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Seasonal influenza is a contagious viral respiratory condition typically occurring in the fall to early spring months of the year globally. The risk of infection from seasonal influenza can be greatly reduced with vaccination. Unfortunately, research has indicated that the seasonal influenza vaccination rate in Saudi Arabia is low. This study assessed the uptake of seasonal influenza vaccination among adults residing in Al-Jouf region, Saudi Arabia. A cross-sectional survey targeting adults (20–80 years) residing in Al-Jouf region, Saudi Arabia, was conducted to gather information about their sociodemographic characteristics, chronic conditions, knowledge about periodic health examinations (PHE), regular use of PHE, and uptake of seasonal influenza vaccination. Comparative statistics and a multivariate logistic regression analysis were conducted to determine characteristics associated with the uptake of seasonal influenza vaccination. A total of 624 respondents completed the survey and participated in this study. Among the participants, 27.4% indicated they visited their primary healthcare centers or hospitals every year to get a seasonal influenza vaccination. The regression analysis showed that the odds of getting a seasonal influenza vaccination were higher among employed respondents (Odds Ratio [OR] = 1.73; P = 0.039), respondents who were employees of the healthcare sector (OR = 2.31; P = 0.001), and those with a higher PHE Knowledge Score (OR = 1.22; P = 0.008), compared to their counterparts. Seasonal influenza is a serious condition warranting appropriate prevention measures, including vaccination. However, this study confirmed low rates of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Interventions to boost vaccination uptake, in particular among unemployed individuals, those not working in the healthcare sector, and those with lower PHE knowledge Scores, are therefore recommended. [ABSTRACT FROM AUTHOR]

Background: The influenza virus is an important cause of morbidity and mortality for diabetics. The seasonal influenza vaccine's immunologic effectiveness is proven within the type 1 and type 2 diabetic populations, but the level of evidence is low. This article presents a systematic review for the bias in the measure of the effectiveness of seasonal influenza vaccination among diabetics.Methods: Using systematic review methods, we searched three electronic databases for published literature (MEDLINE, EMBASE and the Cochrane Library) and two grey literature (SIGLE and NHS EED) databases, to identify studies published between 1997 and 2013, examining the effect of seasonal influenza vaccination, among diabetics, on any measure for influenza morbidity or mortality.Results: 725 records were identified from the three databases and screening, short-listing was undertaken independently by two reviewers. After de-duplication, all records were screened by title and then abstract, and 34 short-listed records were reviewed in full, with 7 studies included: 4 cohort studies and 3 case-control studies, conducted in 7 countries. The most common outcome of interest in studies (n=4) was all-cause mortality among elderly diabetics (>65 years), with individual studies reporting reductions in risk of between 33% [95%CI: 4%-54%] and 68% [95%CI: 58%-75%]. We found only two studies for working-age adult diabetics: one reporting that vaccination prevented hospitalizations due to pneumonia or influenza (vaccine effectiveness [VE] 43%, [95%CI: 28%-54%]) and all-cause hospitalizations (VE: 28% [95%CI: 24%-32%]); and, another reporting no significant decrease in all-cause mortality for working-age adult diabetics. We have identified three major biases: the use of indirect health outcomes, a risk of selection bias (health-seeking bias), and no adjustment for participant pneumococcal vaccination status. The most recent included article finds that morbimortality is still lower during off-season influenza in both vaccinated and non-vaccinated diabetics, indicating important residual confounding.Conclusion: To date, the strength of evidence supporting the routine use of seasonal influenza vaccination is low for diabetics older than 65, and very low for working-age diabetics. [ABSTRACT FROM AUTHOR]

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Abstract: Syndromic surveillance is a novel automated approach to monitoring influenza activity, but there is no consensus regarding the most informative data sources for use within such a system. By comparing physician billing data from Quebec, Canada and hospital admission records, we assessed the timeliness of medical visits for influenza-like illnesses (ILI) to two types of outpatient healthcare settings. Overall, ILI visits by children aged 5–17years at community-based settings were the most strongly correlated with hospital admissions and gave the greatest lead over hospital admissions. However, a degree of year-to-year variation suggests that syndromic surveillance of influenza should not focus on just a single subgroup. These findings reveal the richness of these real-time data for epidemic monitoring and demonstrate the flexibility of syndromic surveillance. By using real-time data, an evolving epidemic can be rapidly characterized by its epidemiological patterns, which is not possible with traditional surveillance systems. [Copyright &y& Elsevier]

Abstract: Antiviral drugs will initially be the mainstay of pharmaceutical intervention in an influenza pandemic. Used primarily for therapeutic treatment, they can also lower transmission in the community. We use mathematical modelling to study the impact of different antiviral coverage strategies, with a limited stockpile. Aggressive coverage offers several advantages, even if this should exhaust the stockpile prematurely. However, where a sub-group of the population has a high mortality risk, a strategy to minimise deaths must be carefully balanced, and is not always in agreement with prioritising treatment for those at risk. We discuss implications for public health planning. [Copyright &y& Elsevier]

Background: Influenzanet was launched in several European countries to monitor influenza-like illness during flu seasons with the help of volunteering participants and Web-based technologies. As in the case of developing fields, ethical approaches are not well developed in the collection, processing, and analysis of participants' information. Existing controversies and varying national ethical regulations can, thus, hamper efficient cross-border research collaboration to the detriment of quality disease surveillance. Objective: This scoping review characterizes current practices on how ethical, legal, and social issues (ELSIs) pertinent to research ethics are handled by different Influenzanet country groups to analyze similarities and identify the need for further harmonization of ethical approaches. Methods: A literature search was carried out on PubMed, Web of Science, Global Digital Library on Ethics, and Bioethics Literature Database to identify ELSIs for Influenzanet country platforms. Only English-language papers were included with publication dates from 2003 to 2017. Publications were screened for the application of bioethics principles in the implementation of country platforms. Additional publications gathered from the Influenzanet Consortium website, reference screening, and conference proceeding were screened for ELSIs. Results: We gathered 96 papers from our search methodology. In total, 28 papers that mentioned ELSIs were identified and included in this study. The Research Ethics Committee (REC) approvals were sought for recruiting participants and collecting their data in 8 of 11 country platforms and informed e-consent was sought from participants in 9 of 11 country platforms. Furthermore, personal data protection was ensured throughout the Consortium using data anonymization before processing and analysis and using aggregated data. Conclusions: Epidemics forecasting activities, such as Influenzanet, are beneficial; however, its benefits could be further increased through the harmonization of data gathering and ethical requirements. This objective is achievable by the Consortium. More transparency should be promoted concerning REC-approved research for Influenzanet-like systems. The validity of informed e-consent could also be increased through the provision of a user friendly and standard information sheet across the Consortium where participants agree to its terms, conditions, and privacy policies before being able to fill in the questionnaire. This will help to build trust in the general public while preventing any decline in participation. [ABSTRACT FROM AUTHOR]

Infodemiology can be defined as the science of distribution and determinants of information in an electronic medium, specifically the Internet, or in a population, with the ultimate aim to inform public health and public policy. Infodemiology data can be collected and analyzed in near real time. Examples for infodemiology applications include: the analysis of queries from Internet search engines to predict disease outbreaks (eg. influenza); monitoring peoples' status updates on microblogs such as Twitter for syndromic surveillance; detecting and quantifying disparities in health information availability; identifying and monitoring of public health relevant publications on the Internet (eg. anti-vaccination sites, but also news articles or expert-curated outbreak reports); automated tools to measure information diffusion and knowledge translation, and tracking the effectiveness of health marketing campaigns. Moreover, analyzing how people search and navigate the Internet for health-related information, as well as how they communicate and share this information, can provide valuable insights into health-related behavior of populations. Seven years after the infodemiology concept was first introduced, this paper revisits the emerging fields of infodemiology and infoveillance and proposes an expanded framework, introducing some basic metrics such as information prevalence, concept occurrence ratios, and information incidence. The framework distinguishes supply-based applications (analyzing what is being published on the Internet, eg. on Web sites, newsgroups, blogs, microblogs and social media) from demand-based methods (search and navigation behavior), and further distinguishes passive from active infoveillance methods. Infodemiology metrics follow population health relevant events or predict them. Thus, these metrics and methods are potentially useful for public health practice and research, and should be further developed and standardized. [ABSTRACT FROM AUTHOR]