Influenza and Other Respiratory Viruses最新文献_第5页

Home-Based Testing as an Approach to Estimate Influenza Vaccine Effectiveness in South Africa, 2021–2022—A Pilot Study 以家庭为基础的测试作为估计南非流感疫苗有效性的方法，2021-2022-一项试点研究

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-12-08 DOI: 10.1111/irv.70034

Jocelyn Moyes, Mvuyo Makhazi, Sibongile Walaza, Phiwokuhle Ntombela, Fahima Moosa, Anne von Gottberg, Nicole Wolter, Mignon du Plessis, Gillian Hunt, Cherie Cawood, Erica Dueger, Cheryl Cohen

Background

Surveillance programmes for influenza and other respiratory pathogens are important to generate vaccine effectiveness (VE) estimates and to inform vaccine composition. We aimed to explore the feasibility and acceptability of home-based testing.

Methods

In three out of nine provinces in South Africa, we established a self-referral system for individuals aged ≥ 18 years with respiratory symptoms of ≤ 10 days duration. Following consent, swab collection material was delivered to participants who also completed a questionnaire including self-reported vaccination status. Swabs were tested by PCR for influenza, respiratory syncytial virus (RSV) and SARS-CoV-2. A test-negative methodology was used to estimate influenza VE.

Results

Of 1456 samples collected between 19 November 2021 and 3 September 2022, 73 (5%) tested positive for influenza, 38 (3%) tested positive for RSV and 394 (27%) for SARS-CoV-2. We subtyped 55% (40/73) of the influenza positive specimens; 16/40 (40%) were influenza A(H1N1)pdm09; 10/40 (25%)A(H3N2)) and all 14/40(35%) influenza B were B/Victoria. Only 20% (279/1451) of participants reported influenza-like illness case definition symptoms of fever and cough. Influenza vaccine coverage was 11% (157/1454). The overall influenza VE was 26% (95% confidence interval: −73%, 69%). Of the completed acceptability questionnaires, 123/127 (97%) participants would make use of the service again; 90% (1306) were recruited via the COVID-19 testing centre (call in, social media, webpage), and 7% (99/1306) through CoughWatchSA.

Conclusions

Home-based swabbing was feasible and acceptable. We were able to calculate an influenza VE, although a larger sample size and verification of vaccine status may improve the VE estimates in the future.

背景：流感和其他呼吸道病原体的监测计划对于估算疫苗有效性（VE）和确定疫苗组成非常重要。我们的目的是探索家庭检测的可行性和可接受性：在南非九个省中的三个省，我们为年龄≥18 岁、呼吸道症状持续时间≤10 天的人建立了自我转诊系统。在征得同意后，我们将拭子采集材料送到参与者手中，参与者还需填写一份问卷，其中包括自我报告的疫苗接种情况。拭子通过 PCR 对流感、呼吸道合胞病毒 (RSV) 和 SARS-CoV-2 进行检测。采用检测阴性的方法来估计流感 VE：在 2021 年 11 月 19 日至 2022 年 9 月 3 日期间采集的 1456 份样本中，73 份（5%）流感检测呈阳性，38 份（3%）RSV 检测呈阳性，394 份（27%）SARS-CoV-2 检测呈阳性。我们对 55%(40/73) 呈阳性的流感样本进行了分型，其中 16/40(40%) 为甲型 H1N1 pdm09 流感，10/40(25%)为甲型 H3N2 流感，14/40(35%)为乙型/维多利亚乙型流感。只有 20% 的参与者（279/1451）报告了流感样病例定义的发烧和咳嗽症状。流感疫苗接种率为 11%（157/1454）。总体流感病毒携带率为 26%（95% 置信区间：-73%，69%）。在完成的接受度调查问卷中，123/127（97%）的参与者表示会再次使用该服务；90%（1306）的参与者是通过 COVID-19 检测中心（电话、社交媒体、网页）招募的，7%（99/1306）的参与者是通过 CoughWatchSA 招募的：结论：在家中进行拭子测试是可行的，也是可以接受的。我们能够计算出流感VE，尽管更大的样本量和对疫苗接种情况的核实可能会提高未来的VE估计值。

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引用次数: 0

Rapid and Safe Neutralization Assay for Circulating H5N1 Influenza Virus in Dairy Cows 奶牛中流行H5N1流感病毒的快速安全中和试验

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-12-02 DOI: 10.1111/irv.70048

Kei Miyakawa, Makoto Ota, Kaori Sano, Fumitaka Momose, Takashi Okura, Noriko Kishida, Tomoko Arita, Yasushi Suzuki, Masayuki Shirakura, Hideki Asanuma, Shinji Watanabe, Akihide Ryo, Hideki Hasegawa

Rapid and safe neutralization assays are required for highly pathogenic avian influenza viruses, including a clade 2.3.4.4b H5N1 subtype recently found in cows. Here, we report a neutralization assay using luminescent virus-like particles. This assay has lower biosafety requirements and provides a larger dynamic range than conventional methods. We applied this technique to evaluate the cross-reactivity of neutralizing antibodies induced by clade 2.3.4.4b candidate vaccine viruses (CVVs) with the cow-derived H5N1 virus. Our findings indicate that these CVVs share antigenic characteristics with the cow-derived H5N1 virus, suggesting the potential efficacy of vaccines developed using these CVVs.

需要对高致病性禽流感病毒进行快速和安全的中和试验，包括最近在奶牛中发现的一种进化枝2.3.4.4b H5N1亚型。在这里，我们报告了一种使用发光病毒样颗粒的中和试验。该分析具有较低的生物安全要求，并提供比传统方法更大的动态范围。我们应用该技术评价了2.3.4.4b支候选疫苗病毒（CVVs）诱导的中和抗体与牛源H5N1病毒的交叉反应性。我们的研究结果表明，这些cvv与牛源性H5N1病毒具有相同的抗原特征，这表明使用这些cvv开发的疫苗具有潜在功效。

引用次数: 0

Influenza Vaccine Effectiveness Against Symptomatic Influenza in Primary Care: A Test Negative Case Control Study Over Two Influenza Seasons 2022/2023 and 2023/2024 in Ireland 流感疫苗对初级保健中症状性流感的有效性：爱尔兰2022/2023和2023/2024两个流感季节的检测阴性病例对照研究

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-12-02 DOI: 10.1111/irv.70023

Louise Marron, Adele McKenna, Joan O'Donnell, Michael Joyce, Charlene Bennett, Jeff Connell, Lisa Domegan

Introduction

Live attenuated influenza vaccine (LAIV) is recommended in Ireland for all children aged 2–17 years. Quadrivalent influenza vaccine (QIV) is recommended for all others eligible for vaccination, including those ≥ 18 years with underlying medical conditions and all aged ≥ 65 years. We aimed to estimate influenza vaccine effectiveness (IVE) against acute respiratory infection (ARI) presentations to primary care due to influenza over two influenza seasons in Ireland, to inform vaccination recommendations and communication campaigns.

Methods

We undertook a test-negative case control study within the Irish sentinel general practice surveillance network as part of the Vaccine Effectiveness Burden and Impact Studies (VEBIS) network. We compared influenza vaccination status among influenza PCR positive cases with influenza PCR negative controls, both with ARI presentations, of all ages. We estimated IVE using logistic regression adjusting for age, onset time, medical conditions and sex.

Results

In 2022/2023, there were 288 cases and 765 controls. In 2023/2024, there were 567 cases and 1832 controls. In 2022/2023, overall IVE was 42% (95% CI 9 to 64) and 50% (95% CI −30 to 83) in 2- to 17-year-olds. Overall IVE in 2023/2024 was 35% (95% CI 15 to 51) and 68% (95% CI 30 to 87) in 2- to 17-year-olds.

Conclusion

Influenza vaccination reduced the risk of influenza among ARI patients presenting to general practice, demonstrating the benefits of vaccination, particularly among children. Promotion of the seasonal influenza vaccine to recommended groups, should remain a public health priority. Targeted vaccination campaigns for children promoting LAIV should emphasise the effectiveness of LAIV in children.

在爱尔兰，推荐所有2-17岁的儿童接种减毒流感活疫苗。建议所有其他符合接种条件的人接种四价流感疫苗（QIV），包括那些年龄≥18岁且有潜在疾病的人和年龄≥65岁的人。我们的目的是评估流感疫苗（IVE）在爱尔兰两个流感季节内预防因流感引起的急性呼吸道感染（ARI）向初级保健的有效性，为疫苗接种建议和宣传活动提供信息。作为疫苗有效性负担和影响研究（VEBIS）网络的一部分，我们在爱尔兰哨点全科医生监测网络中进行了一项检测阴性病例对照研究。我们比较了所有年龄的流感PCR阳性病例和流感PCR阴性对照的流感疫苗接种情况，两者都有ARI表现。我们使用逻辑回归对年龄、发病时间、医疗条件和性别进行校正，估计IVE。结果2022/2023年共288例，对照组765例。在2023/2024年，有567例病例和1832例对照。在2022/2023年，2- 17岁儿童的总体IVE为42% （95% CI 9 - 64）和50% （95% CI - 30 - 83）。2023/2024年，2- 17岁儿童的总体IVE为35% （95% CI 15 - 51）和68% （95% CI 30 - 87）。结论流感疫苗接种降低了ARI患者的流感风险，证明了疫苗接种的益处，特别是在儿童中。向推荐人群推广季节性流感疫苗仍应是公共卫生的优先事项。有针对性的儿童疫苗接种运动促进LAIV应强调LAIV在儿童中的有效性。

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引用次数: 0

Biases in Routine Influenza Surveillance Indicators Used to Monitor Infection Incidence and Recommendations for Improvement 用于监测感染发生率的常规流感监测指标的偏差及改进建议

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-12-01 DOI: 10.1111/irv.70050

Oliver Eales, James M. McCaw, Freya M. Shearer

Background

Monitoring how the incidence of influenza infections changes over time is important for quantifying the transmission dynamics and clinical severity of influenza. Infection incidence is difficult to measure directly, and hence, other quantities which are more amenable to surveillance are used to monitor trends in infection levels, with the implicit assumption that they correlate with infection incidence.

Methods

Here, we demonstrate, through mathematical reasoning using fundamental mathematical principles, the relationship between the incidence of influenza infections and three commonly reported surveillance indicators: (1) the rate per unit time of influenza-like illness reported through sentinel healthcare sites, (2) the rate per unit time of laboratory-confirmed influenza infections and (3) the proportion of laboratory tests positive for influenza (‘test-positive proportion’).

Results

Our analysis suggests that none of these ubiquitously reported surveillance indicators are a reliable tool for monitoring influenza incidence. In particular, we highlight how these surveillance indicators can be heavily biassed by the following: the dynamics of circulating pathogens (other than influenza) with similar symptom profiles, changes in testing rates and differences in infection rates, symptom rates and healthcare-seeking behaviour between age-groups and through time. We make six practical recommendations to improve the monitoring of influenza infection incidence. The implementation of our recommendations would enable the construction of more interpretable surveillance indicator(s) for influenza from which underlying patterns of infection incidence could be readily monitored.

Conclusions

The implementation of all (or a subset) of our recommendations would greatly improve understanding of the transmission dynamics, infection burden and clinical severity of influenza, improving our ability to respond effectively to seasonal epidemics and future pandemics.

背景：监测流感感染发生率随时间的变化对于量化流感的传播动态和临床严重程度非常重要。感染发生率很难直接测量，因此，更适合监测的其他数量被用于监测感染水平的趋势，隐含的假设是它们与感染发生率相关。方法运用基本的数学原理，通过数学推理，论证了流感感染发生率与三个常用监测指标之间的关系：(1)卫生保健哨点报告的每单位时间流感样疾病发生率；(2)每单位时间实验室确诊流感感染率；(3)流感实验室检测呈阳性的比例（“检测阳性比例”）。结果我们的分析表明，这些普遍报道的监测指标都不是监测流感发病率的可靠工具。特别是，我们强调这些监测指标如何受到以下因素的严重影响：具有相似症状特征的流行病原体（流感除外）的动态、检测率的变化和感染率的差异、不同年龄组和不同时期的症状率和求医行为。我们提出了六项切实可行的建议，以改善流感感染发病率的监测。实施我们的建议将有助于建立更具可解释性的流感监测指标，由此可以很容易地监测感染发生率的基本模式。实施我们的全部（或部分）建议将大大提高对流感传播动态、感染负担和临床严重程度的了解，提高我们有效应对季节性流行病和未来大流行的能力。

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引用次数: 0

RSV Disease Burden in Older Adults: An Italian Multiregion Pilot Study of Acute Respiratory Infections in Primary Care Setting, Winter Season 2022–2023 老年人 RSV 疾病负担：意大利多地区基层医疗机构急性呼吸道感染试点研究（2022-2023 年冬季

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-26 DOI: 10.1111/irv.70049

Sara Bracaloni, Enrica Esposito, Michela Scarpaci, Tommaso Cosci, Beatrice Casini, Federica Chiovelli, Guglielmo Arzilli, Mauro Pistello, Donatella Panatto, Matilde Ogliastro, Daniela Loconsole, Maria Chironna, Caterina Rizzo, RSVComNet Italy

Background

Respiratory syncytial virus (RSV) is a major cause of hospital admission in adults over 65, leading to severe complications and death. However, the disease burden in primary care for older adults in Europe is poorly understood. This pilot study aims to test a study protocol for evaluating the clinical burden of RSV in older adults in primary care settings in Italy.

Methods

In the 2022–23 winter season, we designed a study on RSV burden in individuals over 65 with acute respiratory infections (ARIs) in Liguria, Apulia, and Tuscany, Italy. Recruited patients underwent nasopharyngeal swabs for RSV confirmation and provided epidemiological and clinical data. RSV-positive patients completed follow-up questionnaires after 14 and 30 days regarding their clinical conditions, healthcare utilization, and socio-economic impact.

Results

We enrolled 152 patients with ARIs; 33 (21.7%) tested positive for RSV. The median disease duration was 14 days, with 3% hospitalized. Among RSV-positive patients, 87% received drug treatment, 52% of whom received antibiotics. After diagnosis, 74% required further GP consultations within 2 weeks. Additionally, 48% incurred extra costs. On day 30, 21% reported health complications or deterioration.

Conclusions

Our pilot study highlights the need for an ARIs surveillance system for older adults in primary care. This is crucial for defining vaccination strategies to reduce the disease burden on these patients and the healthcare system. Moreover, these data are essential for assessing costs and parameters for cost-effectiveness models, facilitating informed decisions in public health planning and resource allocation.

背景呼吸道合胞病毒（RSV）是 65 岁以上成年人入院治疗的主要原因，可导致严重并发症和死亡。然而，人们对欧洲老年人初级保健的疾病负担知之甚少。这项试点研究旨在测试一项研究方案，以评估意大利基层医疗机构中老年人 RSV 的临床负担。方法在 2022-23 年冬季，我们设计了一项关于意大利利古里亚、阿普利亚和托斯卡纳 65 岁以上急性呼吸道感染 (ARI) 患者 RSV 负担的研究。被招募的患者接受了鼻咽拭子检查以确认 RSV，并提供了流行病学和临床数据。RSV 阳性患者在 14 天和 30 天后填写了有关其临床状况、医疗保健使用情况和社会经济影响的随访问卷。结果我们共招募了 152 名急性呼吸道感染患者，其中 33 人（21.7%）的 RSV 检测结果呈阳性。中位病程为 14 天，3% 的患者住院治疗。在 RSV 阳性患者中，87% 接受了药物治疗，其中 52% 接受了抗生素治疗。确诊后，74%的患者需要在两周内进一步咨询全科医生。此外，48%的患者还产生了额外费用。第 30 天，21% 的患者报告出现健康并发症或病情恶化。结论我们的试点研究强调了在初级保健中为老年人建立急性呼吸道感染监控系统的必要性。这对于确定疫苗接种策略以减轻这些患者和医疗系统的疾病负担至关重要。此外，这些数据对于评估成本和成本效益模型参数至关重要，有助于在公共卫生规划和资源分配方面做出明智的决策。

{"title":"RSV Disease Burden in Older Adults: An Italian Multiregion Pilot Study of Acute Respiratory Infections in Primary Care Setting, Winter Season 2022–2023","authors":"Sara Bracaloni, Enrica Esposito, Michela Scarpaci, Tommaso Cosci, Beatrice Casini, Federica Chiovelli, Guglielmo Arzilli, Mauro Pistello, Donatella Panatto, Matilde Ogliastro, Daniela Loconsole, Maria Chironna, Caterina Rizzo, RSVComNet Italy","doi":"10.1111/irv.70049","DOIUrl":"https://doi.org/10.1111/irv.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory syncytial virus (RSV) is a major cause of hospital admission in adults over 65, leading to severe complications and death. However, the disease burden in primary care for older adults in Europe is poorly understood. This pilot study aims to test a study protocol for evaluating the clinical burden of RSV in older adults in primary care settings in Italy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the 2022–23 winter season, we designed a study on RSV burden in individuals over 65 with acute respiratory infections (ARIs) in Liguria, Apulia, and Tuscany, Italy. Recruited patients underwent nasopharyngeal swabs for RSV confirmation and provided epidemiological and clinical data. RSV-positive patients completed follow-up questionnaires after 14 and 30 days regarding their clinical conditions, healthcare utilization, and socio-economic impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 152 patients with ARIs; 33 (21.7%) tested positive for RSV. The median disease duration was 14 days, with 3% hospitalized. Among RSV-positive patients, 87% received drug treatment, 52% of whom received antibiotics. After diagnosis, 74% required further GP consultations within 2 weeks. Additionally, 48% incurred extra costs. On day 30, 21% reported health complications or deterioration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our pilot study highlights the need for an ARIs surveillance system for older adults in primary care. This is crucial for defining vaccination strategies to reduce the disease burden on these patients and the healthcare system. Moreover, these data are essential for assessing costs and parameters for cost-effectiveness models, facilitating informed decisions in public health planning and resource allocation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inpatient Burden of Respiratory Syncytial Virus Infection and Influenza in Children Younger Than 5 Years in Japan, 2011–2022: A Database Study 2011-2022 年日本 5 岁以下儿童呼吸道合胞病毒感染和流感的住院负担：一项数据库研究。

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-21 DOI: 10.1111/irv.70045

Takeshi Arashiro, Rolf Kramer, Jing Jin, Munehide Kano, Fangyuan Wang, Isao Miyairi

Background

Respiratory syncytial virus (RSV) and influenza virus are major viral etiologies of pediatric lower respiratory tract infection, but comparative data on inpatient burden are lacking.

Methods

Using a large-scale health claims database in Japan, we identified patients under 5 years of age with a confirmed RSV or influenza diagnosis as an outpatient or inpatient between 2011 and 2022. Hospitalization rate, inpatient characteristics, various in-hospital outcomes/complications, and healthcare resource utilization were described.

Results

A total of 176,911 RSV-confirmed outpatients, 153,383 influenza-confirmed outpatients, 90,413 RSV-confirmed hospitalizations, and 11,186 influenza-confirmed hospitalizations were identified. Among outpatients, 24.7% of RSV infection and 2.8% of influenza cases required hospitalization within 1 week. There was no co-morbidities/prematurity for 95.0% of RSV hospitalizations and 96.5% of influenza hospitalizations. Proportions of in-hospital outcomes/complications were (RSV infection vs. influenza): oxygen use 47.6% vs. 14.8%, mechanical ventilation 2.1% vs. 0.7%, pneumonia 33.6% vs. 12.8%, otitis media 7.7% vs. 2.3%, febrile seizure 1.5% vs. 34.4%, encephalitis/encephalopathy 0.1% vs. 0.5%, myocarditis < 0.1% vs. 0.6%, antibiotics prescription 48.0% vs. 24.4%. The mean inpatient stay was 6.1 vs. 4.3 days at direct medical costs of 435,744 vs. 315,809 JPY/patient. These trends held true in age-stratified data. In-hospital death occurred in 31 RSV infection and 6 influenza cases.

Conclusions

Although both infections resulted in substantial burden, RSV infection led to more frequent hospitalizations, worse in-hospital outcomes, longer inpatient stays, higher medical costs, and more frequent antibiotics prescription compared to influenza. Most RSV hospitalizations occurred among healthy term children, emphasizing the need for prevention measures in all children.

背景：呼吸道合胞病毒（RSV呼吸道合胞病毒（RSV）和流感病毒是小儿下呼吸道感染的主要病毒病因，但缺乏有关住院患者负担的比较数据：我们利用日本的大规模健康索赔数据库，确定了 2011 年至 2022 年期间门诊或住院的确诊为 RSV 或流感的 5 岁以下患者。我们对住院率、住院病人特征、各种住院结果/并发症以及医疗资源利用情况进行了描述：结果：共发现 176911 名 RSV 确诊门诊患者、153383 名流感确诊门诊患者、90413 名 RSV 确诊住院患者和 11186 名流感确诊住院患者。在门诊病人中，24.7%的 RSV 感染病例和 2.8% 的流感病例需要在一周内住院治疗。在 95.0% 的 RSV 住院病例和 96.5% 的流感住院病例中，没有并发症/早产儿。住院结果/并发症的比例为（RSV 感染与流感）：使用氧气 47.6% 对 14.8%、机械通气 2.1% 对 0.7%、肺炎 33.6% 对 12.8%、中耳炎 7.7% 对 2.3%、发热性惊厥 1.5% 对 34.4%、脑炎/脑病 0.1% 对 0.5%、心肌炎结论：虽然两种感染都会造成巨大的负担，但与流感相比，RSV 感染导致更频繁的住院治疗、更差的院内预后、更长的住院时间、更高的医疗费用和更频繁的抗生素处方。大多数 RSV 住院病例都发生在健康的足月儿童身上，因此需要对所有儿童采取预防措施。

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引用次数: 0

Influenza in Adults Seeking Care at Seven European Emergency Departments: A Prospective Active Surveillance During the 2019–2020 Influenza Season 欧洲七国急诊科就诊成人的流感情况：2019-2020年流感季节期间的前瞻性主动监测

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-20 DOI: 10.1111/irv.70040

Sélilah Amour, Alberto Perez Rubio, Andrea Orsi, Michael Oppert, Micha Loebermann, Carlos del Pozo Vegas, Karim Tazarourte, Marion Douplat, Laurent Jacquin, Giancarlo Icardi, Jonas Walker, Andrea Glass, Joshua Nealon, Sandra S. Chaves, FERS Study Group, Hélène Bricout, Philippe Vanhems

Background

Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis.

Methods

The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019–20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.

Results

There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.

Conclusion

Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization.

背景流感可能与非呼吸道疾病相关，但由于医疗系统缺乏常规流感检测，尤其是在患者未出现流感样病症（ILI）的情况下，对这些疾病的记录较少。我们的目的是测量因非创伤性原因到急诊科就诊的流感病例比例，描述他们的临床表现和急诊科出院诊断。方法该研究于2019-20流感季节在法国、西班牙、意大利和德国的七家医院进行，为期10周。邀请因非创伤性原因在急诊室就诊的患者（≥ 18 岁）参加。征得同意的患者提供上呼吸道拭子样本，通过反转录聚合酶链反应进行流感检测。此外，还收集了临床和人口统计学数据。结果共纳入 8678 名患者，50.7% 为女性，年龄中位数为 57 岁。其中 494 人（5.7%）为实验室确诊流感病例。然而，只有 24.3% 的实验室确诊流感病例在急诊室出院时是流感。在所有确诊为流感的病例中，47.6%的病例出院诊断为非呼吸道疾病，随着年龄的增长，这一比例也在增加。在流感病例中，符合欧洲疾病预防与控制中心 ILI 病例定义的病例最多（68.6%）。老年患者（≥ 65 岁）根据任何 ILI 征兆/症状被识别的频率较低。结论我们的研究结果表明，仅凭临床表现和医疗记录并不能轻易评估流感对急诊室就诊患者的影响。在成年人中预防流感可减少医疗服务的使用。

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引用次数: 0

Technological Barriers to Routine Genomic Surveillance for Vaccine Development Against SARS-CoV-2 in Africa: A Systematic Review 非洲常规基因组监测用于开发 SARS-CoV-2 疫苗的技术障碍：系统回顾

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-18 DOI: 10.1111/irv.70047

Kimberly Cheryl Chido Konono, Keiko Msusa, Samuel Mpinganjira, Adidja Amani, Charles Nyagupe, Michael Ngigi

The Global Initiative on Sharing All Influenza Data, a public-access database for sharing severe acute respiratory syndrome coronavirus 2 genomic sequencing data, has received significantly less data from African countries compared to the global total. Furthermore, the contribution of these data was infrequent and, for some countries, non-existent. The primary aim of this review is to identify the technological barriers to routine genomic surveillance in Africa. PubMed and Google Scholar were searched for the relevant articles, and other eligible articles were identified from the reference list examination according to the PRISMA checklist. Eighty-four full-text articles were analysed for eligibility, and 49 published full-texted articles were included in the final qualitative analysis. The main technological barriers identified were limited genomic surveillance capacity, limited genomic sequencing infrastructure, lack of resources and skilled or trained scientists, and the high cost of importing, establishing, and maintaining a genomic sequencing facility. The Africa Pathogen Genomics Initiative aims to improve genomic surveillance capacity across Africa, through resources, training, education, infrastructure, and regional sequencing centres. Furthermore, collaborations between African governments and international partners or national, private, and academic institutions are imperative to sustain genomic surveillance in Africa, and investment in genomic sequencing and research and development is paramount. Longer turnaround times interfere with global viral evolution monitoring and national implementation of effective policies to reduce the burden and disease. Establishing effective genomic surveillance systems guides public health responses and vaccine development for diseases endemic in Africa.

全球共享所有流感数据倡议是一个用于共享严重急性呼吸系统综合症冠状病毒 2 基因组测序数据的公共访问数据库，与全球总数相比，非洲国家提供的数据少得多。此外，这些数据的贡献并不频繁，有些国家甚至根本没有贡献数据。本综述的主要目的是找出非洲常规基因组监测的技术障碍。我们在 PubMed 和 Google Scholar 上检索了相关文章，并根据 PRISMA 核对表从参考文献列表中确定了其他符合条件的文章。对 84 篇全文文章进行了资格分析，49 篇已发表的全文文章被纳入最终定性分析。发现的主要技术障碍包括基因组监测能力有限、基因组测序基础设施有限、缺乏资源和熟练或训练有素的科学家，以及进口、建立和维护基因组测序设施的成本高昂。非洲病原体基因组计划旨在通过资源、培训、教育、基础设施和区域测序中心，提高整个非洲的基因组监测能力。此外，非洲各国政府与国际合作伙伴或国家、私营和学术机构之间的合作对于维持非洲的基因组监测至关重要，对基因组测序和研发的投资也至关重要。较长的周转时间会影响全球病毒演变监测和国家实施有效政策以减轻疾病负担。建立有效的基因组监测系统可指导公共卫生应对措施和非洲流行病疫苗的开发。

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引用次数: 0

Virological and Clinical Outcomes of Influenza Outpatients Treated With Baloxavir, Oseltamivir, or Laninamivir in the 2023–2024 Season 2023-2024 年流感季节接受巴洛沙韦、奥司他韦或拉尼那韦治疗的流感门诊患者的病毒学和临床结果

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-18 DOI: 10.1111/irv.70042

Takeyuki Goto, Naoki Kawai, Takuma Bando, Yoshio Takasaki, Shizuo Shindo, Tomonori Sato, Naoki Tani, Yong Chong, Hideyuki Ikematsu

Background

Clinical data on patients infected with influenza B Victoria (BV) after the approval of baloxavir is lacking.

Methods

This observational study of the Japanese 2023–2024 influenza season analyzed data from 25 outpatients with A(H1N1)pdm09, 36 with A(H3N2), and 65 with BV. Viral samples were collected before and after administering an antiviral (70 patients received baloxavir and 56 received a neuraminidase inhibitor), on days 1, 5, and 10. Isolated viruses after culturing were amplified using RT-PCR and sequenced to detect mutations of concern, including acidic protein (PA)-amino acid (AA) E23X/I38X for influenza A and M34X/I38X for BV. Fever and symptoms were tracked via self-reporting diaries.

Results

No PA-AA-substituted virus was detected from 126 pre-treatment samples. In the baloxavir cohort, one (7.1%, 1/14) PA I38F-substituted A(H1N1)pdm09 and two (11.1%, 2/18) PA I38T-substituted A(H3N2) viruses were isolated on day 5 but not on day 10. No (0%, 0/37) PA-AA-substituted BV was detected on day 5 or after. The virus isolation rate on day 5 was higher among patients with BV than with influenza A in both baloxavir (35.1% vs. 14.3% for A(H1N1)pdm09 and 16.7% for A(H3N2)) and oseltamivir-treated patients (44.4% vs. 0% for A(H1N1)pdm09 and 33.3% for A(H3N2)). Patients with PA-AA-substituted influenza A after baloxavir administration did not have longer fever duration than those without virus isolation or with wild-type virus on day 5, for both A(H1N1)pdm09 and A(H3N2).

Conclusions

Baloxavir-resistant variants were not detected in influenza BV before treatment, as with A. The emergence of PA-AA-substituted influenza A after baloxavir administration was temporal and did not cause prolonged symptoms. No baloxavir-resistant BV variants were observed after baloxavir administration.

背景缺乏巴洛沙韦获批上市后乙型流感维多利亚（BV）感染者的临床数据。方法这项针对日本 2023-2024 年流感季节的观察性研究分析了 25 名甲型 H1N1 pdm09、36 名甲型 H3N2 和 65 名 BV 门诊患者的数据。在使用抗病毒药物（70 名患者使用巴洛沙韦，56 名患者使用神经氨酸酶抑制剂）前后的第 1、5 和 10 天采集了病毒样本。用 RT-PCR 扩增培养后分离出的病毒，并进行测序以检测相关突变，包括甲型流感的酸性蛋白 (PA) - 氨基酸 (AA) E23X/I38X 和乙型流感的 M34X/I38X。通过自我报告日记跟踪发热和症状。结果 126 份治疗前样本中未检测到 PA-AA 取代病毒。在巴洛沙韦队列中，第5天分离到1个（7.1%，1/14）PA I38F替代的A(H1N1)pdm09病毒，第10天未分离到2个（11.1%，2/18）PA I38T替代的A(H3N2)病毒。第 5 天及以后均未检测到 PA-AA 取代的 BV（0%，0/37）。在巴洛沙韦（A(H1N1)pdm09为35.1%对14.3%，A(H3N2)为16.7%）和奥司他韦（A(H1N1)pdm09为44.4%对0%，A(H3N2)为33.3%）治疗的患者中，第5天BV患者的病毒分离率高于甲型流感患者。就 A(H1N1)pdm09 和 A(H3N2) 而言，服用巴洛沙韦后感染 PA-AA 取代型甲型流感的患者在第 5 天的发烧持续时间并不比未分离病毒或感染野生型病毒的患者长。结论与甲型流感一样，治疗前在乙型流感病毒中未检测到耐巴洛沙韦变异株。服用巴洛沙韦后未发现耐巴洛沙韦的BV变异株。

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引用次数: 0

Impact of Age and Comorbid Conditions on Incidence Rates of COVID-19-Associated Hospitalizations, 2020–2021 2020-2021 年年龄和合并症对 COVID-19 相关住院发病率的影响。

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses

Pub Date : 2024-11-17 DOI: 10.1111/irv.70016

Lisa Saiman, Edward E. Walsh, Angela R. Branche, Angela Barrett, Luis Alba, Sonia Gollerkeri, Julia A. Schillinger, Matthew Phillips, Lyn Finelli

Background

COVID-19-associated hospitalization rates by age and comorbid conditions can more precisely assess risk for severe illness and target prevention and treatment strategies.

Methods

We performed a retrospective study to estimate population-based COVID-19-associated hospitalization among patients by age and selected comorbid conditions in three hospital systems in Rochester and New York City (NYC), NY. Incidence rate ratios (IRR) comparing incidence rates for patients with and without these comorbidities were determined.

Results

From March 2020 to December 2021, 7779 patients were hospitalized with COVID-19 of whom 43.8% had ≥3 comorbid conditions. Overall annual incidence ranged from 325.3 to 965.8 per 100,000 persons. Age group-specific incidence was lowest in children 10–14 years (range 4.4–58.9) and highest in adults ≥85 years (range 2790.5–5889.6). Incidence rates for comorbid conditions generally increased with increasing age while IRR decreased with increasing age. Children in NYC 5–17 years with asthma or obesity had 3.4 and 53.3 times higher hospitalization rates, respectively, than children without these conditions. Adults in all age groups with obesity, diabetes, coronary artery disease, or congestive heart failure CHF had 1.6–4.7 times, 1.7–7.2 times, 2.0–10.1 times, or 1.7–20.2 times higher hospitalization rates, respectively, than those without these conditions. Adults ≥50 years with asthma had 1.5 to 1.8 times higher hospitalization rates than those without asthma.

Conclusions

The burden of hospitalization with COVID-19 was high, particularly among adults ≥85 years and adults with obesity, diabetes, CAD, or CHF. However, the impact of comorbidities was less in older adults. Population-based incidence rates by age and comorbidities provide more precise estimates of the benefits of vaccines and antiviral medications.

背景：按年龄和合并症分类的 COVID-19 相关住院率可以更准确地评估重症风险，并有针对性地制定预防和治疗策略：按年龄和合并症分类的 COVID-19 相关住院率可更准确地评估重症风险，并有针对性地制定预防和治疗策略：方法：我们进行了一项回顾性研究，在纽约州罗切斯特市和纽约市（NYC）的三个医院系统中，按年龄和选定的合并症估算人群中与 COVID-19 相关的住院率。结果显示，从 2020 年 3 月到 2021 年 12 月，COVID-19 患者的住院率将达到 20%：2020年3月至2021年12月，7779名患者因COVID-19住院，其中43.8%的患者合并症≥3种。总体年发病率为每 10 万人 325.3 例至 965.8 例。10-14岁儿童的年龄组发病率最低（范围为4.4-58.9），≥85岁的成年人发病率最高（范围为2790.5-5889.6）。随着年龄的增长，合并症的发病率普遍上升，而IRR则随着年龄的增长而下降。患有哮喘或肥胖症的 5-17 岁《纽约时报》儿童的住院率分别是无哮喘或肥胖症儿童的 3.4 倍和 53.3 倍。患有肥胖症、糖尿病、冠状动脉疾病或充血性心力衰竭（CHF）的各年龄组成人的住院率分别是无上述疾病者的 1.6-4.7 倍、1.7-7.2 倍、2.0-10.1 倍或 1.7-20.2 倍。≥50岁的成人哮喘患者的住院率是非哮喘患者的1.5至1.8倍：COVID-19造成的住院负担很高，尤其是在年龄≥85岁的成年人和患有肥胖症、糖尿病、CAD或心房颤动的成年人中。然而，合并症对老年人的影响较小。按年龄和合并症划分的基于人群的发病率能更精确地估计疫苗和抗病毒药物的益处。

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引用次数: 0