. Safe vaccination of patients with egg allergy with an adjuvanted pandemic H1N1 vaccine.

    Science.gov (United States)

    Gagnon, Remi; Primeau, Marie Noel; Des Roches, Anne; Lemire, Chantal; Kagan, Rhoda; Carr, Stuart; Ouakki, Manale; Benoît, Mélanie; De Serres, Gaston

    2010-08-01

    Because influenza vaccine contains some residual egg protein, there is a theoretic risk of anaphylaxis when vaccinating patients with egg allergy. The objective of this study was to estimate the risk of anaphylaxis in children with egg allergy administered an adjuvanted monovalent 2009 pandemic influenza A/H1N1 influenza vaccine (Arepanrix; GlaxoSmithKline, Mississauga, Ontario, Canada). Patients with confirmed egg allergy with a history of respiratory or cardiovascular reactions after egg ingestion were vaccinated in 2 divided doses (10% and 90%) administered at a 30-minute interval, whereas children with other types of egg-induced allergic reactions were vaccinated with a single dose. All patients remained under observation for 60 minutes after vaccination. A 24-hour follow-up telephone call was made to detect any delayed reaction. The main outcome was the occurrence of an anaphylactic reaction according to criteria specified by the Brighton Collaboration. Among the 830 patients with confirmed egg allergy, only 9% required the vaccine to be administered in divided doses. No patient had an anaphylactic reaction. Nine patients had minor allergic symptoms treated with an antihistamine (1 in the 60 minutes after vaccination and 8 in the following 23 hours), and 3 others received salbutamol (1 in the first 60 minutes after vaccination). Further vaccination of more than 3600 other children with reported egg allergy caused no anaphylaxis based on the criteria of the Brighton Collaboration, although 2 patients received epinephrine for symptoms compatible with allergy. Although anaphylaxis after influenza immunization is a theoretic risk, vaccination of patients with egg allergy with an adjuvanted monovalent pH1N1 influenza vaccine resulted in no cases of anaphylaxis and on that basis appears safe. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  16. A case with myocarditis secondary to Influenza virus (H1N1

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    Fesih Aktar

    2015-09-01

    Full Text Available Although influenza is an acute and uncomplicated disease, that limits itself in the healthy children, it may lead to death by rarely forming the sickness. The most common complication of influenza is pneumonia and it is a rare complication which is developed together with myocarditis by influenza A and B viruses. A 32 months-old male patient was admitted for rapidly developed respiratory distress and tachycardia after fever, cough, vomiting, malaise and runny nose. His general status was medium, he had conscious and had hepatomegaly, tachycardia, dyspnea, tachypnea, intercostal-subcostal retractions and bilateral rhonchus. Cardiac enzyme levels and other laboratory parameters were found normal. Myocarditis and ejection fraction was determined as 42% in echocardiography. However, hospitalization hours between 24 and 48, the patient, whose significant respiratory compromise developed, was intubated and fastened to a mechanical ventilator. H1N1 is produce in nasopharyngeal swab culture at the sixth day of follow-up. Because we think H1N1 virus was responsible from current myocarditis, oseltamivir treatment was initiated. In the fourth day of the treatment the patient’s fever returned to normal, in the ninth day a dramatic recovery was observed. In tracking echocardiography, a significant improvement was observed in the ejection fraction and myocarditis picture compared with admission time. This case was presented in order to remind that in a patients, who present with influenza findings but have respiratory distress and tachycardia in addition to lower respiratory tract infection, myocarditis should also be considered in the differential diagnosis and to remind that promising results could be obtained with the early diagnosis and treatment.

  17. Determining symptoms for chest radiographs in patients with swine flu (H1N1)

    International Nuclear Information System (INIS)

    Al-Nakshabandi, Nizar A.

    2011-01-01

    The question arises about the chest X-ray findings and clinical symptoms in swine flu and about the most important clinical finding when correlated with the chest radiograph. Should physicians order a chest X-ray in each patient suspected of having swine flu? There were 179 patients with a high suspicion of swine flu. All 179 patients had an initial chest radiograph. As many as 65 males (representing 56% of the projected study population) had a normal chest radiograph, while 35 males (representing 55.6% of the study population) had an abnormal chest X-ray. As many as 51 females (representing 44% of the population) had a normal chest X-ray, while 20 females (representing 44% of the study population) had abnormal chest X-rays. Polymerase chain reaction (PCR) was not a determining factor for normal vs. abnormal chest X-ray (CXR). Rapid antigen test was not a determining factor for normal vs. abnormal CXR. Fever was not a determining factor for normal vs. abnormal CXR. Cough appears to be a determining factor for normal vs. abnormal CXR. Sore throat appears to be a determining factor for normal vs. abnormal CXR. Chest pain was not a determining factor for normal vs. abnormal CXR. Presence of cough with PCR was statistically significant. In my opinion, chest radiographs in patients with suspected H1N1 should only be obtained if there is a cough or sore throat. Other symptoms associated with H1N1 do not warrant a chest radiograph unless absolutely necessary

  18. Subtype identification of the novel A H1N1 and other human influenza A viruses using an oligonucleotide microarray.

    Science.gov (United States)

    Kang, Xiaoping; Li, Yongqiang; Sun, Honghe; Wu, Weili; Liu, Hong; Lin, Fang; Qing, Chenfeng; Chang, Guohui; Zhu, Qingyu; Chen, Weijun; Yang, Yinhui

    2010-01-01

    A novel strain of influenza A (H1N1) virus was isolated in Mexico and the US in March and April 2009. This novel virus spread to many countries and regions in a few months, and WHO raised the level of pandemic alert from phase 5 to phase 6 on June 11, 2009. The accurate identification of H1N1 virus and other human seasonal influenza A viruses is very important for further treatment and control of their infections. In this study, we developed an oligonucleotide microarray to subtype human H1N1, H3N2 and H5N1 influenza viruses, which could distinguish the novel H1N1 from human seasonal H1N1 influenza viruses and swine H1N1 influenza viruses. The microarray utilizes a panel of primers for multiplex PCR amplification of the hemagglutinin (HA), neuraminidase (NA) and matrix (MP) genes of human influenza A viruses. The 59-mer oligonucleotides were designed to distinguish different subtypes of human influenza A viruses. With this microarray, we accurately identified and correctly subtyped the reference virus strains. Moreover, we confirmed 4 out of 39 clinical throat swab specimens from suspected cases of novel H1N1.

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

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    Wong Carmen

    2010-10-01

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

  20. Racial disparities in exposure, susceptibility, and access to health care in the US H1N1 influenza pandemic.

    Science.gov (United States)

    Quinn, Sandra Crouse; Kumar, Supriya; Freimuth, Vicki S; Musa, Donald; Casteneda-Angarita, Nestor; Kidwell, Kelley

    2011-02-01

    We conducted the first empirical examination of disparities in H1N1 exposure, susceptibility to H1N1 complications, and access to health care during the H1N1 influenza pandemic. We conducted a nationally representative survey among a sample drawn from more than 60,000 US households. We analyzed responses from 1479 adults, including significant numbers of Blacks and Hispanics. The survey asked respondents about their ability to impose social distance in response to public health recommendations, their chronic health conditions, and their access to health care. Risk of exposure to H1N1 was significantly related to race and ethnicity. Spanish-speaking Hispanics were at greatest risk of exposure but were less susceptible to complications from H1N1. Disparities in access to health care remained significant for Spanish-speaking Hispanics after controlling for other demographic factors. We used measures based on prevalence of chronic conditions to determine that Blacks were the most susceptible to complications from H1N1. We found significant race/ethnicity-related disparities in potential risk from H1N1 flu. Disparities in the risks of exposure, susceptibility (particularly to severe disease), and access to health care may interact to exacerbate existing health inequalities and contribute to increased morbidity and mortality in these populations.

  1. Monitoring and Characterization of Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, Japan, 2009–2010

    Science.gov (United States)

    Ujike, Makoto; Ejima, Miho; Anraku, Akane; Shimabukuro, Kozue; Obuchi, Masatsugu; Kishida, Noriko; Hong, Xu; Takashita, Emi; Fujisaki, Seiichiro; Yamashita, Kazuyo; Horikawa, Hiroshi; Kato, Yumiko; Oguchi, Akio; Fujita, Nobuyuki; Tashiro, Masato

    2011-01-01

    To monitor and characterize oseltamivir-resistant (OR) pandemic (H1N1) 2009 virus with the H275Y mutation, we analyzed 4,307 clinical specimens from Japan by neuraminidase (NA) sequencing or inhibition assay; 61 OR pandemic (H1N1) 2009 viruses were detected. NA inhibition assay and M2 sequencing indicated that OR pandemic (H1N1) 2009 virus was resistant to M2 inhibitors, but sensitive to zanamivir. Full-genome sequencing showed OR and oseltamivir-sensitive (OS) viruses had high sequence similarity, indicating that domestic OR virus was derived from OS pandemic (H1N1) 2009 virus. Hemagglutination inhibition test demonstrated that OR and OS pandemic (H1N1) 2009 viruses were antigenically similar to the A/California/7/2009 vaccine strain. Of 61 case-patients with OR viruses, 45 received oseltamivir as treatment, and 10 received it as prophylaxis, which suggests that most cases emerged sporadically from OS pandemic (H1N1) 2009, due to selective pressure. No evidence of sustained spread of OR pandemic (H1N1) 2009 was found in Japan; however, 2 suspected incidents of human-to-human transmission were reported. PMID:21392439

  2. Effect of Maxing Shigan Tang on H1N1 Influenza A Virus-Associated Acute Lung Injury in Mice.

    Science.gov (United States)

    Zhong, Yanchun; Zhou, Jie; Liang, Ning; Liu, Bihao; Lu, Ruirui; He, Yu; Liang, Chunlin; Wu, Junbiao; Zhou, Yuan; Hu, Miaomiao; Zhou, Jiuyao

    2016-01-01

    This study is aimed at examining the effects of Maxing Shigan Tang (MST) treatment on H1N1-associated acute lung injury (ALI) and exploring the possible mechanism. Mice were randomly divided into a control group, model group, peroxisomal proliferator activator receptor γ (PPARγ) inhibition group (PPARγ-), PPARγ activation group (PPARγ+), and MST group. Influenza A (H1N1) virus of the Fort Monmouth 1 (FM1) strain was used to induce an ALI mice model. Hematoxylin and eosin staining was performed to investigate the effect of MST treatment on H1N1-associated ALI. Cell apoptosis of lung tissues of each group were conducted through transferase-mediated dUTP nick end-labeling methods. Moreover, the expression level of caspase 3, activity of caspase 3, and serum level of tumor necrosis factor (TNF)-α of each group were also analyzed. Finally, quantitative real-time polymerase chain reaction and Western blotting analysis were carried out to detect angiopoietin-like 4 (ANGPTL4) expression level. We found that mice infected with the FM1 strain of H1N1 influenza A virus developed severe ALI, and MST could improve H1N1-induced ALI. Moreover, MST decreased lung cell apoptosis and reduced the serum content of TNF-α. In addition, MST significantly induced the ANGPTL4 expression in H1N1-induced ALI. MST improves H1N1-associated ALI maybe through targeting ANGPTL4 in mice. © 2017 S. Karger AG, Basel.

  3. Circulating levels of miR-150 are associated with poorer outcomes of A/H1N1 infection.

    Science.gov (United States)

    Morán, Juan; Ramírez-Martínez, Gustavo; Jiménez-Alvarez, Luis; Cruz, Alfredo; Pérez-Patrigeon, Santiago; Hidalgo, Alfredo; Orozco, Lorena; Martínez, Angélica; Padilla-Noriega, Luis; Avila-Moreno, Federico; Cabello, Carlos; Granados, Julio; Ortíz-Quintero, Blanca; Ramírez-Venegas, Alejandra; Ruíz-Palacios, Guillermo M; Zlotnik, Albert; Merino, Enrique; Zúñiga, Joaquín

    2015-10-01

    Overproduction of pro-inflammatory cytokines and chemokines is frequently associated with severe clinical manifestations in patients infected with influenza A/H1N1 virus. Micro-RNAs (miRNAs) are highly conserved small non-coding RNA molecules that post-transcriptionally regulate gene expression and are potential biomarkers and therapeutic targets in different inflammatory conditions. We studied the circulating and miRNA profiles in critically ill A/H1N1 patients, A/H1N1 patients with milder disease, asymptomatic housemates and healthy controls. Cytokine, chemokine and growth factors that were potential targets of differentially expressed miRNAs were assessed. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and interactome analysis of these miRNAs were also performed. Critically ill patients exhibited a significant over-expression of circulating miR-150 (pH1N1 disease whereas miR-210, miR-126 and miR-222 were downregulated in individuals exposed to the A/H1N1 virus. Significant correlations (pH1N1 infection. The differential expression of miRNAs related with immune processes in severe A/H1N1 disease supports the potential role of these miRNAs as biomarkers of disease progression. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Isolation and complete genomic characterization of pandemic H1N1/2009 influenza viruses from Cuban swine herds.

    Science.gov (United States)

    Pérez, Lester Josué; Perera, Carmen Laura; Vega, Armando; Frías, Maria T; Rouseaux, Dagmar; Ganges, Llilianne; Nuñez, José Ignacio; Díaz de Arce, Heidy

    2013-06-01

    The emergence of the pandemic H1N1/2009 influenza virus poses a potential global threat for human and animal health. In this study, we carried out pandemic H1N1/2009 influenza virus surveillance in swine herds in Cuba intending to determine whether the virus was circulating among pig populations. As a result we describe, for the first time, the detection of pandemic H1N1/2009 influenza virus in swine herds in Cuba. In addition, phylogenetic analysis and molecular characterization of three viral isolates were performed. Phylogenetic relationships confirmed that all of the eight genes of the three isolates were derived from the pandemic H1N1/2009 virus. The Cuban isolates, formed an independent cluster within the pandemic H1N1/2009 influenza strains. Different molecular markers, previously described in pandemic H1N1/2009 influenza viruses, related with adaptive evolution, viral evasion from the host-immune response, virulence and dissemination were also present in Cuban pandemic H1N1/2009 isolates. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Pandemic H1N1 influenza A directly induces a robust and acute inflammatory gene signature in primary human bronchial epithelial cells downstream of membrane fusion

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    Paquette, Stéphane G. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Banner, David [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Chi, Le Thi Bao [Department of Microbiology, Hue University of Medicine and Pharmacy, Thua Thien Hue (Viet Nam); Carlo Urbani Centre, Hue University of Medicine and Pharmacy, Thua Thien Hue (Viet Nam); Leon, Alberto J. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); International Institute of Infection and Immunity, Shantou University Medical College, Shantou, Guangdong (China); Xu, Luoling; Ran, Longsi [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Huang, Stephen S.H. [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Farooqui, Amber [Division of Experimental Therapeutics, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario (Canada); International Institute of Infection and Immunity, Shantou University Medical College, Shantou, Guangdong (China); and others

    2014-01-05

    Pandemic H1N1 influenza A (H1N1pdm) elicits stronger pulmonary inflammation than previously circulating seasonal H1N1 influenza A (sH1N1), yet mechanisms of inflammatory activation in respiratory epithelial cells during H1N1pdm infection are unclear. We investigated host responses to H1N1pdm/sH1N1 infection and virus entry mechanisms in primary human bronchial epithelial cells in vitro. H1N1pdm infection rapidly initiated a robust inflammatory gene signature (3 h post-infection) not elicited by sH1N1 infection. Protein secretion inhibition had no effect on gene induction. Infection with membrane fusion deficient H1N1pdm failed to induce robust inflammatory gene expression which was rescued with restoration of fusion ability, suggesting H1N1pdm directly triggered the inflammatory signature downstream of membrane fusion. Investigation of intra-virion components revealed H1N1pdm viral RNA (vRNA) triggered a stronger inflammatory phenotype than sH1N1 vRNA. Thus, our study is first to report H1N1pdm induces greater inflammatory gene expression than sH1N1 in vitro due to direct virus–epithelial cell interaction. - Highlights: • We investigated H1N1pdm/sH1N1 infection in primary epithelial cells. • H1N1pdm directly initiated a robust inflammatory gene signature, sH1N1 did not. • H1N1pdm viral RNA triggered a stronger response than sH1N1. • H1N1pdm induces greater response due to direct virus–cell interaction. • These results have potential to impact vaccine and therapeutic development.

  6. Pandemic H1N1 influenza A directly induces a robust and acute inflammatory gene signature in primary human bronchial epithelial cells downstream of membrane fusion

    International Nuclear Information System (INIS)

    Paquette, Stéphane G.; Banner, David; Chi, Le Thi Bao; Leon, Alberto J.; Xu, Luoling; Ran, Longsi; Huang, Stephen S.H.; Farooqui, Amber

    2014-01-01

    Pandemic H1N1 influenza A (H1N1pdm) elicits stronger pulmonary inflammation than previously circulating seasonal H1N1 influenza A (sH1N1), yet mechanisms of inflammatory activation in respiratory epithelial cells during H1N1pdm infection are unclear. We investigated host responses to H1N1pdm/sH1N1 infection and virus entry mechanisms in primary human bronchial epithelial cells in vitro. H1N1pdm infection rapidly initiated a robust inflammatory gene signature (3 h post-infection) not elicited by sH1N1 infection. Protein secretion inhibition had no effect on gene induction. Infection with membrane fusion deficient H1N1pdm failed to induce robust inflammatory gene expression which was rescued with restoration of fusion ability, suggesting H1N1pdm directly triggered the inflammatory signature downstream of membrane fusion. Investigation of intra-virion components revealed H1N1pdm viral RNA (vRNA) triggered a stronger inflammatory phenotype than sH1N1 vRNA. Thus, our study is first to report H1N1pdm induces greater inflammatory gene expression than sH1N1 in vitro due to direct virus–epithelial cell interaction. - Highlights: • We investigated H1N1pdm/sH1N1 infection in primary epithelial cells. • H1N1pdm directly initiated a robust inflammatory gene signature, sH1N1 did not. • H1N1pdm viral RNA triggered a stronger response than sH1N1. • H1N1pdm induces greater response due to direct virus–cell interaction. • These results have potential to impact vaccine and therapeutic development

  7. Influenza A/H1N1 2009 pandemic and respiratory virus infections, Beijing, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Yaowu Yang

    Full Text Available To determine the role of the pandemic influenza A/H1N1 2009 (A/H1N1 2009pdm in acute respiratory tract infections (ARTIs and its impact on the epidemic of seasonal influenza viruses and other common respiratory viruses, nasal and throat swabs taken from 7,776 patients with suspected viral ARTIs from 2006 through 2010 in Beijing, China were screened by real-time PCR for influenza virus typing and subtyping and by multiplex or single PCR tests for other common respiratory viruses. We observed a distinctive dual peak pattern of influenza epidemic during the A/H1N1 2009pdm in Beijing, China, which was formed by the A/H1N1 2009pdm, and a subsequent influenza B epidemic in year 2009/2010. Our analysis also shows a small peak formed by a seasonal H3N2 epidemic prior to the A/H1N1 2009pdm peak. Parallel detection of multiple respiratory viruses shows that the epidemic of common respiratory viruses, except human rhinovirus, was delayed during the pandemic of the A/H1N1 2009pdm. The H1N1 2009pdm mainly caused upper respiratory tract infections in the sampled patients; patients infected with H1N1 2009pdm had a higher percentage of cough than those infected with seasonal influenza or other respiratory viruses. Our findings indicate that A/H1N1 2009pdm and other respiratory viruses except human rhinovirus could interfere with each other during their transmission between human beings. Understanding the mechanisms and effects of such interference is needed for effective control of future influenza epidemics.

  8. A comparison of H1N1 influenza among pediatric inpatients in the pandemic and post pandemic era.

    Science.gov (United States)

    Rao, Suchitra; Torok, Michelle R; Bagdure, Dayanand; Cunningham, Maureen A; Williams, Joshua T B; Curtis, Donna J; Wilson, Karen; Dominguez, Samuel R

    2015-10-01

    The novel influenza A H1N1 (A[H1N1]pdm09) strain emerged in 2009, contributing to significant morbidity and mortality. It is not known whether illness associated with A(H1N1) pdm09 in the post-pandemic era exhibits a similar disease profile. The objectives of this study were to compare the burden of disease of A(H1N1) pdm09 influenza from the 2009 pandemic year to the post-pandemic years (2010-2014), and to explore potential reasons for any differences. We conducted a retrospective cohort study of inpatients admitted to Children's Hospital Colorado with a positive respiratory specimen for influenza from May-December, 2009 and December, 2010-April, 2014. Univariate and multivariate analyses were conducted to compare the demographics and clinical characteristics of patients with H1N1 during the two periods. There were 388 inpatients with influenza A(H1N1) pdm09 in 2009, and 117 during the post-pandemic years. Ninety-four percent of all H1N1 during the post-pandemic era was observed during the 2013-2014 influenza season. Patients with A(H1N1) pdm09 during the post-pandemic year were less likely to have an underlying medical condition (PH1N1) pdm09 during the post-pandemic years appeared to have less severe disease than patients with A(H1N1) pdm09 during the pandemic year. The reasons for this difference are likely multifactorial. Published by Elsevier B.V.

  9. Birth outcomes following immunization of pregnant women with pandemic H1N1 influenza vaccine 2009-2010.

    Science.gov (United States)

    Eaton, Abigail; Lewis, Ned; Fireman, Bruce; Hansen, John; Baxter, Roger; Gee, Julianne; Klein, Nicola P

    2017-09-13

    Following the H1N1 influenza pandemic in 2009, pregnant women were recommended to receive both seasonal (TIV) and H1N1 influenza vaccines. This study presents incidence of adverse birth and pregnancy outcomes among a population of pregnant women immunized with TIV and H1N1 vaccines at Kaiser Permanente Northern California during 2009-2010. We telephone surveyed pregnant Kaiser Permanente Northern California members to assess non-medically-attended reactions following H1N1, TIV or both vaccines during 2009-2010 (n=5365) in a separate study. Here we assessed preterm birth (H1N1 only, H1N1 prior to TIV immunization, TIV prior to H1N1 and both immunizations given at the same time. Results did not vary significantly between groups. Comparing H1N1 with TIV, incidence were similar for preterm births (6.37vs 6.28/100 births), very preterm births (5.30vs 8.29/1000 births), LBW (4.19vs 2.90/100 births), very LBW (4.54vs 5.52/1000 births), small for gestational age (9.99vs 9.24/1000 births), spontaneous abortion (7.10vs 6.83/1000 pregnancies), stillbirths (7.10vs 4.57/1000 pregnancies), and congenital anomalies (2.66vs 2.43/100 births). Although constrained by small sample size, complex vaccine groups, and differential vaccine availability during 2009-2010, this study found no difference in adverse birth outcomes between H1N1 vaccine and TIV. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Development and characterization of a panel of cross-reactive monoclonal antibodies generated using H1N1 influenza virus.

    Science.gov (United States)

    Guo, Chun-yan; Tang, Yi-gui; Qi, Zong-li; Liu, Yang; Zhao, Xiang-rong; Huo, Xue-ping; Li, Yan; Feng, Qing; Zhao, Peng-hua; Wang, Xin; Li, Yuan; Wang, Hai-fang; Hu, Jun; Zhang, Xin-jian

    2015-08-01

    To characterize the antigenic epitopes of the hemagglutinin (HA) protein of H1N1 influenza virus, a panel consisting of 84 clones of murine monoclonal antibodies (mAbs) were generated using the HA proteins from the 2009 pandemic H1N1 vaccine lysate and the seasonal influenza H1N1(A1) vaccines. Thirty-three (39%) of the 84 mAbs were found to be strain-specific, and 6 (7%) of the 84 mAbs were subtype-specific. Twenty (24%) of the 84 mAbs recognized the common HA epitopes shared by 2009 pandemic H1N1, seasonal A1 (H1N1), and A3 (H3N2) influenza viruses. Twenty-five of the 84 clones recognized the common HA epitopes shared by the 2009 pandemic H1N1, seasonal A1 (H1N1) and A3 (H3N2) human influenza viruses, and H5N1 and H9N2 avian influenza viruses. We found that of the 16 (19%) clones of the 84 mAbs panel that were cross-reactive with human respiratory pathogens, 15 were made using the HA of the seasonal A1 (H1N1) virus and 1 was made using the HA of the 2009 pandemic H1N1 influenza virus. Immunohistochemical analysis of the tissue microarray (TMA) showed that 4 of the 84 mAb clones cross-reacted with human tissue (brain and pancreas). Our results indicated that the influenza virus HA antigenic epitopes not only induce type-, subtype-, and strain-specific monoclonal antibodies against influenza A virus but also cross-reactive monoclonal antibodies against human tissues. Further investigations of these cross-reactive (heterophilic) epitopes may significantly improve our understanding of viral antigenic variation, epidemics, pathophysiologic mechanisms, and adverse effects of influenza vaccines. Copyright © 2015 Elsevier GmbH. All rights reserved.

  11. Pandemic Influenza A (H1N1) Outbreak among 15 School-Aged HIV-1-Infected Children

    OpenAIRE

    Feiterna-Sperling, Cornelia; Edelmann, Anke; Nickel, Renate; Magdorf, Klaus; Bergmann, Frank; Rautenberg, Peter; Schweiger, Brunhilde; Wahn, Volker; Krüger, Detlev H.; Hofmann, Jörg

    2010-01-01

    Patients infected with human immunodeficiency virus type 1 (HIV-1) are considered to be at increased risk for 2009 H1N1 influenza-related complications. We performed an observational study after an outbreak of 2009 H1N1 influenza virus infection among a group of 15 HIV-1-infected schoolaged children in Germany in October 2009. Clinical course, kinetics of viral shedding, and antibody response among children with CD4 cell counts >350 cells/µL and 2009 H1N1 influenza virus coinfection did not a...

  12. Novel Influenza A (H1N1/09) Virus Infection during Pregnancy in a Kidney Transplant Recipient

    OpenAIRE

    Lars Rothermund; Reinhold Kreutz; Frieder Keller

    2011-01-01

    We report the first case of a pregnant renal transplant patient with H1N1/09 infection. The woman showed a mild clinical course after diagnosis of H1N1/09 infection and therapy with oseltamivir (2 × 45 mg per day). After delivery by cesarean section, the neonate exhibited moderate respiratory and circulatory dysregulation, which spontaneously normalised a few days postpartum. In conclusion, rapid diagnosis of H1N1/09 and dose-adapted therapy with oseltamivir resulted in successful delivery of...

  13. Pandemik 2009 H1N1 influenza enfeksiyonları Çağrılı Yazar

    OpenAIRE

    Hacımustafaoğlu, Mustafa

    2014-01-01

    In early spring 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico spreaded quickly and on June 11 2009 World Health Organization raised its pandemic level to phase 6 This novel H1N1 pandemic influenza A virus represented a quadruple reassortment of swine human and avian influenza virus strains This pandemic 2009 H1N1 influenza A viruses in different regions of the world were found to be antigenically homogenous Transmission features incubation period and clinical fin...

  14. Safety of the Pandemic H1N1 Influenza Vaccine among Pregnant U.S. Military Women and Their Newborns

    Science.gov (United States)

    2013-03-01

    10.1097/AOG.0b013e318280d64e LEVEL OF EVIDENCE: II In April 2009, a novel strain of influenza A virus , nowknown as pandemic influenza H1N1 , emerged in the...comparison group included active-duty military women who received the 2008–2009 seasonal influenza vaccine (A/Brisbane/59/2007 [ H1N1 ]-like virus , an A...nancy with initial diagnosis at least 1 day after pan- demic H1N1 or seasonal influenza immunization. Additional requirements included an inpatient

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

    Directory of Open Access Journals (Sweden)

    Gerardo Chowell

    2011-05-01

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

  16. Initial psychological responses to Influenza A, H1N1 ("Swine flu").

    Science.gov (United States)

    Goodwin, Robin; Haque, Shamsul; Neto, Felix; Myers, Lynn B

    2009-10-06

    The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses. 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p public transport use (48% Malaysia, 22% Europe, p Malaysia, 17% Europe, p Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened. Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may

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

    Directory of Open Access Journals (Sweden)

    Swaan Corien M

    2011-12-01

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

  18. C-Methylated Flavonoids from Cleistocalyx operculatus and Their Inhibitory Effects on Novel Influenza A (H1N1) Neuraminidase

    DEFF Research Database (Denmark)

    Dao, Trong-Tuan; Tung, Bui-Thanh; Nguyen, Phi-Hung

    2010-01-01

    As part of an ongoing study focused on the discovery of anti-influenza agents from plants, four new (1-4) and 10 known (5-14) C-methylated flavonoids were isolated from a methanol extract of Cleistocalyx operculatus buds using an influenza H1N1 neuraminidase inhibition assay. Compounds 4, 7, 8......, and 14, with a chalcone skeleton, showed significant inhibitory effects on the viral neuraminidases from two influenza viral strains, H1N1 and H9N2. Compound 4 showed the strongest inhibitory activity against the neuraminidases from novel influenza H1N1 (WT) and oseltamivir-resistant novel H1N1 (H274Y...

  19. Analysis of bronchoalveolar lavage fluid in a mouse model of bronchial asthma and H1N1 2009 infection.

    Science.gov (United States)

    Okada, Seigo; Hasegawa, Shunji; Hasegawa, Hideki; Ainai, Akira; Atsuta, Ryo; Ikemoto, Kenzo; Sasaki, Kohsuke; Toda, Shoichi; Shirabe, Komei; Takahara, Midori; Harada, Sawako; Morishima, Tsuneo; Ichiyama, Takashi

    2013-08-01

    Bronchial asthma is known as a risk factor of admission to the intensive care unit. However, the mechanism by which pandemic 2009 H1N1 (A(H1N1)pdm09) infection increases the severity of symptoms in patients with bronchial asthma is unknown; therefore, we aimed at determining this mechanism. Inflammatory cell levels in the bronchoalveolar lavage (BAL) fluid from the non-asthma/mock, non-asthma/A(H1N1)pdm09, asthma/mock, and asthma/A(H1N1)pdm09 groups were determined using BALB/c mice. Cell infiltration levels, cytokine levels, and viral titers were compared among the groups. Neutrophil, monocyte, interleukin (IL)-5, IL-6, IL-10, IL-13, and tumor necrosis factor (TNF)-α levels were significantly higher in the BAL fluid from the non-asthma/A(H1N1)pdm09 and asthma/A(H1N1)pdm09 groups than in the mock groups (p<0.05 for neutrophils and monocytes; p<0.01 for the rest). The number of eosinophils and CD8(+) lymphocytes and the level of transforming growth factor beta 1 (TGF-β1) in BAL fluid in the asthma/A(H1N1)pdm09 group were significantly higher among all groups (p<0.05 for eosinophils and CD8(+) lymphocytes; p<0.01 for TGF-β1). The levels of IL-6, IL-10, IL-13, and TNF-α were significantly higher in the asthma/A(H1N1)pdm09 group than in the non-asthma/A(H1N1)pdm09 group (p<0.05 for IL-6 and IL-10; p<0.01 for IL-13 and TNF-α). The level of IFN-γ in the asthma/A(H1N1)pdm09 group was significantly lower than that in the non-asthma/A(H1N1)pdm09 group (p<0.05). The viral titers in the BAL fluids were higher in the asthma/A(H1N1)pdm09 group than in the non-asthma/A(H1N1)pdm09 group (p<0.05). Histopathological examination showed more severe infiltration of inflammatory cells and destruction of lung tissue in the asthma/A(H1N1)pdm09 group than in the non-asthma/A(H1N1)pdm09 group. Severe pulmonary inflammation induced by elevated levels of cytokines, combined with increased viral replication due to decreased IFN-γ levels, may contribute to worsening respiratory symptoms

  20. Acute hepatic failure in pediatric H1N1 infection: a case report from Al-Adan Hospital, Kuwait

    Directory of Open Access Journals (Sweden)

    Al-Refaee F

    2012-07-01

    Full Text Available Fawaz Al-RefaeeGastroenterology, Hepatology, and Nutrition Unit, Department of Pediatrics, Al-Adan Hospital, Kuwait City, KuwaitAbstract: Liver involvement in pediatric influenza A (H1N1 infection is rare. Focused clinical evaluation and laboratory tests can rule out or identify hepatic complications early on. Here we report on a 9-year-old boy treated by the Gastroenterology, Hepatology, and Nutrition Unit of Al-Adan Hospital’s Pediatric Department. The patient, who was infected with H1N1 during the 2010 pandemic, showed symptoms of associated acute hepatic failure, was managed conservatively, and recovered completely following treatment. The author would like to draw the attention of pediatricians to the hepatic aspect of human H1N1 infection in order for them to recognize it early and treat it in a timely manner.Keywords: influenza A (H1N1, infection, acute liver failure, children

  1. An Analysis of 332 Fatalities Infected with Pandemic 2009 Influenza A (H1N1) in Argentina

    Science.gov (United States)

    Balanzat, Ana M.; Hertlein, Christian; Apezteguia, Carlos; Bonvehi, Pablo; Cámera, Luis; Gentile, Angela; Rizzo, Oscar; Gómez-Carrillo, Manuel; Coronado, Fatima; Azziz-Baumgartner, Eduardo; Chávez, Pollyanna R.; Widdowson, Marc-Alain

    2012-01-01

    Background The apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities. Methods We identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group. Results Of 332 influenza A H1N1pdm fatalities, 226 (68%) were among persons aged Argentina, though timeliness of antiviral treatment improved during the pandemic. PMID:22506006

  2. Epidemiology, clinical characteristics and resource implications of pandemic (H1N1) 2009 in intensive care units in Ireland.

    LENUS (Irish Health Repository)

    Nicolay, Nathalie

    2010-12-01

    To describe the incidence, clinical characteristics and outcomes of critically ill patients in Ireland with pandemic (H1N1) 2009 infection, and to provide a dynamic assessment of the burden of such cases on Irish intensive care units.

  3. Replication, Pathogenesis and Transmission of Pandemic (H1N1) 2009 Virus in Non-Immune Pigs

    DEFF Research Database (Denmark)

    Brookes, Sharon M; Nunez, Alejandor; Choudhury, Bhudipa

    2010-01-01

    The declaration of the human influenza A pandemic (H1N1) 2009 (H1N1/09) raised important questions, including origin and host range [1,2]. Two of the three pandemics in the last century resulted in the spread of virus to pigs (H1N1, 1918; H3N2, 1968) with subsequent independent establishment...... and evolution within swine worldwide [3]. A key public and veterinary health consideration in the context of the evolving pandemic is whether the H1N1/09 virus could become established in pig populations [4]. We performed an infection and transmission study in pigs with A/California/07/09. In combination......, with clearly demonstrable pulmonary pathology, there was apparent selection of a virus variant with glycine (225G). These findings provide potential clues to the existence and biological significance of viral receptor-binding variants with 225D and 225G during the 1918 pandemic [5]....

  4. Thoracic computerized tomographic (CT findings in 2009 influenza A (H1N1 virus infection in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Mojtaba Rostami

    2011-01-01

    Full Text Available Background: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1 in an appropriate clinical setting. Methods: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23 rd 2009 to February 20 th 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1 virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. Results: Patchy infiltration (34.6%, lobar consolidation (30.8%, and interstitial infiltration (26.9% with airbronchogram (38.5% were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8% showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS. Conclusions: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1 in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific.

  5. Thoracic computerized tomographic (CT) findings in 2009 influenza A (H1N1) virus infection in Isfahan, Iran

    Science.gov (United States)

    Rostami, Mojtaba; Javadi, Abbas-Ali; Khorvash, Farzin; Mostafavizadeh, Kamyar; Adibi, Atoosa; Babak, Anahita; Ataei, Behrooz; Meidani, Mohsen; Naeini, Alireza Emami; Salehi, Hasan; Avijgan, Majid; Yazdani, Mohammad Reza; Rezaei, Farshid

    2011-01-01

    BACKGROUND: Pandemic 2009 H1N1 influenza A virus arrived at Isfahan in August 2009. The virus is still circulating in the world. The abnormal thoracic computerized tomographic (CT) scan findings vary widely among the studies of 2009 H1N1 influenza. We evaluated the thoracic CT findings in patients with 2009 H1N1 virus infection to describe findings compared to previously reported findings, and to suggest patterns that may be suggestive for 2009 influenza A (H1N1) in an appropriate clinical setting. METHODS: Retrospectively, the archive of all patients with a diagnosis of 2009 H1N1 influenza A were reviewed, in Al-Zahra Hospital in Isfahan, central Iran, between September 23rd 2009 to February 20th 2010. Out of 216 patients with confirmed 2009 influenza A (H1N1) virus, 26 cases with abnormal CT were enrolled in the study. Radiologic findings were characterized by the type and pattern of opacities and zonal distribution. RESULTS: Patchy infiltration (34.6%), lobar consolidation (30.8%), and interstitial infiltration (26.9%) with airbronchogram (38.5%) were the predominant findings in our patients. Bilateral distribution was seen in 80.8% of the patients. Only one patient (3.8%) showed ground-glass opacity, predominant radiographic finding in the previous reports and severe acute respiratory syndrome (SARS). CONCLUSIONS: The most common thoracic CT findings in pandemic H1N1 were patchy infiltration, lobar consolidation, and interstitial infiltration with airbronchogram and bilateral distribution. While these findings can be associated with other infections; they may be suggestive to 2009 influenza A (H1N1) in the appropriate clinical setting. Various radiographic patterns can be seen in thoracic CT scans of the influenza patients. Imaging findings are nonspecific. PMID:22091280

  6. Long term immune responses to pandemic influenza A/H1N1 infection in solid organ transplant recipients.

    Directory of Open Access Journals (Sweden)

    Aliyah Baluch

    Full Text Available In solid organ transplant (SOT recipients it is unknown if natural infection with influenza confers protection from re-infection with the same strain during the next influenza season. The purpose of this study was to determine if infection with pandemic influenza A/H1N1 (pH1N1 resulted in a long-term immunologic response. Transplant recipients with microbiologically proven pH1N1 infection in 2009/2010 underwent humoral and cell-mediated immunity (CMI testing for pH1N1 just prior to the next influenza season. Concurrent testing for A/Brisbane/59/2007 was done to rule-out cross-reacting antibody. We enrolled 22 adult transplant patients after pH1N1 infection. Follow up testing was done at a median of 7.4 months (range 5.8-15.4 after infection. After excluding those with cross-reactive antibody, 7/19 (36.8% patients were seroprotected. Detectable pH1N1-specific CD4+ and CD8+ interferon-γ producing T-cells were found in 11/22 (50% and 8/22 (36.4% patients respectively. Humoral immunity had a significant correlation with a CD4 response. This is the first study in transplant patients to evaluate long-term humoral and cellular response after natural influenza infection. We show that a substantial proportion of SOT recipients with previous pH1N1 infection lack long-term humoral and cellular immune responses to pH1N1. These patients most likely are at risk for re-infection.

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

    Directory of Open Access Journals (Sweden)

    Yaimi Rosales Mesa

    2014-03-01

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

  8. Peptide sharing between influenza A H1N1 hemagglutinin and human axon guidance proteins.

    Science.gov (United States)

    Lucchese, Guglielmo; Capone, Giovanni; Kanduc, Darja

    2014-03-01

    Epidemiologic data suggest that maternal microbial infections may cause fetal neurodevelopmental disorders, potentially increasing susceptibility to heavy psychopathologies such as schizophrenia, schizophreniform disorder, autism, pervasive developmental disorders, bipolar disorders, psychosis, epilepsy, language and speech disorders, and cognitive impairment in adult offspring. However, the molecular pathomechanisms underlying such a relationship are not clear. Here we analyze the potential role of the maternal immune response to viral infection in determining fetal brain injuries that increase the risk of neurological disorders in the adult. We use influenza infection as a disease model and human axon guidance pathway, a key process in the formation of neural network during midgestation, as a potential fetal target of immune insults. Specifically, we examined influenza A H1N1 hemagglutinin (HA), an antigenic viral protein, for amino acid sequence similarity to a random library of 188 axon guidance proteins. We obtain the results that (1) contrary to any theoretical expectations, 45 viral pentapeptide matches are distributed throughout a subset of 36 guidance molecules; (2) in 24 guidance proteins, the peptide sharing with HA antigen involves already experimentally validated influenza HA epitopes; and (3) most of the axon guidance vs HA peptide overlap is conserved among influenza A viral strains and subsets. Taken together, our data indicate that immune cross-reactivity between influenza HA and axon guidance molecules is possible and may well represent a pathologic mechanism capable of determining neurodevelopmental disruption in the fetus.

  9. The influenza A(H1N1 epidemic in Mexico. Lessons learned

    Directory of Open Access Journals (Sweden)

    Arzoz-Padrés Jacqueline

    2009-09-01

    Full Text Available Abstract Several influenza pandemics have taken place throughout history and it was assumed that the pandemic would emerge from a new human virus resulting from the adaptation of an avian virus strain. Mexico, since 2003 had developed a National Preparedness and Response Plan for an Influenza Pandemic focused in risk communication, health promotion, healthcare, epidemiological surveillance, strategic stockpile, research and development. This plan was challenged on April 2009, when a new influenza A(H1N1 strain of swine origen was detected in Mexico. The situation faced, the decisions and actions taken, allowed to control the first epidemic wave in the country. This document describes the critical moments faced and explicitly point out the lessons learned focused on the decided support by the government, the National Pandemic Influenza Plan, the coordination among all the government levels, the presence and solidarity of international organizations with timely and daily information, diagnosis and the positive effect on the population following the preventive hygienic measures recommended by the health authorities. The international community will be able to use the Mexican experience in the interest of global health.

  10. Oseltamivir storage, distribution and dispensing following the 2009 H1N1 influenza outbreak in Mexico.

    Science.gov (United States)

    Gutiérrez-Mendoza, Luis Meave; Schwartz, Brian; Méndez de Lira, José de Jesús; Wirtz, Veronika J

    2012-10-01

    During an influenza outbreak or pandemic, timely access to antivirals is essential to reduce disease severity and transmission. Best practices in antiviral procurement, storage, distribution, prescription and dispensing must be followed for prompt drug delivery. Mexico implemented a national pandemic preparedness plan in 2006 and created a strategic antiviral stockpile. Oseltamivir powder was stored centrally in bulk for distribution to all 31 states and the capital district during an influenza outbreak. San Luis Potosí, in northern Mexico, was one of the states most intensely affected by the 2009 H1N1 influenza outbreak. The oseltamivir powder was meant to be reconstituted locally but had to be reconstituted centrally during the 2009 influenza outbreak. Doubts arose surrounding the shelf-life of the reconstituted product. As a result of these problems, the first supply of the drug reached San Luis Potosí 11 days after the influenza outbreak had begun. Furthermore, dispensing criteria at the state level had to be changed in conformity with the availability of oseltamivir. Antiviral demand forecasts should be based on clearly defined distribution and dispensing criteria and decentralization of some of the medication stockpile should be considered. Mexico's national pandemic preparedness plan needs to be updated in accordance with the lessons learnt in 2009 to improve strategic stockpile management and ensure rapid delivery of oseltamivir to the population.

  11. Clinical characteristics of fatalities due to influenza A (H1N1) virus in Mexico.

    Science.gov (United States)

    Fajardo-Dolci, Germán; Gutierrez-Vega, Rafael; Arboleya-Casanova, Heberto; Villalobos, Aremis; Wilson, Kate S; García, Sandra G; Sotelo, Julio; Córdova Villalobos, José A; Díaz-Olavarrieta, Claudia

    2010-06-01

    Mexico has experienced a disproportionate mortality burden due to the influenza A(HIN1) pandemic. A study was undertaken to investigate the sociodemographic and clinical characteristics of the first 100 patients who died from confirmed influenza A(H1N1). A clinical evaluation was made of the first 100 consecutive deaths of confirmed cases between 10 April and 28 May 2009 reported by the Federal Ministry of Health. Statistical analysis included disease frequencies and descriptive comparisons with national health data. Most patients (60%) were aged 30-79 years, 53% were female and 40% were residents of Mexico City. On admission, 50% had one or more chronic medical conditions including metabolic syndrome (40%), cardiovascular disease (21%), diabetes (20%), hypertension (20%) and respiratory disease (8%). 38% of women and 26% of men were obese based on body mass index). The main clinical symptoms were fever (84%), cough (85%), dyspnoea (75%) and myalgia (30%). The frequency of all chronic diseases was higher in this sample than in the national statistics. Most (82%) developed symptoms before the Mexican government issued the influenza alert (24 April). Median hospital stay prior to death was 4 days (range 0-58). Patients, mostly young adults, who died from A(HIN1) influenza had a high frequency of one or more chronic diseases upon admission. Most died shortly after the health authorities initiated national influenza control measures.

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

    International Nuclear Information System (INIS)

    Ishiguro, Takashi; Takayanagi, Noboru; Yoneda, Koichiro

    2011-01-01

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

  13. Ambient air quality monitoring during the H1N1 influence period in Pune (India).

    Science.gov (United States)

    Pathak, M; Deshpande, A; Mirashe, P K; Sorte, R B; Ojha, A

    2010-10-01

    Ambient air quality in an urban area is directly linked with activity level in the city including transport, business and industrial activities. Maharashtra Pollution Control Board (MPCB) has established an ambient air quality network in the city including state-of-the-art continuous air quality monitoring stations which indicate short duration air quality variations for criteria and non-criteria pollutants. The influence of H1N1 outbreak in Pune hitting its worst pandemic condition, led the civic authorities to implement stringent isolation measures including closure of schools, colleges, business malls, cinema halls, etc. Additionally, the fear of such a pandemic brought the city to a stand still. It was therefore necessary to assess the impacts of such activity level on ambient air quality in the city. It has been observed that such events have positive impacts on air quality of the city. There was a decrease in PM concentration almost to the tune of 30 to 40% if the impacts of precipitation, i.e. seasonal variations, are taken into account. Similarly, the non criteria pollutants too showed a marked but unusual decrease in their concentrations in this ever growing city. The influence of these in turn led to lowered concentrations of secondary pollutants, i.e. O3. Overall, the ambient air quality of Pune was found to be improved during the study period.

  14. Factores genéticos en casos graves de gripe (H1N1 2009

    Directory of Open Access Journals (Sweden)

    Francesc Calafell i Majó

    2011-01-01

    Full Text Available La pandemia de gripe (H1N1 2009 generó una serie de cuestiones, entre las cuales estuvo que entre un 25 y un 30% de los casos graves de gripe no presentaron ningún factor de riesgo obvio. Hipotetizamos que un elemento que puede contribuir a la respuesta son factores de riesgo gené ticos del huésped involucrados en la mala progresió n de la enfermedad. Varios indicios nos llevaron a esta hipótesis: estudios de agregación familiar en islandeses y mormones de Utah muestran una cierta heredabilidad de la mortalidad por gripe; se conocen casi 300 genes humanos necesarios para la replicació n del virus de la gripe; y los pacientes más graves de gripe (H1N12009 mostraron una desregulació n del sistema inmune adaptativo. Estamos abordando este problema mediante un diseñ o caso-control (casos hospitalizados de gripe (H1N12009 confirmados contra casos ambulatorios, tambié n confirmados para (H1N12009, en el que se genotiparán más de un milló n de polimorfismos de cambios de nucleó tido (SNPs y de variació n de número de copia (CNVs en casos y controles.

  15. Seroepidemiologic Study of Pandemic (H1N1) 2009 during Outbreak in Boarding School, England

    Science.gov (United States)

    Johnson, Sandra; Hardelid, Pia; Raphaely, Nika; Hoschler, Katja; Bermingham, Alison; Abid, Muhammad; Pebody, Richard; Bickler, Graham; Watson, John; O’Moore, Éamonn

    2011-01-01

    We conducted a seroepidemiologic study during an outbreak of pandemic (H1N1) 2009 in a boarding school in England. Overall, 353 (17%) of students and staff completed a questionnaire and provided a serum sample. The attack rate was 40.5% and 34.1% for self-reported acute respiratory infection (ARI). Staff were less likely to be seropositive than students 13–15 years of age (staff 20–49 years, adjusted odds ratio [AOR] 0.30; >50 years AOR 0.20). Teachers were more likely to be seropositive than other staff (AOR 7.47, 95% confidence interval [CI] 2.31–24.2). Of seropositive persons, 44.6% (95% CI 36.2%–53.3%) did not report ARI. Conversely, of 141 with ARI and 63 with influenza-like illness, 45.8% (95% CI 37.0%–54.0%) and 30.2% (95% CI 19.2%–43.0%) had negative test results, respectively. A weak association was found between seropositivity and a prophylactic dose of antiviral agents (AOR 0.55, 95% CI 0.30–0.99); prophylactic antiviral agents lowered the odds of ARI by 50%. PMID:21888793

  16. H1N1 and TV News in Colombia: Risk Representations and Imaginaries

    Directory of Open Access Journals (Sweden)

    Lina Mondragón Pérez

    2013-12-01

    Full Text Available The media play a significant role in public health issues, particularly when they become the main or one of the main sources of information for citizens. Their role is key in risk perceptions of the population no matters if it’s near or away from the actual risk. This work studied the forms of treatment that three Colombian news made of the topic of H1N1 flu in the early days that the news appeared in the media agenda. The analysis here allowed us to meet relevant elements of the position taken by the national news Noticias RCN, Noticias Caracol and CM& in the coverage of the virus, which was characterized by a tendency towards dramatization of the content shown in overexposure of the subject. We searched some elements to approach the representations given by the media and possible matches, and resonance with the public representations with this issue, related to this event and with more general aspects of health risks, whose importance is growing in Colombian and Latin-American media.

  17. Investigating 2009 pandemic influenza A (H1N1) in US schools: what have we learned?

    Science.gov (United States)

    Iuliano, A Danielle; Dawood, Fatimah S; Silk, Benjamin J; Bhattarai, Achuyt; Copeland, Daphne; Doshi, Saumil; France, Anne Marie; Jackson, Michael L; Kennedy, Erin; Loustalot, Fleetwood; Marchbanks, Tiffany; Mitchell, Tarissa; Averhoff, Francisco; Olsen, Sonja J; Swerdlow, David L; Finelli, Lyn

    2011-01-01

    US investigations of school-based outbreaks of 2009 pandemic influenza A (H1N1) virus infection characterized influenza-like illness (ILI) attack rates, transmission risk factors, and adherence to nonpharmaceutical interventions. We summarize seven school-based investigations conducted during April-June 2009 to determine what questions might be answered by future investigations. Surveys were administered 5-28 days after identification of the outbreaks, and participation rates varied among households (39-86%) and individuals (24-49%). Compared with adults (4%-10%) and children aged <4 years (2%-7%), elementary through university students had higher ILI attack rates (4%-32%). Large gatherings or close contact with sick persons were identified as transmission risk factors. More participants reported adherence to hygiene measures, but fewer reported adherence to isolation measures. Challenges included low participation and delays in survey initiation that potentially introduced bias. Although school-based investigations can increase our understanding of epidemiology and prevention strategy effectiveness, investigators should decide which objectives are most feasible, given timing and design constraints.

  18. Economic impacts of a hypothetical H1N1 pandemic : a cross-sectional analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Braeton J.; Shaneyfelt, Calvin R.

    2010-06-01

    A NISAC study on the economic effects of a hypothetical H1N1 pandemic was done in order to assess the differential impacts at the state and industry levels given changes in absenteeism, mortality, and consumer spending rates. Part of the analysis was to determine if there were any direct relationships between pandemic impacts and gross domestic product (GDP) losses. Multiple regression analysis was used because it shows very clearly which predictors are significant in their impact on GDP. GDP impact data taken from the REMI PI+ (Regional Economic Models, Inc., Policy Insight +) model was used to serve as the response variable. NISAC economists selected the average absenteeism rate, mortality rate, and consumer spending categories as the predictor variables. Two outliers were found in the data: Nevada and Washington, DC. The analysis was done twice, with the outliers removed for the second analysis. The second set of regressions yielded a cleaner model, but for the purposes of this study, the analysts deemed it not as useful because particular interest was placed on determining the differential impacts to states. Hospitals and accommodation were found to be the most important predictors of percentage change in GDP among the consumer spending variables.

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

    LENUS (Irish Health Repository)

    Mereckiene, J

    2012-06-01

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

  20. Pandemic Influenza Virus 2009 H1N1 and Adenovirus in a High Risk Population of Young Adults: Epidemiology, Comparison of Clinical Presentations, and Coinfection

    Science.gov (United States)

    2014-01-08

    Pandemic Influenza Virus 2009 H1N1 and Adenovirus in a High Risk Population of Young Adults: Epidemiology, Comparison of Clinical Presentations, and... H1N1 influenza virus (2009 H1N1 ) emerged worldwide, causing morbidity and mortality that disproportionately affected young adults. Upper respiratory...adenovirus and 2009 H1N1 were prospectively collected. Results: 375 trainees with URI enrolled and were tested for both adenovirus and 2009 H1N1 by

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

    DEFF Research Database (Denmark)

    Germundsson, A.; Gjerset, B.; Hjulsager, Charlotte Kristiane

    In March-April 2009, a novel pandemic influenza A (H1N1) virus (pH1N1-09v) emerged in the human population. The first case of pH1N1v infection in pigs was reported from Canada in May 2009. In Norway, pH1N1v infection was recorded in a swine herd on the 10th of October of 2009. Here, we report...... results from the investigation performed during the outbreak and the follow up surveillance performed in the Norwegian pig population. Nasal swabs were collected from herds i) where pigs had been exposed to persons with verified pH1N1-09v infection or with influenza-like illness (ILI); ii) where pigs...... showed clinical signs or iii) with a history of close contact with or close proximity to infected herds. In addition, blood samples were collected from nucleus and multiplier breeding herds. Detection of pH1N1-09v was initially performed using a real-time RT-PCR targeted to detect influenza A virus...

  2. Influenza A (H1N1) was not associated with obesity in pregnant women living in Toluca, México.

    Science.gov (United States)

    Mendieta-Zerón, Hugo; Santillán-Benítez, Jonnathan G