Search

Background Human respiratory syncytial virus (hRSV) is a leading cause of acute lower respiratory tract infection in frail individuals, including children, the elderly and immunocompromised people, with mild to severe symptoms. World Health Organization claims hRSV causes most elderly influenza-like illnesses (ILI) and severe acute respiratory infections (SARI). In this study, different case definitions for hRSV surveillance were examined for accuracy. Methods The following search query ('Respiratory Syncytial Virus' OR 'RSV' OR 'hRSV' AND 'case definition') was used on PubMed/MEDLINE and Scopus with a 15-year-old baseline age restriction to conduct a systematic literature review. Results Of 12 records, 58% employed the SARI definition, 50% the ILI definition and 42% the acute respiratory infection (ARI) definition, with some overlap. In young adults (18–64 years old), most studies show RSV prevalence between 6.25 and 72.54 cases per 1000 per year, and 19.23 to 98.5 in older adults. The outpatient ARI and hospitalized SARI criteria are particularly sensitive and specific. Conclusions Disease burden measurement requires a clear case definition; however, current literature is questionable. Currently, hRSV surveillance uses numerous case definitions with debatable accuracy. The epidemiology, clinical characteristics, and disease burden of hRSV are difficult to characterize without a standard surveillance case definition. [ABSTRACT FROM AUTHOR]

Around the world, the people are simultaneously susceptible to or infected with several infections. This work aims at the analysis of the dynamics of transmission of two deadly viruses, COVID-19 and Influenza, using a co-infection epidemiological model by applying the Caputo fractional derivative. Fractional differential equations are currently used worldwide to model physical and biological phenomena. Our comprehension of complicated phenomena is improved when fractional-order derivatives are used to model systems with memory effects and long-range interactions. Mathematical depictions of infectious disease dynamics and dissemination across communities are provided by epidemiological models, which are essential resources for understanding and controlling infectious diseases. These models support informed decision making to prevent outbreaks, evaluate intervention measures, and help researchers and policymakers understand how diseases spread. A subclass of epidemiological models called co-infection models focuses on studying the dynamics of several infectious illnesses that occur in the same population at the same time. They are especially useful in situations where people are simultaneously susceptible to or infected with several infections. Co-infection models provide information on the development of effective control techniques, the progression of disease, and the interactions between several pathogens. The qualitative study via stability analysis is discussed at equilibrium, the reproduction number R 0 is computed, and the results are simulated using the Laplace Adomian Decomposition Method (LADM) for Fractional Differential Equations. We employ MATLAB R2023a for graphical presentations and numerical simulations. [ABSTRACT FROM AUTHOR]

The basic reproduction, or reproductive number, is a useful index that indicates whether or not there will be an epidemic. However, it is also very important to determine whether an epidemic will eventually decrease and disappear or persist as an endemic. Different infectious diseases have different behaviors and mathematical models used to simulated them should capture the most important processes; however, the models also involve simplifications. Influenza epidemics are usually short-lived and can be modeled with ordinary differential equations without considering demographics. Delays such as the infection time can change the behavior of the solutions. The same is true if there is permanent or temporary immunity, or complete or partial immunity. Vaccination, isolation and the use of antivirals can also change the outcome. In this paper, we introduce several new models and use them to find the effects of all the above factors paying special attention to whether the model can represent an infectious process that eventually disappears. We determine the equilibrium solutions and establish the stability of the disease-free equilibrium using various methods. We also show that many models of influenza or other epidemics with a short duration do not have solutions with a disappearing epidemic. The main objective of the paper is to introduce different ways of modeling immunity in epidemic models. Several scenarios with different immunities are studied since a person may not be re-infected because he/she has total or partial immunity or because there were no close contacts. We show that some relatively small changes, such as in the vaccination rate, can significantly change the dynamics; for example, the existence and number of the disease-free equilibria. We also illustrate that while introducing delays makes the models more realistic, the dynamics have the same qualitative behavior. [ABSTRACT FROM AUTHOR]

Influenza affects a considerable proportion of the global population each year, and meteorological conditions may have a significant impact on its transmission. In this study, we aimed to develop a prediction model for the number of influenza patients at the national level using satellite images and provide a basis for predicting influenza through satellite image data. We developed an influenza incidence prediction model using satellite images and influenza patient data. We collected satellite images and daily influenza patient data from July 2014 to June 2019 and developed a convolutional long short-term memory (LSTM)–LSTM neural network model. The model with the lowest average of mean absolute error (MAE) was selected. The final model showed a high correlation between the predicted and actual number of influenza patients, with an average MAE of 5.9010 per million population. The model performed best with a 2-week time sequence. We developed a national-level prediction model using satellite images to predict influenza incidence. The model offers the advantage of nationwide analysis. These results may reduce the burden of influenza by enabling timely public health interventions. [ABSTRACT FROM AUTHOR]

To report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. Outbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. An epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. The outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9–14 years, 84.6% in those aged 15–24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. The fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved. [ABSTRACT FROM AUTHOR]

Background: The emergence of SARS‐CoV‐2 in late 2019 saw the implementation of public health and social measures (PHSM) by countries across Europe to reduce its transmission and impact on populations. Consequently, countries reported changes in influenza circulation and extensive disruptions to routine surveillance systems. Methods: We describe the epidemiology of influenza in Europe between Weeks 40/2020 and 39/2022 compared to the 2016/17 to 2019/20 seasons, to assess the impact of the COVID‐19 pandemic and PHSM on surveillance systems and influenza circulation. Results: Low detections of influenza were observed through primary care sentinel sources during seasonal influenza periods (Week 40 to 20); 56 (of 39,457 specimens tested; < 1% positivity) in 2020/21 and 7261 (of 64,153 specimens tested; 11% positivity) detections in 2021/22 were observed, compared to an average of 18,383 (of 50,544 specimens tested; 36% positivity) detections in 2016/17 to 2019/20. Similarly, 11 (of 19,989 specimens tested; < 1% positivity) and 1488 (of 23,636 specimens tested; 6% positivity) detections were reported through SARI surveillance sources in 2020/21 and 2021/22, respectively, compared to an average of 2850 (of 10,389 specimens tested; 27% positivity) detections in 2016/17 to 2019/20. However, the 2021/22 interseasonal period saw unusual increases in influenza detections across surveillance site types when PHSM were easing. Conclusion: In conclusion, findings suggest that the restriction and easing of PHSM measures were associated with variations in influenza detections. Our observations of out‐of‐season influenza activity highlight the importance of an integrated respiratory surveillance strategy to monitor circulating respiratory viruses throughout the year to inform optimal prevention and control strategies. [ABSTRACT FROM AUTHOR]

Background Influenza circulation during the 2022–2023 season in the United States largely returned to pre–coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain. Methods To understand effectiveness of the 2022–2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2–negative control-patients. Results A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%–46%) and varied by age (18–64 years: 47% [30%–60%]; ≥65 years: 28% [10%–43%]), and virus (A[H3N2]: 29% [6%–46%], A[H1N1]: 47% [23%–64%]). VE against more severe influenza-associated outcomes included: 41% (29%–50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%–72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%–81%) against influenza with respiratory failure treated with invasive mechanical ventilation. Conclusions During an early 2022–2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure. [ABSTRACT FROM AUTHOR]

Background The Global Influenza Hospital Surveillance Network (GIHSN) has since 2012 provided patient-level data on severe influenza-like-illnesses from >100 participating clinical sites worldwide based on a core protocol and consistent case definitions. Methods We used multivariable logistic regression to assess the risk of intensive care unit admission, mechanical ventilation, and in-hospital death among hospitalized patients with influenza and explored the role of patient-level covariates and country income level. Results The data set included 73 121 patients hospitalized with respiratory illness in 22 countries, including 15 660 with laboratory-confirmed influenza. After adjusting for patient-level covariates we found a 7-fold increase in the risk of influenza-related intensive care unit admission in lower middle-income countries (LMICs), compared with high-income countries (P =.01). The risk of mechanical ventilation and in-hospital death also increased by 4-fold in LMICs, though these differences were not statistically significant. We also find that influenza mortality increased significantly with older age and number of comorbid conditions. Across all severity outcomes studied and after controlling for patient characteristics, infection with influenza A/H1N1pdm09 was more severe than with A/H3N2. Conclusions Our study provides new information on influenza severity in underresourced populations, particularly those in LMICs. [ABSTRACT FROM AUTHOR]

Introduction: Influenza is a serious underestimated viral infection in Pakistan and influenza vaccination and vaccination awareness are low. The current work aimed to develop consensus on influenza epidemiology, prevention, vaccination, and awareness in Pakistan. Methodology: A systematic literature search was conducted to develop recommendations on influenza vaccines in Pakistan. Experts' feedback was incorporated using the modified Delphi method. A three-step process was used, with 18 experts from different specialties from Pakistan who participated in voting rounds to achieve a minimum 75% agreement level. Results: Pakistan has a low-immunization-rate and is susceptible to serious influenza outbreaks and influenza-related complications. Influenza circulates year-round in Pakistan but peaks during January and February. The subtype A/H1N1 is predominant. The experts urged vaccination in all individuals ≥ 6 months of age and with no contraindications. They highlighted special considerations for those with comorbidities and specific conditions. The experts agreed that the inactivated influenza vaccine is safe and efficient in pregnant women, immunocompromised, and comorbid respiratory and cardiovascular patients. Finally, the experts recommended conducting promotional and educational programs to raise awareness on influenza and vaccination. Conclusions: This is the first regional consensus on influenza and influenza vaccination in Pakistan with experts' recommendations to increase influenza vaccination and decrease influenza cases and its associated detrimental effects. [ABSTRACT FROM AUTHOR]

Background Influenza immunization programs aim to reduce the risk and burden of severe outcomes. To inform optimal program strategies, we monitored influenza hospitalizations over 7 seasons, stratified by age, comorbidity, and vaccination status. Methods We assembled data from 4 hospitals involved in an active surveillance network with systematic collection of nasal samples and polymerase chain reaction testing for influenza virus in all patients admitted through the emergency department with acute respiratory infection during the 2012–2013 to 2018–2019 influenza seasons in Quebec, Canada. We estimated seasonal, population-based incidence of influenza-associated hospitalizations by subtype predominance, age, comorbidity, and vaccine status, and derived the number needed to vaccinate to prevent 1 hospitalization per stratum. Results The average seasonal incidence of influenza-associated hospitalization was 89/100 000 (95% confidence interval, 86–93), lower during A(H1N1) (49–82/100 000) than A(H3N2) seasons (73–143/100 000). Overall risk followed a J-shaped age pattern, highest among infants 0–5 months and adults ≥75 years old. Hospitalization risks were highest for children <5 years old during A(H1N1) but for highest adults aged ≥75 years during A(H3N2) seasons. Age-adjusted hospitalization risks were 7-fold higher among individuals with versus without comorbid conditions (214 vs 30/100 000, respectively). The number needed to vaccinate to prevent hospitalization was 82-fold lower for ≥75-years-olds with comorbid conditions (n = 1995), who comprised 39% of all hospitalizations, than for healthy 18–64-year-olds (n = 163 488), who comprised just 6% of all hospitalizations. Conclusions In the context of broad-based influenza immunization programs (targeted or universal), severe outcome risks should be simultaneously examined by subtype, age, comorbidity, and vaccine status. Policymakers require such detail to prioritize promotional efforts and expenditures toward the greatest and most efficient program impact. [ABSTRACT FROM AUTHOR]

During health emergencies, non-pharmaceutical interventions (NPIs) are adopted in various combinations until a vaccine can be produced and widely administered. Containment strategies, including the closure of schools, churches, and dance halls; banning of mass gatherings; mandatory mask wearing; isolation; and disinfection/hygiene measures, require reasonable compliance to be successfully implemented. But what are the most effective measures? To date, few systematic studies have been conducted on the effects of various interventions used in past epidemics/pandemics. Important contributions to our understanding of these questions can be obtained by investigating the historical data from the great influenza pandemic of 1918, an event widely considered one of the greatest natural disasters in human history. Taking on particular importance is the study of the possible role played by the behaviour of the population and the lack of public obedience to the non-pharmaceutical interventions in a Mediterranean country like Italy—one of the most affected countries in Europe—during that pandemic, with special attention paid to the weight of the socio-cultural factors which hindered the ultimate goal of containing the spread of the virus and preventing excess deaths in the country. [ABSTRACT FROM AUTHOR]

Purpose: To assess the epidemiology of seasonal influenza in Huzhou City, Zhejiang Province, China, during 2018–2022 and provide insights for influenza prevention. Methods: Following the National Influenza Surveillance Program, we conducted pathogen surveillance by randomly sampling throat swabs from cases with influenza-like illness (ILI) at two sentinel hospitals. Results: From 2018 to 2022, a total of 3,813,471 cases were treated at two hospitals in Huzhou, China. Among them, there were 112,385 cases of Influenza-Like Illness (ILI), accounting for 2.95% of the total number of cases. A total of 11,686 ILI throat swab samples were tested for influenza viruses, with 1,602 cases testing positive for influenza virus nucleic acid, resulting in a positivity rate of 13.71%. Among the positive strains, there were 677 strains of A(H3N2) virus, 301 strains of A(H1N1) virus, 570 strains of B/Victoria virus, and 54 strains of B/Yamagata virus. The ILI percentage (ILI%) and influenza nucleic acid positivity rate showed winter-spring peaks in the years 2018, 2019, 2021, and 2022, with the peaks concentrated in January and February. Additionally, a small peak was observed in August 2022 during the summer season. No peak was observed during the winter-spring season of 2020. The highest proportion of ILI cases was observed in children aged 0–4 years, followed by school-age children aged 5–14 years. There was a positive correlation between ILI% and influenza virus nucleic acid positivity rate (r = 0.60, p < 0.05). Conclusions: The influenza outbreak in Huzhou from 2020 to 2022 was to some extent influenced by the COVID-19 pandemic and public health measures. After the conclusion of the COVID-19 pandemic, the influenza outbreak in Huzhou may become more severe. Therefore, it is crucial to promptly assess the influenza outbreak trends based on the ILI% and the positivity rate of influenza virus nucleic acid tests. [ABSTRACT FROM AUTHOR]

Background The incidence of certain vaccine-preventative diseases, such as influenza, herpes zoster and pneumococcal infection, continues to be high despite the availability of vaccines, resulting in a substantial health and economic burden on society, particularly among older adults aged ≥65 years. Methods A cost calculator was developed to assess the cost of illness of influenza, herpes zoster and pneumococcal disease in France. Direct medical costs related to diagnosis and treatment in the older adult population in both inpatient and outpatient settings were modelled over a 1-year time horizon. Scenario analyses were conducted to determine the impact of hospitalizations on the results by considering only influenza-attributed diagnoses. Results In France, influenza has the highest incidence, followed by herpes zoster and pneumococcal disease. Similarly, influenza poses the greatest cost burden among all older adults, while pneumococcal disease poses the greatest cost burden among those aged 65–74 years. When considering only influenza-attributed diagnoses, the number of inpatient visits and associated costs was reduced by 63% in the overall older adult population. In the low-incidence season, the number of inpatient visits and associated costs were reduced by 69%, while in the high-incidence season, the number of inpatient visits and associated costs increased by 63%. Conclusion Influenza remains a leading vaccine-preventable disease among older adults in France, resulting in a substantial economic burden that could be prevented by increasing vaccine uptake. [ABSTRACT FROM AUTHOR]

BACKGROUND: Influenza imposes a heavy burden on public health. Little is known, however, of the associations between detailed measures of exposure to ambient air pollution and influenza at an individual level. OBJECTIVE: We examined individual-level associations between six criteria air pollutants and influenza using case-crossover design. METHODS: In this individual-level time-stratified case-crossover study, we linked influenza cases collected by the Guangzhou Center for Disease Control and Prevention from 1 January 2013 to 31 December 2019 with individual residence-level exposure to particulate matter (PM2.5 and PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO). The exposures were estimated for the day of onset of influenza symptoms (lag 0), 1–7 d before the onset (lags 1–7), as well as an 8-d moving average (lag07), using a random forest model and linked to study participants’ home addresses. Conditional logistic regression was developed to investigate the associations between short-term exposure to air pollution and influenza, adjusting for mean temperature, relative humidity, public holidays, population mobility, and community influenza susceptibility. RESULTS: 푁 =108,479 eligible cases were identified in our study. Every 10-μg/m³ increase in exposure to PM2.5, PM10, NO2, and CO and every 5-μg/m³ increase in SO2 over 8-d moving average (lag07) was associated with higher risk of influenza with a relative risk (RR) of 1.028 (95% CI: 1.018, 1.038), 1.041 (95% CI: 1.032, 1.049), 1.169 (95% CI: 1.151, 1.188), 1.004 (95% CI: 1.003, 1.006), and 1.134 (95% CI: 1.107, 1.163), respectively. There was a negative association between O3 and influenza with a RR of 0.878 (95% CI: 0.866, 0.890). CONCLUSIONS: Our findings suggest that short-term exposure to air pollution, except for O3, is associated with greater risk for influenza. Further studies are necessary to decipher underlying mechanisms and design preventive interventions and policies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Air pollution is a major risk factor for planetary health and has long been suspected of predisposing humans to respiratory diseases induced by pathogens like influenza viruses. However, epidemiological evidence remains elusive due to lack of longitudinal data from large cohorts. OBJECTIVE: Our aim is to quantify the short-term association of influenza incidence with exposure to ambient air pollutants in Chinese cities. METHODS: Based on air pollutant data and influenza surveillance data from 82 cities in China over a period of 5 years, we applied a two-stage time series analysis to assess the association of daily incidence of reported influenza cases with six common air pollutants [particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with aerodynamic diameter ≤ 10 μm (PM10), NO2, SO2, CO, and O3], while adjusting for potential confounders including temperature, relative humidity, seasonality, and holiday effects. We built a distributed lag Poisson model for one or multiple pollutants in each individual city in the first stage and conducted a meta-analysis to pool city-specific estimates in the second stage. RESULTS: A total of 3,735,934 influenza cases were reported in 82 cities from 2015 to 2019, accounting for 72.71% of the overall case number reported in the mainland of China. The time series models for each pollutant alone showed that the daily incidence of reported influenza cases was positively associated with almost all air pollutants except for ozone. The most prominent short-term associations were found for SO2 and NO2 with cumulative risk ratios of 1.094 [95% confidence interval (CI): 1.054, 1.136] and 1.093 (95% CI: 1.067, 1.119), respectively, for each 10 μg/m³ increase in the concentration at each of the lags of 1–7 d. Only NO2 showed a significant association with the daily incidence of influenza cases in the multipollutant model that adjusts all six air pollutants together. The impact of air pollutants on influenza was generally found to be greater in children, in subtropical cities, and during cold months. DISCUSSION: Increased exposure to ambient air pollutants, particularly NO2, is associated with a higher risk of influenza-associated illness. Policies on reducing air pollution levels may help alleviate the disease burden due to influenza infection. [ABSTRACT FROM AUTHOR]

Influenza-like illness (ILI) accounts for 500,000 fatalities worldwide yearly. Environmental factors contribute to spread of respiratory infections. This study describes the epidemiological trends of ILI in Cheras, Kuala Lumpur, Malaysia and seeks scientific evidence on ILI activity and environmental factors. Cheras Health District collected ILI surveillance data and the nearest weather station which provided environmental data on mean temperature, humidity, wind speed, cumulative rainfall, particulate matter (PM)10 and PM2.5 levels. A total of 51,245 ILI cases were reported from 1st December 2021 to 30th April 2023. The non-linear relationship between ILI incidence and environmental variables was modelled using the Generalised Additive Model (GAM). The lag time for mean temperature, mean humidity, cumulative rainfall, mean wind speed, PM 10 level, and PM 2.5 level was 2, 3, 3, 3, 0, and 3 days, respectively. The model with the optimal lag better describes ILI case variance (R²=0.5, explained deviance=58%) than the model without lag selection (R²=0.5, explained deviance=57.2%). The Lag Model indicates a significant p-value for PM10 but no significant concurvity between predictor variables. Thus, the final model (R²=0.5, explained deviance=59.2%) has k=15. Higher rainfall, relative humidity, colder temperature, and decreased wind speed increased ILI incidence. PM2.5 and PM10 also contributes to ILI. [ABSTRACT FROM AUTHOR]

Background: Influenza infection can lead to mortality and morbidity. In densely populated Kuala Lumpur, Malaysia, the transmission of influenza-like illness (ILI) is high. This study assessed the prevalence and epidemiology of influenza in the target population. Methods: A cross-sectional convenience sample study was conducted in government clinics of Cheras, Malaysia, from November 1, 2022, to February 28, 2023. Consent was sought from patients older than 18 years with symptoms of ILI (fever, cough, and onset within 10 days). A nasopharyngeal swab preceded an influenza rapid test. Logistic regression was used in SPSS 22.0 to evaluate the data. Results: Among 438 patients, 55 (12.6%) tested positive for influenza type B, 9 (2%) tested positive for type A, and 374 (85.4%) were negative. Patients in the group that was 10 years older than the younger group had 1.47 times the odds of having influenza. The odds of positive influenza rose 1.133 times per unit of body mass index (BMI). Patients with chronic lung illness were 6.7 times (95% confidence interval, 2.742-16.287) more likely to test positive for influenza. Sex and smoking history did not affect the rate of influenza infection (p > 0.05). Conclusions: An association was found between age, BMI, and chronic lung disease with influenza infection but not with sex or smoking. [ABSTRACT FROM AUTHOR]

Background: Generally influenza, a contagious respiratory disease, leads to mild illness, but can present as a severe illness with significant complications for some. It entails significant health challenges and an economic burden. Annual vaccination is considered the most effective preventive measure against influenza, especially in high-risk groups. Method: Epidemiological, demographic and vaccination data of influenza from 2009-to-2019 is collected from Sciensano, the Belgian Institute for Health. Sciensano monitors influenza virus through two surveillances: the Influenza-Like Illness (ILI) surveillance in primary care and the Severe Acute Respiratory Infections (SARI) surveillance in hospital settings. Results: 49.6% [± 8.5] of all ILI-samples tested positive in this period. Influenza A was the dominant circulating type, accounting for 73.7% [± 27.5] of positive samples, while influenza B accounted for 24.3% [± 26.7]. For SARI-surveillance, the average rate of samples tested positive was 36.3% [± 9.3]. Influenza A was responsible for respectively 77.7% [± 23.8] of positive samples and influenza B for 22.2% [± 23.7]. Since 2010, epidemics typically lasted about 9.3 weeks [± 2.7]. From 2012 to 2019 the average vaccine effectiveness was 34.9% [± 15.3]. Conclusion: Influenza is quickly considered a trivial disease, but can have substantial repercussions. It remains difficult to identify the level of treat of influenza due to antigenic evolution. Measures to prevent, control and treat are needed. Vaccines that provide broader and more durable protection that can be produced more rapidly could be a potential solution. [ABSTRACT FROM AUTHOR]

Subsequently, we further analyzed the epidemiological data on the positive rate of IAV infection in children, which indicated that the incidence rate of IAV infection gradually increased, and the positive rate of IAV infection continuously exceeded 40% from the third to seventh week (Figure 1C). We thus conducted a retrospective, single-center, cross-sectional observational study at Henan Children's Hospital to assess the incidence rate of IAV infection in children in Henan. With the normalized management of coronavirus disease 2019 (COVID-19), people have gradually increased their social activities; therefore, there tends to be an outbreak of other respiratory viruses. [Extracted from the article]

Children became sick and died during pandemics roughly 100 years apart, but they are rarely the central focus of historical scholarship. Because children were not the largest group of victims in the 1918 pandemic or in the COVID-19 pandemic and because of their lack of political capital, their needs received little attention. Both pandemics exposed the many holes in the nation's health and welfare infrastructure. We examine responses to children's needs in Philadelphia, Pennsylvania, during the peak pandemic year of 1918 and then show how this legacy of the lack of any child policy infrastructure left the city underresourced during the COVID-19 pandemic. (Am J Public Health. 2023;113(9):985–990. https://doi.org/10.2105/AJPH.2023.307334) [ABSTRACT FROM AUTHOR]

H7N9 avian influenza is a novel virus with high morbidity and mortality that threatens human health and life. Therefore, it is necessary to diagnose H7N9 avian influenza in a timely and rapid manner to prevent further transmission of the virus and greatly reduce the infection and mortality rates. This paper proposes an H7N9 avian influenza diagnostic model that is based on a multilayer belief rule‐based (BRB) inference methodology by considering five typical characteristics of influenza: epidemiology, clinical manifestations, complications, characteristics of imaging tests and positive pathogen test results. Specifically, the severity of H7N9 avian influenza is gradually identified by a multilayer BRB model, and then the diagnostic model is optimized by a genetic algorithm (GA) to improve the diagnostic accuracy. Finally, the feasibility of the model is verified by fivefold cross‐validation with a real clinical dataset. The performance of the proposed diagnostic model is compared with those of the BP neural network (BPNN) model and support vector machine (SVM) model, and the results show that the multilayer BRB model can achieve rapid and satisfactory diagnostic results for H7N9 avian influenza. The experiment shows that the accuracy of the BRB model for H7N9 avian influenza hierarchical diagnosis provided in this paper is 0.903, which is higher than 0.818 of the BP neural network (BPNN) modules and 0.844 of the support vector machine (SVM) models. Especially when diagnosing the suspected and confirmed degree of H7N9 disease, it is more realized satisfactory diagnostic accuracy. [ABSTRACT FROM AUTHOR]

This study was aimed at demonstrating the impact of a health education intervention on reducing the incidence of influenza-like illnesses symptoms among Malaysian Hajj pilgrims. This study utilizes a quasi-experimental study in the evaluation of the impact of the intervention. Participants were recruited during Hajj orientation courses organized by private Hajj companies. Participants from two companies were assigned to an intervention group and control group, respectively. The intervention group received a smartphone-based health education intervention guided by the Health Belief Model (HBM), while the control group received a regular Hajj guide intervention smartphone application before departure to Hajj. Data on the incidence of influenza-like illnesses (ILI) were collected from participants from two Hajj companies before and after returning from Hajj. Data analysis was conducted using SPSS with descriptive analysis, and analytical tests were conducted at 5% significance level. A total of 102 pilgrims completed the study in both intervention and control groups. The incidence of ILI and Non-ILI symptoms were statistically significant when the intervention and control groups (p = 0.049) were compared. In conclusion, health education has an impact on reducing the incidence of ILI and non-ILI among Hajj pilgrims. [ABSTRACT FROM AUTHOR]

Given the evolving nature of the COVID-19 pandemic and the importance of vaccines, it is imperative to understand the relationships between receiving the COVID-19 vaccine and other vaccines, such as the flu vaccine. Data were obtained from a survey as part of an evaluation of the StopFlu Kaiser Permanente media campaign, promoting the flu and COVID-19 vaccines in communities of color across eight states and the District of Columbia. The outcome considered was receiving the COVID-19 vaccine. The exposure considered was receiving the flu vaccine. Covariates included demographic factors, and sources of trusted health information. Overall, 4,185 participants had complete data and were included the analysis. Logistic regression was used to assess the relationship between receiving the flu vaccine and COVID-19 vaccine. Among participants, 77.8% reported receiving the COVID-19 vaccine and 55.4% received the flu vaccine. After adjusting for demographics and sources of trusted health information, participants reporting receiving the flu vaccine had 5.18 times the odds of also receiving the COVID-19 vaccine [Adjusted Odds Ratio (AOR): 5.18 95% Confidence Interval (CI): 4.24–6.32]. Trusting advice from a doctor and healthcare organization also had increased odds of receiving the COVID-19 vaccine. (AOR: 1.84 95%CI: 1.45–2.33, AOR: 2.08 95%CI: 1.64–2.63). This study demonstrates that promotion of one vaccine may influence uptake of other vaccines, which is important given the highly politicized nature of the COVID-19 vaccine. Further research could provide more insight into how promotion of a vaccine could impact behavior with regards to another. [ABSTRACT FROM AUTHOR]

Background. Influenza causes various seasonal respiratory diseases, resulting in significant morbidity and mortality in children. Influenza is a highly contagious disease causing global pandemics. This study aimed to investigate the frequency and outcome of influenza in children admitted to the Tabriz Children's Hospital. Methods. This cross-sectional study included suspected influenza patients admitted to the Tabriz Children's Medical Center between 2014 and 2019 diagnosed with positive influenza through RT-PCR of pharyngeal secretions samples. Results. We evaluated 114 cases of influenza with a median age of 48 months (range: 2-156 months) and 53.5% were boys. A total of 87 cases (77%) were infected with subtype A/H3N2, which was the most frequent, followed by 2 cases (1.8%) of subtype A/H1N1, 23 cases (20.4%) of subtype B 23, and one case (0.8%) of uncategorized A subtype. The disease was common in winter with 63 cases (56.3%). Conclusion. The frequency of influenza in children during five years was 8.95%, which is higher in males. Also, the highest frequency of influenza in the present study was observed in the age group of 1 to 5 years. The mortality rate of influenza in children during the last five years was equal to 7.9%. Practical Implications. Children under 5 years of age are more susceptible to influenza (especially type A subtype H3N2) and higher hospitalization rate and mortality, which can be prevented with a vaccine. [ABSTRACT FROM AUTHOR]

Cross-species virus transmission events can lead to dire public health emergencies in the form of epidemics and pandemics. One example in animals is the emergence of the H3N8 equine influenza virus (EIV), first isolated in 1963 in Miami, FL, USA, after emerging among horses in South America. In the early 21st century, the American lineage of EIV diverged into two 'Florida' clades that persist today, while an EIV transferred to dogs around 1999 and gave rise to the H3N8 canine influenza virus (CIV), first reported in 2004. Here, we compare CIV in dogs and EIV in horses to reveal their host-specific evolution, to determine the sources and connections between significant outbreaks, and to gain insight into the factors controlling their different evolutionary fates. H3N8 CIV only circulated in North America, was geographically restricted after the first few years, and went extinct in 2016. Of the two EIV Florida clades, clade 1 circulates widely and shows frequent transfers between the USA and South America, Europe and elsewhere, while clade 2 was globally distributed early after it emerged, but since about 2018 has only been detected in Central Asia. Any potential zoonotic threat of these viruses to humans can only be determined with an understanding of its natural history and evolution. Our comparative analysis of these three viral lineages reveals distinct patterns and rates of sequence variation yet with similar overall evolution between clades, suggesting epidemiological intervention strategies for possible eradication of H3N8 EIV. [ABSTRACT FROM AUTHOR]

Background Current understanding of severe respiratory syncytial virus (RSV) infections in adults is limited by clinical underrecognition. We compared the prevalence, clinical characteristics, and outcomes of RSV infections vs influenza in adults hospitalized with acute respiratory illnesses (ARIs) in a prospective national surveillance network. Methods Hospitalized adults who met a standardized ARI case definition were prospectively enrolled across 3 respiratory seasons from hospitals participating across all sites of the US Hospitalized Adult Influenza Vaccine Effectiveness Network (2016–2019). All participants were tested for RSV and influenza using real-time reverse-transcription polymerase chain reaction assay. Multivariable logistic regression was used to test associations between laboratory-confirmed infection and characteristics and clinical outcomes. Results Among 10 311 hospitalized adults, 6% tested positive for RSV (n = 622), 18.8% for influenza (n = 1940), and 75.1% negative for RSV and influenza (n = 7749). Congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD) was more frequent with RSV than influenza (CHF: 37.3% vs 28.8%, P <.0001; COPD: 47.6% vs 35.8%, P <.0001). Patients with RSV more frequently had longer admissions (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.06–1.80) for stays >1 week) and mechanical ventilation (OR, 1.45; 95% CI, 1.09–1.93) compared with influenza but not compared with the influenza-negative group (OR, 1.03; 95% CI,.82–1.28 and OR, 1.17; 95% CI,.91–1.49, respectively). Conclusions The prevalence of RSV across 3 seasons was considerable. Our findings suggest that those with RSV have worse outcomes compared with influenza and frequently have cardiopulmonary conditions. This study informs future vaccination strategies and underscores a need for RSV surveillance among adults with severe ARI. [ABSTRACT FROM AUTHOR]

Although the natural hosts of avian influenza viruses (AIVs) are wild birds, multiple subtypes of AIVs have established epidemics in numerous mammals due to their cross-species spillover. Replication and evolution in intermedia mammalian hosts may facilitate AIV adaptation in humans. Because of their large population and intimacy with humans, dogs could act as such an intermedia host. To monitor the epidemiology of canine influenza viruses (CIVs) in Liaoning, China, we performed three surveillances in November 2018, March 2019, and April 2019. Five H3N2 and seven novel H3N6 CIVs had been isolated. Since the N6 neuraminidase (NA) genes were clustered with the H5N6 AIV, there is a high possibility that these H3N6 CIVs were generated from a H3N2 CIVs and H5N6 AIVs reassortment case. In addition, the H3N6 CIV showed increased mammalian adaptation ability compared to all the H3N2 strains in both in vitro and in vivo studies. Even though isolated 3 months later, the March 2019 isolated H3N2 viruses replicated more efficiently than the November 2018 isolated viruses. Our study indicated that H3 CIVs were undergoing an evolution process, through both genetic mutations and gene reassortment, at an incredible speed. [ABSTRACT FROM AUTHOR]

Objectives We estimated influenza-like symptom (ILS) incidence among healthcare personnel (HCP) in four hospitals and the economic impact due to ILS in the Thai HCP population during July 2020–June 2021 (Thailand's expected 2020 influenza season), which also coincided with the novel coronavirus disease 2019 pandemic. Methods We followed HCP, in a prospective observational cohort, weekly for ≥1 of: muscle pain, cough, runny nose/nasal congestion, sore throat, or difficulty breathing. We fitted population-averaged Poisson regression models to identify factors associated with acquiring ILS and to calculate ILS incidence. We applied epidemiologic parameters to Thailand's HCP population (227 349 persons) to estimate economic impact. Results Of 2184 participants, adjusted all-cause ILS incidence was 6.1 episodes per 100 person-years (95% confidence interval 3.4–10.9). Among Thailand's HCP population, 13 909 ILS episodes were estimated to occur annually and would result in US$235 135 economic loss. Controlling for study site and calendar month, factors associated with acquiring ≥1 ILS versus no ILS included being female, having asthma, and using personal protective equipment 'frequently, but not always'. Conclusions All-cause ILS resulted in considerable economic loss among Thai HCP workforce. These findings underscore the importance of public health interventions to reduce the risk of acquiring ILS. [ABSTRACT FROM AUTHOR]

Objectives: The Advisory Committee on Immunization Practices recommends persons aged ≥6 months receive an influenza vaccination annually, and certain adults aged ≥19 years receive the 23-valent pneumococcal polysaccharide vaccine alone or in series with the 13-valent pneumococcal conjugate vaccine, depending on age, chronic conditions, and smoking status. This study examines the prevalence of influenza and pneumococcal vaccination relative to Healthy People 2020 goals to understand how vaccination receipt differs by veteran status and sociodemographic subgroups. Methods: We analyzed pooled data from the 2016-2018 National Health Interview Survey (N = 35 094) in 2021 to estimate the prevalence of influenza and pneumococcal vaccination for men aged 25-64 years and for men aged ≥65 years by veteran status and selected sociodemographic subgroups. We used 2-tailed t tests with an α =.05 to identify significant differences. Results: Among men, 44.7% of veterans and 33.5% of nonveterans aged 25-64 years and 71.0% of veterans and 64.9% of nonveterans aged ≥65 years received an influenza vaccine in the past year. Among men aged 25-64 years at high risk for pneumococcal disease, 35.9% of veterans and 20.8% of nonveterans had ever received ≥1 dose of any pneumococcal vaccination. Disparities in the prevalence of vaccination within examined sociodemographic characteristics were often smaller in magnitude among veterans than among nonveterans for both vaccinations. Conclusions: Vaccination rates were below Healthy People 2020 targets for both groups, except influenza vaccination among veterans aged ≥65 years. Understanding differences in vaccine uptake may inform efforts to improve vaccination rates by identifying subgroups who are at high risk of disease and have low vaccination rates. [ABSTRACT FROM AUTHOR]

Since the start of the 2019 pandemic, wastewater-based epidemiology (WBE) has proven to be a valuable tool for monitoring the prevalence of SARS-CoV-2. With methods and infrastructure being settled, it is time to expand the potential of this tool to a wider range of pathogens. We used over 500 archived RNA extracts from a WBE program for SARS-CoV-2 surveillance to monitor wastewater from 11 treatment plants for the presence of influenza and norovirus twice a week during the winter season of 2021/2022. Extracts were analyzed via digital PCR for influenza A, influenza B, norovirus GI, and norovirus GII. Resulting viral loads were normalized on the basis of NH4-N. Our results show a good applicability of ammonia-normalization to compare different wastewater treatment plants. Extracts originally prepared for SARS-CoV-2 surveillance contained sufficient genomic material to monitor influenza A, norovirus GI, and GII. Viral loads of influenza A and norovirus GII in wastewater correlated with numbers from infected inpatients. Further, SARS-CoV-2 related non-pharmaceutical interventions affected subsequent changes in viral loads of both pathogens. In conclusion, the expansion of existing WBE surveillance programs to include additional pathogens besides SARS-CoV-2 offers a valuable and cost-efficient possibility to gain public health information. [ABSTRACT FROM AUTHOR]

Background: Vaccine-preventable diseases such as pertussis, measles, and influenza remain among the most significant medical and socioeconomic issues in Kazakhstan, despite significant vaccination achievements. Thus, here we aimed to analyze the long-term dynamics and provide information on the current epidemiology of pertussis, measles, and influenza in Kazakhstan. Methods: A retrospective analysis of the long-term dynamics of infectious diseases was carried out using the data from the statistical collections for 2010-2020 and the Unified Payment System from 2014 to 2020. Results: During the 2010-2020 years, the long-term dynamics show an unequal distribution of pertussis, measles, and influenza-related morbidity. In comparison with earlier years, registration of infectious disease was the highest in 2019 and 2020. The incidence cases among registered infectious diseases in 2019 were: pertussis-147, measles-13,326, and in 2020: influenza-2,678. High incidence rates have been documented in Pavlodar, North Kazakhstan, Mangystau regions, and the cities of Shymkent and Nur-Sultan. The incidence varies depending on the seasonality: pertussis (summer-autumn), measles (winter-spring), and influenza (mostly in winter). Conclusion: The findings highlight the importance of focusing more on the characteristics of the epidemic process of vaccine-preventable diseases in order to assess the effectiveness of implemented measures and verify new routes in strengthening the epidemiological surveillance system. [ABSTRACT FROM AUTHOR]

The 10 years between the last influenza pandemic and start of the severe acute respiratory syndrome coronavirus 2 pandemic have been marked by great advances in our ability to follow influenza occurrence and determine vaccine effectiveness (VE), largely based on widespread use of the polymerase chain reaction assay. We examine the results, focusing mainly on data from the United States and inactivated vaccines. Surveillance has expanded, resulting in increased ability to characterize circulating viruses and their impact. The surveillance has often confirmed previous observations on timing of outbreaks and age groups affected, which can now be examined in greater detail. Selection of strains for vaccines is now based on enhanced viral characterization using immunologic, virologic, and computational techniques not previously available. Vaccine coverage has been largely stable, but VE has remained modest and, in some years, very low. We discuss ways to improve VE based on existing technology while we work toward supraseasonal vaccines. [ABSTRACT FROM AUTHOR]

Background Children account for a large portion of global influenza burden and transmission, and a better understanding of influenza in children is needed to improve prevention and control strategies. Methods To examine the incidence and transmission of influenza we conducted a prospective community-based study of children aged 0–14 years in Managua, Nicaragua, between 2011 and 2019. Participants were provided with medical care through study physicians and symptomatic influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). Wavelet analyses were used to examine seasonality. Generalized growth models (GGMs) were used to estimate effective reproduction numbers. Results From 2011 to 2019, 3016 children participated, with an average of ∼1800 participants per year and median follow-up time of 5 years per child, and 48.3% of the cohort in 2019 had been enrolled their entire lives. The overall incidence rates per 100 person-years were 14.5 symptomatic influenza cases (95% confidence interval [CI]: 13.9–15.1) and 1.0 influenza-associated acute lower respiratory infection (ALRI) case (95% CI:.8–1.1). Symptomatic influenza incidence peaked at age 9–11 months. Infants born during peak influenza circulation had lower incidence in the first year of their lives. The mean effective reproduction number was 1.2 (range 1.02–1.49), and we observed significant annual patterns for influenza and influenza A, and a 2.5-year period for influenza B. Conclusions This study provides important information for understanding influenza epidemiology and informing influenza vaccine policy. These results will aid in informing strategies to reduce the burden of influenza. [ABSTRACT FROM AUTHOR]

Background Understanding the burden of influenza is necessary to optimize recommendations for influenza vaccination. We describe the epidemiology of severe influenza in 50- to 64-year-old residents of metropolitan Toronto and Peel region, Canada, over 7 influenza seasons. Methods Prospective population-based surveillance for hospitalization associated with laboratory-confirmed influenza was conducted from September 2010 to August 2017. Conditions increasing risk of influenza complications were as defined by Canada's National Advisory Committee on Immunization. Age-specific prevalence of medical conditions was estimated using Ontario health administrative data. Population rates were estimated using Statistics Canada data. Results Over 7 seasons, 1228 hospitalizations occurred in patients aged 50–64 years: 40% due to A(H3N2), 30% A(H1N1), and 22% influenza B. The average annual hospitalization rate was 15.6, 20.9, and 33.2 per 100 000 in patients aged 50–54, 55–59, and 60–64 years, respectively; average annual mortality was 0.9/100 000. Overall, 33% of patients had received current season influenza vaccine; 963 (86%) had ≥1 underlying condition increasing influenza complication risk. The most common underlying medical conditions were chronic lung disease (38%) and diabetes mellitus (31%); 25% of patients were immunocompromised. The average annual hospitalization rate was 6.1/100 000 in those without and 41/100 000 in those with any underlying condition, and highest in those with renal disease or immunocompromise (138 and 281 per 100 000, respectively). The case fatality rate in hospitalized patients was 4.4%; median length of stay was 4 days (interquartile range, 2–8 days). Conclusions The burden of severe influenza in 50- to 64-year-olds remains significant despite our universal publicly funded vaccination program. These data may assist in improving estimates of the cost-effectiveness of new strategies to reduce this burden. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Biology is the property of Instituto Internacional de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To explore the 2020-2021 influenza season by describing the case of Italy.Methods: FluNet was searched for Italian data on virological samples. French, German, and Spanish data were collected for comparison. InfluNet was used for Italian epidemiological data on influenza-like illness (ILI). Data were extracted for the period from the 42nd week of 2020 to the 16th week of 2021 and for the previous 5-year period. The Containment and Health Index were used to describe the containment measures.Results: Among 6818 samples, 0% were positive in Italy in the 2020-2021 season (28.8% in the previous 5-year period; the percentage change in the total number of tested specimens was -51.3%). In France, Germany, and Spain, the percentage change was -23%, -7%, and -61%, respectively. The Italian ILI incidence remained below the baseline levels (mean 0.0144/100,000 inhabitants; range 0.0085-0.0204). In the previous 5-year period, the mean incidence was 0.041/100,000 inhabitants. With the increase in containment measures, a deflection of ILI incidence was described (P = .015).Conclusions: Despite the reduced number of collected specimens compared to previous seasons and a slight rise in influenza vaccination rates, containment measures represent the most likely factor that helped to reduce cases in the 2020-2021 influenza season in Italy. [ABSTRACT FROM AUTHOR]

Coronavirus (COVID-19) laid bare the disproportionate effects of infectious agents on vulnerable communities. However, historically, infectious diseases have long been known to affect certain communities to a greater extent than others. The mechanisms behind these differences are multifactorial, and lie less in biological susceptibility and instead more on socioeconomic factors and other social determinants of health. This article highlights health disparities in common infections such as respiratory syncytial virus, tuberculosis, HIV, syphilis, and influenza and will use lessons learned from previous pathogens and infectious disease disparities in vulnerable populations to provide context to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

We collected data on mass mortality in Sandwich terns (Thalasseus sandvicensis) during the 2022 breeding season in the Netherlands. Mortality was associated with at least 2 variants of highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b. We report on carcass removal efforts relative to survival in colonies. Mitigation strategies urgently require structured research. [ABSTRACT FROM AUTHOR]

Background Recent population-based data are limited regarding influenza-associated hospitalizations in US children. Methods We identified children <18 years hospitalized with laboratory-confirmed influenza during 2010–2019 seasons, through the Centers for Disease Control and Prevention's Influenza Hospitalization Surveillance Network. Adjusted hospitalization and in-hospital mortality rates were calculated, and multivariable logistic regression was conducted to evaluate risk factors for pneumonia, intensive care unit (ICU) admission, mechanical ventilation, and death. Results Over 9 seasons, adjusted influenza-associated hospitalization incidence rates ranged from 10 to 375 per 100 000 persons each season and were highest among infants <6 months old. Rates decreased with increasing age. The highest in-hospital mortality rates were observed in children <6 months old (0.73 per 100 000 persons). Over time, antiviral treatment significantly increased, from 56% to 85% (P <.001), and influenza vaccination rates increased from 33% to 44% (P =.003). Among the 13 235 hospitalized children, 2676 (20%) were admitted to the ICU, 2262 (17%) had pneumonia, 690 (5%) required mechanical ventilation, and 72 (0.5%) died during hospitalization. Compared with those <6 months of age, hospitalized children ≥13 years old had higher odds of pneumonia (adjusted odds ratio, 2.7 [95% confidence interval, 2.1–3.4], ICU admission (1.6 [1.3–1.9]), mechanical ventilation (1.6 [1.1–2.2]), and death (3.3 [1.2–9.3]). Conclusions Hospitalization and death rates were greatest in younger children at the population level. Among hospitalized children, however, older children had a higher risk of severe outcomes. Continued efforts to prevent and attenuate influenza in children are needed. [ABSTRACT FROM AUTHOR]

Background: Evidence on the effectiveness of influenza vaccine in preventing antibiotic prescriptions for influenza-like illness (ILI) in adults is limited.Methods: A primary care-based case-control study was conducted to estimate influenza vaccine effectiveness (VE) against influenza-like illness (ILI) and antibiotic prescribing for ILI in adults aged ≥40 years. Cases were patients diagnosed with ILI from 1st June to 30th September in each year, 2015-2018; a subset of those with ILI prescribed antibiotics was also defined. Controls were patients attending a practice who did not receive an ILI diagnosis. Generalised estimating equations were used to calculate adjusted VE overall, by age (<65 versus ≥65 years) and comorbidity status.Results: The number of ILI cases varied from 558 in 2018 to 2901 in 2017 and controls from 86618 in 2015 to 136763 in 2017. Over 4 years the pooled estimate of VE was 24% (95%CI, 11% to 34%) against ILI and 15% (95%CI, -3% to 29%) against antibiotic prescription for ILI. Influenza vaccine was effective in reducing ILI with an associated antibiotic prescriptions in patients aged <65 years (VE=23%, 95%CI, 3% to 38%) and if no comorbidities were recorded (VE=22%, 95%CI, 1% to 39%) but not in other subgroups.Conclusions: Influenza vaccine reduced the likelihood of antibiotic prescriptions for ILI in low-risk adults (40-64 years and those without comorbidities). [ABSTRACT FROM AUTHOR]

Background: Influenza vaccination varies widely across long-term care facilities (LTCFs) due to staff behaviors, LTCF practices, and patient factors. It is unclear how seasonal LTCF vaccination varies between cohabitating but distinct short-stay and long-stay residents. Thus, we assessed the correlation of LTCF vaccination between these populations and across seasons.Methods: The study design is a national retrospective cohort using Medicare and Minimum Data Set (MDS) data. Participants include U.S. LTCFs. Short-stay and long-stay Medicare-enrolled residents age ≥ 65 in U.S. LTCFs from a source population of residents during October 1st-March 31st in 2013-2014 (3,042,881 residents; 15,683 LTCFs) and 2014-2015 (3,143,174, residents; 15,667 LTCFs). MDS-assessed influenza vaccination was the outcome. Pearson correlation coefficients were estimated to assess seasonal correlations between short-stay and long-stay resident vaccination within LTCFs.Results: The median proportion of short-stay residents vaccinated across LTCFs was 70.4% (IQR, 50.0-82.7%) in 2013-2014 and 69.6% (IQR, 50.0-81.6%) in 2014-2015. The median proportion of long-stay residents vaccinated across LTCFs was 85.5% (IQR, 78.0-90.9%) in 2013-2014 and 84.6% (IQR, 76.6-90.3%) in 2014-2015. Within LTCFs, there was a moderate correlation between short-stay and long-stay vaccination in 2013-2014 (r = 0.50, 95%CI: 0.49-0.51) and 2014-2015 (r = 0.53, 95%CI: 0.51-0.54). Across seasons, there was a moderate correlation for LTCFs with short-stay residents (r = 0.54, 95%CI: 0.53-0.55) and a strong correlation for those with long-stay residents (r = 0.68, 95%CI: 0.67-0.69).Conclusions: In LTCFs with inconsistent influenza vaccination across seasons or between populations, targeted vaccination protocols for all residents, regardless of stay type, may improve successful vaccination in this vulnerable patient population. [ABSTRACT FROM AUTHOR]

Influenza prevention and control has been one of the biggest challenges encountered in the public health domain. The vaccination against influenza plays a pivotal role in the prevention of influenza, particularly for the elderly and small children. According to the epidemiology of influenza in China, the nation is under a heavy burden of this disease. Therefore, as a contribution to the prevention and control of influenza in China through the provision of relevant information, the present report discusses the production and batch issuance of the influenza vaccine, analysis of the vaccination status and vaccination rate of the influenza vaccine, and the development trend of the influenza vaccine in China. [ABSTRACT FROM AUTHOR]

Background Meta-analyses of individual patient data from randomized, controlled trials show that early oseltamivir treatment for influenza cut the risk of pneumonia and hospitalization by 44% and 63%, respectively. However, data on the effectiveness of inhaled zanamivir in preventing hospitalization and death are lacking. Methods This nationwide, population-based, cohort study included all outpatients treated with inhaled zanamivir or oral oseltamivir within 48 hours after a clinical diagnosis of influenza before and after the rollout of inhaled zanamivir as the first-line antiviral in Taiwan. The main outcome was influenza-related hospitalization or death within 14 days. Those who developed the outcome within 2 days were excluded from analyses. Propensity score stratification was used to control confounding from covariates. Results A total of 865 032 eligible influenza outpatients were included in the analysis. The risk of developing the main outcome (adjusted hazard ratio [aHR], 1.01; 95% confidence interval [CI],.96 to 1.06) did not differ between the inhaled zanamivir group (n = 595 897, 68.9%, the reference) and the oral oseltamivir group (n = 269 135, 31.1%). Prespecified analysis on high-risk subgroups further showed that inhaled zanamivir is not inferior to oral oseltamivir in either patients aged ≥65 years (aHR, 1.14; 95% CI: 1.05 to 1.25) or patients with chronic lung diseases (aHR, 1.23; 95% CI: 1.08 to 1.41). Conclusions Inhaled zanamivir is not inferior to oral oseltamivir as outpatient treatment in preventing influenza-related hospitalization or death for patients whose conditions do not require hospitalization within 2 days. [ABSTRACT FROM AUTHOR]

Background Although human case numbers of variant influenza viruses have increased worldwide, the epidemiology of human cases and human-to-human transmissibility of different variant viruses remain uncertain. Methods We used descriptive statistics to summarize the epidemiologic characteristics of variant virus infections. The hospitalization rate, case-fatality, and hospitalization-fatality risks were used to assess disease severity. Transmissibility of variant viruses between humans was determined by the effective reproductive number (R e ) and probability of infection following exposure to human cases. Results We identified 707 naturally infected cases of variant viruses from 1959 to 2021, and their spatiotemporal/demographic characteristics changed across subtypes. The clinical severity of cases of variant viruses was generally mild; patients older than 18 years with underlying conditions were associated with hospitalization. Of 69 clusters of human infections with variant viruses (median cluster size: 2), the upper limit of R e was 0.09 (H1N1v, H1N2v, and H3N2v: 0.20 vs 0.18 vs 0.05), whereas it was not significantly different from the pooled estimates for avian influenza A(H7N9) and A(H5N1) viruses (0.10). Moreover, contacts of H5N1 cases (15.7%) had a significantly higher probability of infection than contacts of individuals with H7N9 (4.2%) and variant virus infections (4.2%–7.2%). Conclusions The epidemiology of cases of variant viruses varied across time periods, geographical regions, and subtypes during 1959–2021. The transmissibility of different variant viruses between humans remains limited. However, given the continuous evolution of viruses and the rapidly evolving epidemiology of cases of variant viruses, improving the surveillance systems for human variant virus infections is needed worldwide. [ABSTRACT FROM AUTHOR]

Background Concurrent detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and another respiratory virus in individuals can document contemporaneous circulation. We used an ongoing, community-based study of school-aged children and their households to evaluate SARS-CoV-2 codetections with other respiratory viruses in a non–medically attended population over a 2-year period. Methods Household enrollment was predicated on an acute respiratory illness in a child residing in that household who was also a kindergarten through 12th-grade student in the participating school district. Demographic, symptom, and household composition data and self-collected nasal specimens were obtained on the recruitment day, and 7 and 14 days later, from the index child and all other household members. All specimens were tested for SARS-CoV-2 and influenza A/B by reverse-transcription polymerase chain reaction. Day 0 specimens from the index children were simultaneously tested for 16 pathogens using a commercial respiratory pathogen panel (RPP). To assess viral codetections involving SARS-CoV-2, all household specimens were tested via RPP if the index child's day 0 specimen tested positive to any of the 16 pathogen targets in RPP and any household member tested positive for SARS-CoV-2. Results Of 2109 participants (497 index children in 497 households with 1612 additional household members), 2 (0.1%) were positive for both SARS-CoV-2 and influenza A; an additional 11 (0.5%) were positive for SARS-CoV-2 and another RPP-covered respiratory virus. Codetections predominantly affected school-aged children (12 of 13 total) and were noted in 11 of 497 households. Conclusions SARS-CoV-2 codetections with other respiratory viruses were uncommon and predominated in school-aged children. [ABSTRACT FROM AUTHOR]

In the last year of the Great War, Italy was also hit by the Spanish flu. The Civic Hospitals faced a deadly disaster with insufficient resources. All the heavy workload fell on the female nursing staff, who were the only ones able ensure the continuity of the hospital services. This study aimed to explore the impact of the influenza on the health of the nurses at the Maggiore Hospital in Milan during the second and third epidemic waves. Historical research was conducted between February and May 2020. Primary sources were retrieved from the historical archives of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and the daily newspaper Corriere della Sera. In the autumn of 1918, the Maggiore Hospital in Milan changed its organization to hospitalise patients affected by the influenza pandemic. Although the hospital managers wanted to protect their healthcare staff from the risks of contagion by means of prophylaxis rules, 388 lay nurses and 80 religious sister nurses were affected by this insidious disease. The second and third waves of the pandemic claimed 25 victims of duty. Remembered for their altruism and spirit of abnegation, the hospital community honoured their sacrifice, and the citizens expressed their gratitude. [ABSTRACT FROM AUTHOR]