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Summary: In this multi-institutional retrospective cohort study, we compared the long-term risk of osteonecrosis of the jaw following the use of denosumab vs. bisphosphonates in osteoporotic patients. After 2-year use, the likelihood of osteonecrosis of the jaw is lower with denosumab compared to bisphosphonates, and the difference increases with time. Purpose: To compare the long-term risk of osteonecrosis of the jaw (ONJ) between osteoporotic patients treated with bisphosphonates (BPs) and denosumab. Methods: This multi-institutional retrospective cohort study included patients aged > 40 years with osteoporosis between January 2010 and December 2018. Patients who met the eligibility criteria were divided into BPs and denosumab groups by propensity score matching (PSM). The risk of ONJ of denosumab vs. BPs was estimated using a Cox proportional hazards model and was described by the cumulative incidence rate using the Kaplan–Meier method. Results: A total of 84,102 patients with osteoporosis were enrolled, among whom, 8962 were eligible for inclusion based on their first-line drug use (denosumab, n = 3,823; BPs, n = 5,139). Following PCM matching (1:1), the BPs and denosumab groups included 3665 patients each. The incidence density of ONJ in the denosumab and BPs matching groups was 1.47 vs. 2.49 events (per 1000 person-years), respectively. The hazard ratio of ONJ in the denosumab vs. BPs group was estimated as 0.581 (95% confidence interval: 0.33–1.04, p = 0.07). The cumulative incidence rates of ONJ in both groups were similar for the first and second years of drug use (p = 0.062), but significantly different from the third year onwards (p = 0.022). The severity of ONJ was not significantly different between the two groups. Conclusion: In osteoporotic patients, after 2 years of use, the likelihood of ONJ being induced by denosumab is lower than that of BPs, and the difference increases with time. [ABSTRACT FROM AUTHOR]

Several species of ambrosia beetles in the genera Euwallacea, Xyleborus, and Xylosandrus (Coleoptera: Curculionidae: Scolytinae) are considered major pests in agriculture, forestry and urban areas. Their concealed lifestyle allows them to evade detection, and increases their chances of being introduced to non-native regions. Their reproduction is dominated by sibling mating within maternal galleries, and this behaviour makes them difficult to control. Although a handful of studies have identified natural enemies associated with ambrosia beetles, very few have done this with the goal of creating a classical biological control programme. In this study, we sought to identify hymenopteran parasitoids associated with the invasive Euwallacea fornicatus species complex. We collected branches from infested trees in a native region in Taiwan, recorded parasitoid emergence, and attempted to rear any emerging parasitoids using laboratory reared hosts and experimentally infested logs. We identified three species of parasitoid wasps that successfully parasitised beetles in the E. fornicatus species complex. These species were all new to science belonging to the genera Eucosmophorus (Braconidae), Phymastichus (Eulophidae), and Plastanoxus (Bethylidae). [ABSTRACT FROM AUTHOR]

This study aimed to identify the key factors that may influence farmers' support for organic farming, which is an eco-friendly approach that nourishes the productivity of agricultural and ecological systems. To explore farmers' adoption of organic-agriculture-related behaviors and the factors that influence these behavioral intentions, this research developed a questionnaire based on Kaiser's theory of ecological behavior. The participants were 152 farmers, who were recruited via stratified sampling from four major agricultural zones in the county. The results revealed that environmental knowledge, environmental value, and feelings of responsibility positively influenced farmers' behavioral intentions toward organic agriculture. The positive influence of environmental knowledge on behavioral intentions was enhanced by farmers' experience, age, and time spent in agriculture each week. However, the positive influences of environmental value and feelings of responsibility were not moderated by the three aforementioned variables. Appropriate promotional and educational measures should incorporate the real-life experiences of farmers to increase their environmental knowledge, environmental value, and feelings of responsibility toward organic agriculture, thereby effectively enhancing their willingness to adopt this type of agriculture. [ABSTRACT FROM AUTHOR]

Border management serves as a crucial control checkpoint for governments to regulate the quality and safety of imported food. In 2020, the first-generation ensemble learning prediction model (EL V.1) was introduced to Taiwan's border food management. This model primarily assesses the risk of imported food by combining five algorithms to determine whether quality sampling should be performed on imported food at the border. In this study, a second-generation ensemble learning prediction model (EL V.2) was developed based on seven algorithms to enhance the "detection rate of unqualified cases" and improve the robustness of the model. In this study, Elastic Net was used to select the characteristic risk factors. Two algorithms were used to construct the new model: The Bagging-Gradient Boosting Machine and Bagging-Elastic Net. In addition, Fβ was used to flexibly control the sampling rate, improving the predictive performance and robustness of the model. The chi-square test was employed to compare the efficacy of "pre-launch (2019) random sampling inspection" and "post-launch (2020–2022) model prediction sampling inspection". For cases recommended for inspection by the ensemble learning model and subsequently inspected, the unqualified rates were 5.10%, 6.36%, and 4.39% in 2020, 2021, and 2022, respectively, which were significantly higher (p < 0.001) compared with the random sampling rate of 2.09% in 2019. The prediction indices established by the confusion matrix were used to further evaluate the prediction effects of EL V.1 and EL V.2, and the EL V.2 model exhibited superior predictive performance compared with EL V.1, and both models outperformed random sampling. [ABSTRACT FROM AUTHOR]

The Euwallacea fornicatus species complex (Coleoptera: Curculionidae: Scolytinae: Xyleborini) is a group of four cryptic ambrosia beetle species. Native to Asia, several members of the complex have invaded other continents, where they cause significant economic losses to agricultural crops (e.g., avocado) and natural ecosystems. We were primarily interested in developing management strategies by focusing on the flight behavior of the beetles. Thus, seasonal differences in flight activity were assessed using panel traps baited with a commercial quercivorol lure, placed in infested avocado orchards in Danei, Tainan, Taiwan. Same traps were used to investigate the flight activity of a natural enemy, an undescribed species of the Braconid genus Eucosmophorus sp. Shothole borer species were identified using a DNA-based, high resolution melting assay. Trap data were compared to the predictions of a simple degree-day model, incorporating developmental data and several environmental parameters known to influence flight. Such as the time period representing most of flight activity in a day and temperature-dependent flight propensity. In stark contrast to the degree-day model which predicted the highest emergence, and by extension flight, of shothole borers during spring and summer (May to November), flight activity was actually lowest during these months, and instead, peaked during the winter (October to March). Abundance of the parasitoid wasp closely mirrored flight activity of the shothole borers. The mismatch of trapping and modeling data can have many causes, heavy precipitation and possibly cooperative brood care may suppress the dispersal behavior of the shothole borers during the summer. [ABSTRACT FROM AUTHOR]

Species belonging to the Euwallacea fornicatus Eichhoff (Coleoptera: Scolytinae) species complex have invaded the continental U.S. since at least 2003. Three species of this complex are known to have established, two in California (E. fornicatus; and Euwallacea kuroshio), and a third in Florida (Euwallacea perbrevis). Their native ranges are spread across southern and southeast Asia. In Taiwan, all three species occur in sympatry. They attack healthy trees of widely varied species and cause severe damage and death to the trees. The attractant quercivorol is commonly used to promote their detection by passive trapping. Recent studies in Florida have shown that trapping of E. perbrevis can be further improved by adding a synergist, α-copaene, alongside the quercivorol lure. Thus, we were interested in testing the effectiveness of α-copaene for trapping the other invasive members of the complex in California and in an area of Taiwan where all three species co-occur. We found that α-copaene marginally enhanced the trapping of E. perbrevis in Taiwan, but had no effect on the trapping of E. fornicatus or E. kuroshio in either California or Taiwan. We conclude that any enhancing effect of α-copaene is specific to E. perbrevis. This highlights the economic importance of accurate species identification in developing and implementing an efficient, and yet cost-effective, monitoring program for the management of E. fornicatus and E. kuroshio in California and elsewhere. [ABSTRACT FROM AUTHOR]

Background The factors that predict the progression of Mycoplasma pneumoniae infection remain inconclusive. Therefore, we investigated macrolide resistance prevalence, M pneumoniae genotype, and clinical characteristics of childhood M pneumoniae respiratory tract infections in Taiwan. Methods A total of 295 children hospitalized with respiratory tract infections with positive serological M pneumoniae immunoglobulin M test results were enrolled in this 3-year prospective study. Oropharyngeal swabs were obtained for M pneumoniae cultures and polymerase chain reaction tests. All M pneumoniae specimens were further characterized by P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide resistance genotyping. The clinical characteristics and blood cytokine profiles were analyzed accordingly. Results Of 138 M pneumoniae specimens, type I P1 was the predominant (136 of 138, 98.6%). The MLVA type P (4-4-5-7-2) was the leading strain (42 of 138, 30.4%), followed by type J, U, A, and X. The overall macrolide-resistant rate was 38.4% (53 of 138); the resistance rate increased dramatically yearly: 10.6% in 2017, 47.5% in 2018, and 62.5% in 2019 (P  < .001). All macrolide-resistant M pneumoniae (MRMP) harbored the A2063G mutation and were MLVA type 4-5-7-2 (49 of 53, 92.5%), especially type U and X. No significant differences in clinical symptoms, duration of hospital stay, and radiographic findings were identified among patients between MRMP and macrolide-sensitive M pneumoniae (MSMP) groups. Patients with MRMP infection had more febrile days before and during hospitalization and higher interleukin (IL)-13 and IL-33 levels than patients with MSMP infection (P  < .05). Conclusions Macrolide-resistant M pneumoniae surged in Taiwan throughout the study period, but macrolide resistance was not a determinant factor of clinical severity. [ABSTRACT FROM AUTHOR]

The Euwallacea fornicatus species complex is native to Asia but has invaded many countries globally. This complex includes four cryptic species that infest a wide range of economic crops, including tea. One of them is Euwallacea perbrevis Schedl, which has been a major pest of tea in Sri Lanka and India for over a century. The species complex was first recorded infesting tea in Taiwan over 80 years ago but the specific identity of that first record is unknown. Furthermore, although tea is an important industry in Taiwan, this pest has attracted limited attention. Hence, we surveyed tea gardens across the island, determining infestation rates, and identifying the Euwallacea species present. We also used sticky traps to monitor the annual flight dynamics of the beetles and of a parasitoid natural enemy, an undescribed species of Eucosmophorus. Levels of infestation varied even between neighboring gardens. Highly infested tea gardens were located mainly in central Taiwan and some in eastern Taiwan. The peak flight activity of the species complex occurred between October and March, when the parasitoid was also abundant. Molecular identification of the trapped beetles identified them as E. fornicatus sensu stricto Eichhoff and E. kuroshio Gomez & Hulcr, but E. perbrevis was not detected. In contrast to the situation in Sri Lanka, where E. perbrevis attacks the highly visible terminal branches of the tea plant, in Taiwan, E. fornicatus s. s. and E. kuroshio predominantly attacked the main bole and underground parts. We propose that the 'hidden' nature of this attack, and the similarities of the symptoms to a common fungal disease of tea, may have led to an underestimation of the impact of the species complex on tea, not only in Taiwan but also in other tea growing countries. • E. fornicatus s. s. and E. kuroshio are dominant in tea gardens of Taiwan. • E. perbrevis was not detected in tea gardens of Taiwan. • Peak flight activity of SHB occurred between October and March. • SHB prefer to attack lower part of the main trunk of the tea plant. [ABSTRACT FROM AUTHOR]

Abstract: Fifty-seven salted seafood products sold in the fishing village stores in Taiwan, including salted fish product, salted mollusc product and salted shrimp product, were tested to determine the occurrence of histamine and histamine-forming bacteria. Although the average content of each of nine different biogenic amines in all samples was less than 5.0mg/100g, 10.5% (6/57) of tested samples had the histamine content greater than the 5.0mg/100g allowable limit suggested by the US Food and Drug Administration. One histamine-producing bacterial strain, capable of producing 78.5ppm of histamine in trypticase soy broth supplemented with 1.0% l-histidine (TSBH), was identified as Bacillus megaterium. The B. megaterium isolate was a halotolerant bacterium which grew well to an elevated NaCl concentration of 15% in TSBH medium. Besides, it had a consistent ability to produce >300ppm of histamine at 10% NaCl concentration in TSBH medium after 72h. [Copyright &y& Elsevier]

Abstract: This study explores technological innovations and industry clustering in the bicycle industry in Taiwan. It shows that clustering in the bicycle industry not only decreases transaction costs among the firms in the cluster but also increases cooperation and efficiency between the bicycle manufacturers and their partners as a result of standardization and modularization of bicycle components. Following a patent analysis, the study finds that two systems—the wheel system and the bicycle frame system—are the strengths of Taiwanese bicycle and component manufacturers; conversely, the transmission (i.e., gears) and brake systems are their weaknesses. Moreover, industry clustering increases the efficiency of information exchange such that the spillover effect of technological innovation is significant. [Copyright &y& Elsevier]

• Avian polyomavirus (APV) isolates collected from parrots in Taiwan were amplified via polymerase chain reaction, after which the whole genomes of these isolates were sequenced. • The APV-positive rate was 14.2%, and the full lengths of the APV Taiwan isolates varied from 4971 to 4982 bps. • The nucleotide identities of the VP1 and VP4 genes ranged from 98.8 to 100%, whereas the nucleotide sequence of the Large T-Ag gene had the highest identity. • APV Taiwan isolates could be classified into five independent groups in a phylogenetic tree based on the whole genome. • Two possible recombination events in the genomes of APV isolates were identified. Avian polyomavirus (APV) is a non-enveloped virus with a circular double-stranded DNA genome approximately 5000 bp in length. APV was first reported in fledgling budgerigars (Melopsittacus undulatus) as the causative agent of budgerigar fledgling disease, resulting in high parrot mortality rates in the 1980s. This disease has been observed worldwide, and APV has a wide host range including budgerigars, cockatoos, lorikeets, lovebirds, and macaws. Twenty APV isolates have been collected from healthy and symptomatic parrots in Taiwan from 2015 to 2019. These isolates were then amplified via polymerase chain reaction, after which the whole genomes of these isolates were sequenced. The overall APV-positive rate was 14.2%, and the full lengths of the APV Taiwan isolates varied from 4971 to 4982 bps. The APV genome contains an early region that encodes two regulatory proteins (the large tumor antigen (Large T-Ag) and the small tumor antigen (Small t-Ag)) and a late region which encodes the capsid proteins VP1, VP2, VP3, and VP4. The nucleotide identities of the VP1 and VP4 genes ranged from 98.7 to 100%, whereas the nucleotide sequence of the Large T-Ag gene had the highest identity (99.2–100%) relative to other APV isolates from the GenBank database. A phylogenetic tree based on the whole genome demonstrated that the APV Taiwan isolates were closely related to Japanese and Portuguese isolates. Recombination events were analyzed using the Recombination Detection Program version 4 and APV Taiwan isolate TW-3 was identified as a minor parent of the APV recombinants. In this study, we first reported the characterization of the whole genome sequences of APV Taiwan isolates and their phylogenetic relationships with all APV isolates available in the GenBank database. [ABSTRACT FROM AUTHOR]

Abstract: This study focuses on a project with benchmark significance in the Taiwan government’s Web 2.0 plan, and employs on-site observation and in-depth interviews to explore how the government uses policies to help innovators obtain complementary resources, and thereby speed up the pace of service innovation and enhance the service innovation success rate. The results of this study indicate that the government can successfully intervene in the service innovation process. First, the government can develop systematic service innovation methodologies providing innovators with clear steps and principles to follow when determining target groups and performing service design and verification. Second, because most innovators are limited by insufficient resources and it is usually difficult for innovators to obtain relevant resources during the service innovation process, the service innovation success rate is quite low. With an eye on this, the government should actively clarify key issues that may be faced by innovators during each stage of the service innovation process, and can use various policy tools to provide innovators with the complementary resources needed at each stage, increasing innovators’ chance of success. [Copyright &y& Elsevier]

Coronaviruses (CoVs) are significant animal and human pathogens, characterized by being enveloped RNA viruses with positive-sense single-stranded RNA. The Coronaviridae family encompasses four genera, among which gammacoronaviruses pose a major threat to the poultry industry, which infectious bronchitis virus (IBV) being the most prominent of these threats. Particularly, IBV adversely affects broiler growth and egg production, causing substantial losses. The IBV strains currently circulating in Taiwan include the IBV Taiwan-I (TW-I) serotype, IBV Taiwan-II (TW-II) serotype, and vaccine strains. Therefore, ongoing efforts have focused on developing novel vaccines and discovering antiviral agents. The envelope (E) proteins of CoVs accumulate in the endoplasmic reticulum-Golgi intermediate compartment prior to virus budding. These E proteins assemble into viroporins, exhibiting ion channel activity that leads to cell membrane disruption, making them attractive targets for antiviral therapy. In this study, we investigated the E proteins of IBV H-120, as well as IBV serotypes TW-I and TW-II. E protein expression resulted in inhibited bacteria growth, increased permeability of bacteria to β-galactosidase substrates, and blocked protein synthesis of bacteria by hygromycin B (HygB). Furthermore, in the presence of E proteins, HygB also impeded protein translation in DF-1 cells and damaged their membrane integrity. Collectively, these findings confirm the viroporin activity of the E proteins from IBV H-120, IBV serotype TW-I, and IBV serotype TW-II. Next, the viroporin inhibitors, 5-(N,N-hexamethylene) amiloride (HMA) and 4,4'-diisothiocyano stilbene-2,2'-disulphonic acid (DIDS) were used to inhibit the viroporin activities of the E proteins of IBV H-120, IBV serotype TW-I, and IBV serotype TW-II. In chicken embryos and chickens infected with IBV serotypes TW-I and IBV TW-II, no survivors were observed at 6 and 11 days post-infection (dpi), respectively. However, treatments with both DIDS and HMA increased the survival rates in infected chicken embryos and chickens and mitigated histopathological lesions in the trachea and kidney. Additionally, a 3D pentameric structure of the IBV E protein was constructed via homology modeling. As expected, both inhibitors were found to bind to the lipid-facing surface within the transmembrane domain of the E protein, inhibiting ion conduction. Taken together, our findings provide comprehensive evidence supporting the use of viroporin inhibitors as promising antiviral agents against IBV Taiwan isolates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Young children are susceptible to enterovirus (EV) infections, which cause significant morbidity in this age group., Objective: This study investigated the characteristics of virus strains and the epidemiology of EVs circulating among young children in Taiwan from 2011 to 2020., Methods: Children diagnosed with EV infections from 2011 to 2020 were identified from the routine national health insurance data monitoring disease system, real-time outbreak and disease surveillance system, national laboratory surveillance system, and Statistics of Communicable Diseases and Surveillance Report, a data set (secondary data) of the Taiwan Centers for Disease and Control. Four primary outcomes were identified: epidemic features, characteristics of sporadic and cluster cases of EV infections, and main cluster institutions., Results: From 2011 to 2020, between 10 and 7600 person-times visited the hospitals for EV infections on an outpatient basis daily. Based on 2011 to 2020 emergency department EV infection surveillance data, the permillage of EV visits throughout the year ranged from 0.07‰ and 25.45‰. After typing by immunofluorescence assays, the dominant type was coxsackie A virus (CVA; 8844/12,829, 68.9%), with most constituting types CVA10 (n=2972), CVA2 (n=1404), CVA6 (n=1308), CVA4 (n=1243), CVA16 (n=875), and CVA5 (n=680); coxsackie B virus CVB (n=819); echovirus (n=508); EV-A71 (n=1694); and EV-D68 (n=10). There were statistically significant differences (P<.001) in case numbers of EV infections among EV strains from 2011 to 2020. Cases in 2012 had 15.088 times the odds of being EV-A71, cases in 2014 had 2.103 times the odds of being CVA, cases in 2015 had 1.569 times the odds of being echovirus, and cases in 2018 had 2.274 times the odds of being CVB as cases in other years. From 2011 to 2020, in an epidemic analysis of EV clusters, 57 EV clusters were reported. Clusters that tested positive included 53 (53/57, 93%) CVA cases (the major causes were CVA6, n=32, and CVA10, n=8). Populous institutions had the highest proportion (7 of 10) of EV clusters., Conclusions: This study is the first report of sporadic and cluster cases of EV infections from surveillance data (Taiwan Centers for Disease and Control, 2011-2020). This information will be useful for policy makers and clinical experts to direct prevention and control activities to EV infections that cause the most severe illness and greatest burden to the Taiwanese., (© Fang-Chen Liu, Bao-Chung Chen, Yao-Ching Huang, Shi-Hao Huang, Ren-Jei Chung, Pi-Ching Yu, Chia-Peng Yu. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).)

Before the COVID-19 pandemic, Mycoplasma pneumoniae infections emerged during spring to summer yearly in Taiwan, but infections were few during the pandemic. M. pneumoniae macrolide resistance soared to 85.7% in 2020 but declined to 0% during 2022-2023. Continued molecular surveillance is necessary to monitor trends in macrolide-resistant M. pneumoniae.

Myopia has been linked to body weight and sedentary status, but the association with quantitatively measured physical fitness in adults has not been examined. Cross-sectional analyses were performed to investigate the association between physical fitness and myopia in 3,669 military men (aged 29.4 years) in Taiwan. The severity of myopia obtained from the left eye was classified as mild (-0.5 to -3.0 diopters; n = 544), moderate -3.1 to -6.0 diopters; n = 563), and high (<-6.0 diopters; n =150); others were defined as nonmyopia ( n = 2,412). Aerobic fitness was evaluated by time for a 3000-meter run test, and muscular endurance was evaluated by numbers of 2-min sit-ups and 2-min push-ups. A value of p < .0125 was considered significant. A multiple linear regression analysis was used to determine the relationship. Individuals who were less physically fit had higher risk of myopia. The associations were dose-dependently significant with mild, moderate, and high myopia for 3000-meter running time (β = 9.64; 95% confidence intervals [3.22, 16.05], β = 12.41; 95% CI [6.05, 18.76], and β = 20.87; 95% CI [9.22, 32.51], respectively) after controlling for the potential covariates. There tended to be an inverse association with moderate and high myopia for numbers of 2-min push-ups (β = -1.38; 95% CI [-2.43, -0.34] and β = -2.10; 95% CI [- 3.97, -0.22], respectively) and 2-min sit-ups (β = -0.83; 95% CI [-1.54, -0.12] and β = -1.29; 95% CI [-2.56, -0.02], respectively), respectively. This study suggested that physical fitness, particularly aerobic fitness of the military males who received regular training, is inversely associated with myopia severity, independent of service specialty, body mass index, and educational level.

We report 2 cases of neonatal Legionella infection associated with aspiration of contaminated water used in hospitals to make infant formula. The molecular profiles of Legionella strains isolated from samples from the infants and from water dispensers were indistinguishable. Our report highlights the need to consider nosocomial legionellosis among neonates who have respiratory symptoms.

Objective: Spontaneous intracranial hypotension (SIH) is caused by spinal cerebrospinal fluid (CSF) leakage. An underlying connective tissue disorder has been hypothesized to cause dural weakness and predisposition to CSF leak. We conducted a case-controlled study to investigate the role of connective tissue disorders in SIH patients., Methods: We recruited 55 consecutive SIH patients (38 F, 17 M; mean age, 40.8 ± 9.8 years) and 55 age- and sex-matched control individuals (mean age, 38.0 ± 8.9 years) for this study. The connective tissue disorders were evaluated by: (i) Beighton hypermobility scores and revised diagnostic criteria for benign joint hypermobility syndrome; (ii) skin and skeletal manifestations of Ehlers-Danlos syndrome (EDS); and (iii) skeletal features of Marfan syndrome., Results: The frequencies of joint hypermobility according to Beighton scores >4/9 (SIH 23.6% vs controls 16.4%, P = 0.48) and revised benign joint hypermobility syndrome criteria (SIH 23.6% vs controls 34.5%, P = 0.29) did not differ between SIH patients and controls. Sixteen patients and 16 controls had one or more skin features of EDS (P = 1.0). Nine SIH patients (16.4%) demonstrated the skeletal features of Marfan syndrome; this frequency did not differ from that of the control group (9.1%; P = 0.262). Only dolichostenomelia (disproportionately long limbs) was more prominent in SIH patients than in controls (34.5% vs 9.1%; P = 0.002)., Conclusion: Compared with Western studies, the frequencies of connective tissue disorders were higher in our SIH patients. However, these frequencies did not differ between SIH patients and control individuals, except for dolichostenomelia.

Background: An epidemic of influenza B/Malaysia/2506/2004 was reported in Taiwan during the 2006-2007 flu season. We investigated the flu vaccination history and clinical and Laboratory characteristics of children with influenza B infection., Methods: We enrolled children younger than 18 years old who visited one of two hospitals between November 2006 and February 2007 with influenza-like illnesses. Throat swabs were taken on their first visit and cultured for viruses. Complete and differential blood counts and blood biochemical parameters were analyzed in some children., Results: Influenza virus was cultured from 51.0% of patients (101/198), 87 (86.1%) of who were infected with influenza virus type B. The remaining 14 (13.9%) were infected with influenza virus type AH3. The 87 children (median age 7.8 years) with culture-proven influenza B virus infection were enrolled. Nine parents reported that enrolled children had been vaccinated against influenza. Leukopenia was found in 56.1% (32/57) of patients, leukocytosis in 3.5% (2/57), and thrombocytopenia in 1.8% (1/57). Thirteen of 23 patients (56%) tested for creatine kinase (CK) had elevated levels ( >160 U/L), and 11 of 23 (47.8%) had myalgia associated with raised CK (p < 0.05). Twenty-six children developed complications, including one case of pneumonia with acute respiratory distress syndrome and one case of flu-associated encephalitis., Conclusion: Most children who contracted influenza B infection had not been vaccinated. Almost half the children had leukopenia, and some had leukocytosis, but thrombocytopenia was rare. There was a significant association between raised CK levels and myalgia in influenza B infection.