90 results on '"Q. Sue Huang"'
Search Results
2. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand
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Q. Sue Huang, Tim Wood, Lauren Jelley, Tineke Jennings, Sarah Jefferies, Karen Daniells, Annette Nesdale, Tony Dowell, Nikki Turner, Priscilla Campbell-Stokes, Michelle Balm, Hazel C. Dobinson, Cameron C. Grant, Shelley James, Nayyereh Aminisani, Jacqui Ralston, Wendy Gunn, Judy Bocacao, Jessica Danielewicz, Tessa Moncrieff, Andrea McNeill, Liza Lopez, Ben Waite, Tomasz Kiedrzynski, Hannah Schrader, Rebekah Gray, Kayla Cook, Danielle Currin, Chaune Engelbrecht, Whitney Tapurau, Leigh Emmerton, Maxine Martin, Michael G. Baker, Susan Taylor, Adrian Trenholme, Conroy Wong, Shirley Lawrence, Colin McArthur, Alicia Stanley, Sally Roberts, Fahimeh Rahnama, Jenny Bennett, Chris Mansell, Meik Dilcher, Anja Werno, Jennifer Grant, Antje van der Linden, Ben Youngblood, Paul G. Thomas, NPIsImpactOnFlu Consortium, and Richard J. Webby
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Science - Abstract
New Zealand has been relatively successful in controlling COVID-19 due to implementation of strict non-pharmaceutical interventions. Here, the authors demonstrate a striking decline in reports of influenza and other non-influenza respiratory pathogens over winter months in which the interventions have been in place.
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- 2021
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3. Activated CD4+ T cells and CD14hiCD16+ monocytes correlate with antibody response following influenza virus infection in humans
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Sook-San Wong, Christine M. Oshansky, Xi-Zhi J. Guo, Jacqui Ralston, Timothy Wood, Gary E. Reynolds, Ruth Seeds, Lauren Jelley, Ben Waite, Trushar Jeevan, Mark Zanin, Marc-Alain Widdowson, Q. Sue Huang, Paul G. Thomas, Richard J. Webby, Nikki Turner, Michael Baker, Cameron Grant, Colin McArthur, Sally Roberts, Adrian Trenholmes, Conroy Wong, Susan Taylor, Mark Thompson, Diane Gross, Jazmin Duque, Kathryn Haven, Debbie Aley, Pamela Muponisi, Bhamita Chand, Yan Chen, Laurel Plewes, Frann Sawtell, Shirley Lawrence, Reniza Cogcoy, Jo Smith, Franie Gravidez, Mandy Ma, Shona Chamberlin, Kirstin Davey, Tania Knowles, Jo-Ann McLeish, Angela Todd, Judy Bocacao, Wendy Gunn, Pamela Kawakami, Susan Walker, Robyn Madge, Nicole Moore, Fahimeh Rahnama, Helen Qiao, Fifi Tse, Mahtab Zibaei, Tirzah Korrapadu, Louise Optland, and Cecilia Dela Cruz
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influenza ,cellular immunity ,infection ,antibody ,monocytes ,seroconversion ,Medicine (General) ,R5-920 - Abstract
Summary: The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts.
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- 2021
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4. A Modular Cytokine Analysis Method Reveals Novel Associations With Clinical Phenotypes and Identifies Sets of Co-signaling Cytokines Across Influenza Natural Infection Cohorts and Healthy Controls
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Liel Cohen, Andrew Fiore-Gartland, Adrienne G. Randolph, Angela Panoskaltsis-Mortari, Sook-San Wong, Jacqui Ralston, Timothy Wood, Ruth Seeds, Q. Sue Huang, Richard J. Webby, Paul G. Thomas, and Tomer Hertz
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innate immunology ,cytokines ,chemokines ,influenza ,biomarker ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Cytokines and chemokines are key signaling molecules of the immune system. Recent technological advances enable measurement of multiplexed cytokine profiles in biological samples. These profiles can then be used to identify potential biomarkers of a variety of clinical phenotypes. However, testing for such associations for each cytokine separately ignores the highly context-dependent covariation in cytokine secretion and decreases statistical power to detect associations due to multiple hypothesis testing. Here we present CytoMod—a novel data-driven approach for analysis of cytokine profiles that uses unsupervised clustering and regression to identify putative functional modules of co-signaling cytokines. Each module represents a biosignature of co-signaling cytokines. We applied this approach to three independent clinical cohorts of subjects naturally infected with influenza in which cytokine profiles and clinical phenotypes were collected. We found that in two out of three cohorts, cytokine modules were significantly associated with clinical phenotypes, and in many cases these associations were stronger than the associations of the individual cytokines within them. By comparing cytokine modules across datasets, we identified cytokine “cores”—specific subsets of co-expressed cytokines that clustered together across the three cohorts. Cytokine cores were also associated with clinical phenotypes. Interestingly, most of these cores were also co-expressed in a cohort of healthy controls, suggesting that in part, patterns of cytokine co-signaling may be generalizable. CytoMod can be readily applied to any cytokine profile dataset regardless of measurement technology, increases the statistical power to detect associations with clinical phenotypes and may help shed light on the complex co-signaling networks of cytokines in both health and infection.
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- 2019
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5. Sexual Transmission of Zika Virus and Persistence in Semen, New Zealand, 2016
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Jay Harrower, Tomasz Kiedrzynski, Simon Baker, Arlo Upton, Fahimeh Rahnama, Jill Sherwood, Q. Sue Huang, Angela Todd, and David Pulford
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Zika ,Zika virus ,sexual transmission ,semen ,arbovirus ,arboviral disease ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Published
- 2016
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6. Seroepidemiologic Effects of Influenza A(H1N1)pdm09 in Australia, New Zealand, and Singapore
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James M. Trauer, Don Bandaranayake, Robert Booy, Mark I. Chen, Michelle Cretikos, Gary K. Dowse, Dominic E. Dwyer, Michael E. Greenberg, Q. Sue Huang, Gulam Khandaker, Jen Kok, Karen L. Laurie, Vernon J. Lee, Jodie McVernon, Scott Walter, and Peter G. Markey
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Influenza A Virus, H1N1 Subtype ,serology ,Influenza, Human ,Population Groups, viruses ,Influenza A virus ,H1N1 subtype ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
To estimate population attack rates of influenza A(H1N1)pdm2009 in the Southern Hemisphere during June–August 2009, we conducted several serologic studies. We pooled individual-level data from studies using hemagglutination inhibition assays performed in Australia, New Zealand, and Singapore. We determined seropositive proportions (titer >40) for each study region by age-group and sex in pre- and postpandemic phases, as defined by jurisdictional notification data. After exclusions, the pooled database consisted of, 4,414 prepandemic assays and 7,715 postpandemic assays. In the prepandemic phase, older age groups showed greater seropositive proportions, with age-standardized, community-based proportions ranging from 3.5% in Singapore to 11.9% in New Zealand. In the postpandemic phase, seropositive proportions ranged from 17.5% in Singapore to 30.8% in New Zealand, with highest proportions seen in school-aged children. Pregnancy and residential care were associated with lower postpandemic seropositivity, whereas Aboriginal and Torres Strait Islander Australians and Pacific Peoples of New Zealand had greater postpandemic seropositivity.
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- 2013
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7. Comparison of the pandemic H1N1 2009 experience in the Southern Hemisphere with pandemic expectations
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Kristina A. Grant, James E. Fielding, Geoff N. Mercer, Dale Carcione, Lisa Lopez, David W. Smith, Q. Sue Huang, and Heath A. Kelly
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influenza ,surveillance ,pandemic ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Objective: To describe the epidemiological characteristics of the 2009 H1N1 pandemic virus (pH1N1) over the 2009 and 2010 influenza seasons in Australia and New Zealand (NZ) and compare them with expectations based on previous pandemics. Methods: Laboratory‐confirmed influenza and influenza‐like illness (ILI) data were collected from established general practitioner sentinel surveillance schemes in NZ, Victoria and Western Australia (WA) throughout the 2009 and 2010 winter influenza seasons. Respiratory swabs from a sample of ILI patients were tested for influenza type and subtype. ILI rates and laboratory‐confirmed influenza data were analysed by age group and over time. Morbidity, mortality and reproductive number data were collated from the published literature. Results: Peak ILI rates and the percentage of influenza‐positive swabs from ILI patients from all sentinel surveillance schemes were considerably lower in 2010 than 2009. Compared to the population, cases of ILI were over‐represented in the young. While the age distributions in NZ and WA remained consistent, ILI cases were significantly younger in Victoria in 2009 compared to 2010. In Victoria, laboratory‐confirmed pH1N1 comprised up to 97% of influenza‐positive swabs in 2009 but only 56–87% in 2010. Mortality and hospitalisations were lower in 2010. The effective reproduction number (R) for pH1N1 was estimated to be 1.2–1.5 in NZ and WA, similar to estimated R values for seasonal influenza. Data from the surveillance systems indicated differences in the epidemiology of pH1N1 compared to expectations based on previous pandemics. In particular, there was no evidence of a second pandemic wave associated with increased mortality, and complete influenza strain replacement did not occur. Implications: Pandemic planning needs to accommodate the potential for influenza viruses to produce pandemics of various infectiousness and degrees of severity.
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- 2012
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8. Using whole-genome sequencing in the rapid response to SARS-CoV-2 in Aotearoa New Zealand
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White, Rhys T, Jelley, Lauren, Douglas, Jordan, Xiaoyun Ren, Winter, David, Genomics Team, Covid-19 Wgs, Bunce, Michael, Carr, Sam, Mcneill, Andrea, Q Sue Huang, Swadi, Tara, Devine, Tom, Mcelnay, Caroline, Sherwood, Jillian, Shoemack, Phil, Fox-Lewis, Andrew, Williamson, Felicity, Harrower, Jay, Storey, Matt, Jefferies, Sarah, Smit, Erasmus, Hadfield, James, Kenny, Aoife, Sporle, Andrew, G Edwin Reynolds, Mouldey, Kip, Lowe, Lindsay, Sonder, Gerard, Drummond, Alexei J, Welch, David, Holmes, Edward C, French, Nigel, Simpson, Colin R, De Ligt, Joep, and Geoghegan, Jemma
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- 2023
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9. Circulation of influenza and other respiratory viruses during the COVID-19 pandemic in Australia and New Zealand, 2020-2021.
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O'Neill, Genevieve K., Taylor, Janette, Jen Kok, Dwyer, Dominic E., Dilcher, Meik, Hua, Harry, Levy, Avram, Smith, David, Minney-Smith, Cara A., Wood, Timothy, Jelley, Lauren, Q. Sue Huang, Trenholme, Adrian, McAuliffe, Gary, Barra, Ian, and Sullivan, Sheena G.
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SARS-CoV-2 ,COVID-19 pandemic ,INFLUENZA ,COVID-19 ,RESPIRATORY syncytial virus - Abstract
Objective: Circulation patterns of influenza and other respiratory viruses have been globally disrupted since the emergence of coronavirus disease (COVID-19) and the introduction of public health and social measures (PHSMs) aimed at reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Methods: We reviewed respiratory virus laboratory data, Google mobility data and PHSMs in five geographically diverse regions in Australia and New Zealand. We also described respiratory virus activity from January 2017 to August 2021. Results: We observed a change in the prevalence of circulating respiratory viruses following the emergence of SARS-CoV-2 in early 2020. Influenza activity levels were very low in all regions, lower than those recorded in 2017-2019, with less than 1% of laboratory samples testing positive for influenza virus. In contrast, rates of human rhinovirus infection were increased. Respiratory syncytial virus (RSV) activity was delayed; however, once it returned, most regions experienced activity levels well above those seen in 2017-2019. The timing of the resurgence in the circulation of both rhinovirus and RSV differed within and between the two countries. Discussion: The findings of this study suggest that as domestic and international borders are opened up and other COVID-19 PHSMs are lifted, clinicians and public health professionals should be prepared for resurgences in influenza and other respiratory viruses. Recent patterns in RSV activity suggest that these resurgences in non-COVID-19 viruses have the potential to occur out of season and with increased impact. [ABSTRACT FROM AUTHOR]
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- 2023
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10. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis
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You Li, Xin Wang, Dianna M Blau, Mauricio T Caballero, Daniel R Feikin, Christopher J Gill, Shabir A Madhi, Saad B Omer, Eric A F Simões, Harry Campbell, Ana Bermejo Pariente, Darmaa Bardach, Quique Bassat, Jean-Sebastien Casalegno, Giorgi Chakhunashvili, Nigel Crawford, Daria Danilenko, Lien Anh Ha Do, Marcela Echavarria, Angela Gentile, Aubree Gordon, Terho Heikkinen, Q Sue Huang, Sophie Jullien, Anand Krishnan, Eduardo Luis Lopez, Joško Markić, Ainara Mira-Iglesias, Hannah C Moore, Jocelyn Moyes, Lawrence Mwananyanda, D James Nokes, Faseeha Noordeen, Evangeline Obodai, Nandhini Palani, Candice Romero, Vahid Salimi, Ashish Satav, Euri Seo, Zakhar Shchomak, Rosalyn Singleton, Kirill Stolyarov, Sonia K Stoszek, Anne von Gottberg, Danielle Wurzel, Lay-Myint Yoshida, Chee Fu Yung, Heather J Zar, Harish Nair, Michael Abram, Jeroen Aerssens, Annette Alafaci, Angel Balmaseda, Teresa Bandeira, Ian Barr, Ena Batinović, Philippe Beutels, Jinal Bhiman, Christopher C Blyth, Louis Bont, Sara S Bressler, Cheryl Cohen, Rachel Cohen, Anna-Maria Costa, Rowena Crow, Andrew Daley, Duc-Anh Dang, Clarisse Demont, Christine Desnoyers, Javier Díez-Domingo, Maduja Divarathna, Mignon du Plessis, Madeleine Edgoose, Fausto Martín Ferolla, Thea K Fischer, Amanuel Gebremedhin, Carlo Giaquinto, Yves Gillet, Roger Hernandez, Come Horvat, Etienne Javouhey, Irakli Karseladze, John Kubale, Rakesh Kumar, Bruno Lina, Florencia Lucion, Rae MacGinty, Federico Martinon-Torres, Alissa McMinn, Adam Meijer, Petra Milić, Adrian Morel, Kim Mulholland, Tuya Mungun, Nickson Murunga, Claire Newbern, Mark P Nicol, John Kofi Odoom, Peter Openshaw, Dominique Ploin, Fernando P Polack, Andrew J Pollard, Namrata Prasad, Joan Puig-Barberà, Janine Reiche, Noelia Reyes, Bishoy Rizkalla, Shilpa Satao, Ting Shi, Sujatha Sistla, Matthew Snape, Yanran Song, Giselle Soto, Forough Tavakoli, Michiko Toizumi, Naranzul Tsedenbal, Maarten van den Berge, Charlotte Vernhes, Claire von Mollendorf, Sibongile Walaza, Gregory Walker, Network, Respiratory Virus Global Epidemiology, and investigators, RESCEU
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RJ ,disease burden ,acute lower respiratory infections ,respiratory syncytial virus ,children ,Infant ,General Medicine ,Respiratory Syncytial Virus Infections ,Global Health ,Hospitalization ,Cost of Illness ,Child, Preschool ,Respiratory Syncytial Virus, Human ,Humans ,Hospital Mortality ,Child ,Respiratory Tract Infections ,RC - Abstract
Background Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0–60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0–60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. Methods In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0–60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). Findings In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4–44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9–4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100–49 100), and 101 400 RSV-attributable overall deaths (84 500–125 200) in children aged 0–60 months. In infants aged 0–6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6–9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0–2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800–28 100), and 45 700 RSV-attributable overall deaths (38 400–55 900). 2·0% of deaths in children aged 0–60 months (UR 1·6–2·4) and 3·6% of deaths in children aged 28 days to 6 months (3·0–4·4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). Interpretation RSV contributes substantially to morbidity and mortality burden globally in children aged 0–60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0–60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. Funding EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU).
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- 2022
11. Respiratory Virus-related Emergency Department Visits and Hospitalizations Among Infants in New Zealand
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Adrian Trenholme, Q. Sue Huang, Jazmin Duque, Namrata Prasad, E Claire Newbern, and Cameron C. Grant
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Microbiology (medical) ,medicine.medical_specialty ,Virus ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Humans ,Medicine ,030212 general & internal medicine ,Respiratory system ,Respiratory Tract Infections ,Socioeconomic status ,Disease burden ,Retrospective Studies ,business.industry ,Infant, Newborn ,Infant ,Respiratory infection ,Emergency department ,Hospitalization ,Infectious Diseases ,Virus Diseases ,Acute Disease ,Pediatrics, Perinatology and Child Health ,Hospital admission ,Emergency medicine ,Respiratory virus ,Seasons ,Emergency Service, Hospital ,business ,New Zealand - Abstract
Background Estimates of the contribution of respiratory viruses to emergency department (ED) utilization remain limited. Methods We conducted surveillance of infants with acute respiratory infection (ARI) associated ED visits, which then resulted in either hospital admission or discharge home. Seasonal rates of specific viruses stratified by age, ethnicity, and socioeconomic status were estimated for both visits discharged directly from ED and hospitalizations using rates of positivity for each virus. Results During the 2014-2016 winter seasons, 3585 (66%) of the 5412 ARI ED visits were discharged home directly and 1827 (34%) were admitted to hospital. Among visits tested for all respiratory viruses, 601/1111 (54.1%) of ED-only and 639/870 (73.4%) of the hospital-admission groups were positive for at least one respiratory virus. Overall, respiratory virus-associated ED visit rates were almost twice as high as hospitalizations. Respiratory syncytial virus was associated with the highest ED (34.4 per 1000) and hospitalization rates (24.6 per 1000) among infants. ED visit and hospitalization rates varied significantly by age and virus. Māori and Pacific children had significantly higher ED visit and hospitalization rates for all viruses compared with children of other ethnicities. Conclusions Many infants with acute respiratory virus infections are managed in the ED rather than admitted to the hospital. Higher rates of ED-only versus admitted acute respiratory virus infections occur among infants living in lower socioeconomic households, older infants and infants of Māori or Pacific versus European ethnicity. Respiratory virus infections resulting in ED visits should be included in measurements of ARI disease burden.
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- 2020
12. Risk of Severe Influenza Among Adults With Chronic Medical Conditions
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Q. Sue Huang, Diane Gross, Tiffany A Walker, Conroy Wong, Tim Wood, Michael G Baker, Colin McArthur, Mark G. Thompson, Jennifer Haubrock, Ben Waite, Sally Roberts, and E. Claire Newbern
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Disease ,Rate ratio ,Risk Assessment ,Coronary artery disease ,Young Adult ,03 medical and health sciences ,symbols.namesake ,Age Distribution ,0302 clinical medicine ,Internal medicine ,Influenza, Human ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,030212 general & internal medicine ,Poisson regression ,Aged ,Asthma ,Aged, 80 and over ,COPD ,business.industry ,Incidence ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Hospitalization ,Cross-Sectional Studies ,030104 developmental biology ,Infectious Diseases ,Case-Control Studies ,Chronic Disease ,symbols ,Female ,business ,New Zealand - Abstract
Background Severe influenza illness is presumed more common in adults with chronic medical conditions (CMCs), but evidence is sparse and often combined into broad CMC categories. Methods Residents (aged 18–80 years) of Central and South Auckland hospitalized for World Health Organization-defined severe acute respiratory illness (SARI) (2012–2015) underwent influenza virus polymerase chain reaction testing. The CMC statuses for Auckland residents were modeled using hospitalization International Classification of Diseases, Tenth Revision codes, pharmaceutical claims, and laboratory results. Population-level influenza rates in adults with congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus (DM), and end-stage renal disease (ESRD) were calculated by Poisson regression stratified by age and adjusted for ethnicity. Results Among 891 276 adults, 2435 influenza-associated SARI hospitalizations occurred. Rates were significantly higher in those with CMCs compared with those without the respective CMC, except for older adults with DM or those aged Conclusions Our findings support the increased risk of severe, laboratory-confirmed influenza disease among adults with specific CMCs compared with those without these conditions.
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- 2019
13. Defining the seasonality of respiratory syncytial virus around the world: National and subnational surveillance data from 12 countries
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John Paget, Vernon J. Lee, Mariëtte Hooiveld, Felipe Cotrim de Carvalho, Michel L. A. Dückers, Ana Paula Rodrigues, Q. Sue Huang, Clarisse Demont, Mathieu Bangert, Sonam Wangchuk, Tim Wood, Patricia Bustos, Lisa Staadegaard, Cheryl Cohen, Amparo Larrauri, Raquel Guiomar, Ludmila Novakova, Saverio Caini, Rodrigo Fasce, Adam Meijer, Walquiria Aparecida Ferreira de Almeida, Jocelyn Moyes, Domenica Joseth de Mora Coloma, Binay Thapa, Li Wei Ang, Jojanneke van Summeren, Alfredo Bruno Caicedo, Jan Kynčl, Concepción Delgado-Sanz, Social Psychology, AstraZeneca, and Sanofi
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Surveillance data ,Epidemiology ,respiratory syncytial virus ,viruses ,Respiratory Syncytial Virus Infections ,Biology ,Respiratory syncytial virus ,Virus ,medicine ,Humans ,Epidemics ,Location ,Respiratory Tract Infections ,National data ,Surveillance ,Respiratory tract infections ,seasonality ,Public Health, Environmental and Occupational Health ,Infant ,Original Articles ,Seasonality ,medicine.disease ,United States ,Infectious Diseases ,Respiratory Syncytial Virus, Human ,surveillance ,Original Article ,Seasons ,Demography - Abstract
Background: Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract infections and have a major burden on society. For prevention and control to be deployed effectively, an improved understanding of the seasonality of RSV is necessary. Objectives: The main objective of this study was to contribute to a better understanding of RSV seasonality by examining the GERi multi-country surveillance dataset. Methods: RSV seasons were included in the analysis if they contained ≥100 cases. Seasonality was determined using the "average annual percentage" method. Analyses were performed at a subnational level for the United States and Brazil. Results: We included 601 425 RSV cases from 12 countries. Most temperate countries experienced RSV epidemics in the winter, with a median duration of 10-21 weeks. Not all epidemics fit this pattern in a consistent manner, with some occurring later or in an irregular manner. More variation in timing was observed in (sub)tropical countries, and we found substantial differences in seasonality at a subnational level. No association was found between the timing of the epidemic and the dominant RSV subtype. Conclusions: Our findings suggest that geographical location or climatic characteristics cannot be used as a definitive predictor for the timing of RSV epidemics and highlight the need for (sub)national data collection and analysis. This study was funded by Sanofi/AstraZeneca. Sí
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- 2021
14. Lineage-specific protection and immune imprinting shape the age distributions of influenza B cases
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Q. Sue Huang, Philip Arevalo, Tim Wood, Sarah Cobey, Liza Lopez, Celeste M. Donato, Guus F. Rimmelzwaan, Katia Koelle, Marcos Costa Vieira, and Vijaykrishna Dhanasekaran
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0301 basic medicine ,Surveillance data ,Lineage (genetic) ,Epidemiology ,Cross Protection ,Science ,General Physics and Astronomy ,Biology ,Article ,General Biochemistry, Genetics and Molecular Biology ,Virus ,03 medical and health sciences ,Lineage specific ,Age Distribution ,0302 clinical medicine ,Immune system ,Influenza, Human ,Humans ,Computational models ,030212 general & internal medicine ,Imprinting (psychology) ,Probability ,Ecological epidemiology ,Genetics ,Models, Statistical ,Multidisciplinary ,virus diseases ,General Chemistry ,Virology ,Influenza B virus ,030104 developmental biology ,biology.protein ,Age distribution ,Antibody ,Birth cohort ,Influenza virus ,Immunologic Memory ,Immunologic memory ,New Zealand - Abstract
How a history of influenza virus infections contributes to protection is not fully understood, but such protection might explain the contrasting age distributions of cases of the two lineages of influenza B, B/Victoria and B/Yamagata. Fitting a statistical model to those distributions using surveillance data from New Zealand, we found they could be explained by historical changes in lineage frequencies combined with cross-protection between strains of the same lineage. We found additional protection against B/Yamagata in people for whom it was their first influenza B infection, similar to the immune imprinting observed in influenza A. While the data were not informative about B/Victoria imprinting, B/Yamagata imprinting could explain the fewer B/Yamagata than B/Victoria cases in cohorts born in the 1990s and the bimodal age distribution of B/Yamagata cases. Longitudinal studies can test if these forms of protection inferred from historical data extend to more recent strains and other populations., The earliest infections with influenza A shape the immune responses to future infections, but it is not known if this phenomenon applies to influenza B. Here, the authors use influenza B case data from New Zealand and find evidence for both lineage-specific and imprinting protection.
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- 2021
15. Activated CD4+ T cells and CD14hiCD16+ monocytes correlate with antibody response following influenza virus infection in humans
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Cameron C. Grant, Jazmin Duque, Susan S. Taylor, Gary Reynolds, Q. Sue Huang, Cecilia Dela Cruz, Tim Wood, Robyn Madge, Richard J. Webby, Wendy Gunn, Lauren Jelley, Marc-Alain Widdowson, Susan Walker, Mandy Ma, Mark G. Thompson, Bhamita Chand, Adrian Trenholmes, Xi-zhi J. Guo, Mark Zanin, Fahimeh Rahnama, Louise Optland, Tirzah Korrapadu, Conroy Wong, Judy Bocacao, Nicole Moore, Mahtab Zibaei, Jo Smith, Reniza Cogcoy, Laurel Plewes, Shona Chamberlin, Sook-San Wong, Shirley Lawrence, Kathryn Haven, Tania Knowles, Jo-Ann McLeish, Diane Gross, Yan Chen, Frann Sawtell, Angela Todd, Sally Roberts, Kirstin Davey, Debbie Aley, Christine M. Oshansky, Ruth Seeds, Ben Waite, Michael J. Baker, Paul G. Thomas, Franie Gravidez, Nikki Turner, Pamela Muponisi, Fifi Tse, Colin McArthur, Jacqui Ralston, Trushar Jeevan, Pamela Kawakami, and Helen Qiao
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0301 basic medicine ,Immunoglobulin A ,Cellular immunity ,Medicine (General) ,media_common.quotation_subject ,cellular immunity ,General Biochemistry, Genetics and Molecular Biology ,Virus ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,antibody ,Medicine ,Seroconversion ,seroconversion ,media_common ,biology ,business.industry ,Convalescence ,infection ,030104 developmental biology ,Immunology ,biology.protein ,Respiratory virus ,Antibody ,business ,influenza ,monocytes ,030217 neurology & neurosurgery ,CD8 - Abstract
Summary The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts.
- Published
- 2021
16. Influenza-Associated Outcomes Among Pregnant, Postpartum, and Nonpregnant Women of Reproductive Age
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Mark G. Thompson, Nayyereh Aminisani, E. Claire Newbern, Tim Wood, Q. Sue Huang, Michael G Baker, Ruth Seeds, Namrata Prasad, Marc-Alain Widdowson, and Colin McArthur
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Adult ,0301 basic medicine ,medicine.medical_specialty ,Adolescent ,Orthomyxoviridae ,Rate ratio ,medicine.disease_cause ,Young Adult ,03 medical and health sciences ,Influenza A Virus, H1N1 Subtype ,0302 clinical medicine ,Pregnancy ,Influenza, Human ,Influenza A virus ,Humans ,Immunology and Allergy ,Medicine ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,Young adult ,Pregnancy Trimesters ,biology ,business.industry ,Obstetrics ,Influenza A Virus, H3N2 Subtype ,Reproduction ,Postpartum Period ,Vaccination ,Respiratory infection ,biology.organism_classification ,medicine.disease ,Hospitalization ,Influenza B virus ,030104 developmental biology ,Infectious Diseases ,Female ,Pregnant Women ,business ,Postpartum period - Abstract
Background Pregnant women are prioritized for seasonal influenza vaccination, but the evidence on the risk of influenza during pregnancy that is used to inform these policies is limited. Methods Individual-level administrative data sets and active surveillance data were joined to estimate influenza-associated hospitalization and outpatient visit rates by pregnancy, postpartum, and trimester status. Results During 2012-2015, 46 of 260 (17.7%) influenza-confirmed hospitalizations for acute respiratory infection and 13 of 294 (4.4%) influenza-confirmed outpatient visits were among pregnant and postpartum women. Pregnant and postpartum women experienced higher rates of influenza-associated hospitalization than nonpregnant women overall (rate ratio [RR], 3.4; 95% confidence interval [CI], 2.5-4.7) and by trimester (first, 2.5 [95% CI, 1.2-5.4]; second, 3.9 [95% CI, 2.4-6.3]; and third, 4.8 [95% CI, 3.0-7.7]); the RR for the postpartum period was 0.7 (95% CI, 3.0-7.7). Influenza A viruses were associated with an increased risk (RR for 2009 pandemic influenza A[H1N1] virus, 5.3 [95% CI, 3.2-8.7]; RR for influenza A(H3N2) virus, 3.0 [95% CI, 1.8-5.0]), but influenza B virus was not (RR, 1.8; 95% CI, .7-4.6). Influenza-associated hospitalization rates in pregnancy were significantly higher for Māori women (RR, 3.2; 95% CI, 1.3-8.4), compared with women of European or other ethnicity. Similar risks for influenza-confirmed outpatient visits were not observed. Conclusion Seasonal influenza poses higher risks of hospitalization among pregnant women in all trimesters, compared with nonpregnant women. Hospitalization rates vary by influenza virus type and ethnicity among pregnant women.
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- 2019
17. Sensitivity and specificity of surveillance case definitions in detection of influenza and respiratory syncytial virus among hospitalized patients, New Zealand, 2012-2016
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William Davis, Jazmin Duque, Q. Sue Huang, Natalie Olson, Cameron C. Grant, E. Claire Newbern, Mark Thompson, Ben Waite, Namrata Prasad, Adrian Trenholme, and Eduardo Azziz-Baumgartner
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Microbiology (medical) ,Hospitalization ,Infectious Diseases ,Respiratory Syncytial Virus, Human ,Influenza, Human ,Humans ,Infant ,Respiratory Syncytial Virus Infections ,Child ,Respiratory Tract Infections ,New Zealand - Abstract
The WHO is exploring the value of adding RSV testing to existing influenza surveillance systems to inform RSV control programs. We evaluate the usefulness of four commonly used influenza surveillance case-definitions for influenza and RSV surveillance.SHIVERS, a multi-institutional collaboration, conducted surveillance for influenza and RSV in four New Zealand hospitals. Nurses reviewed admission logs, enrolled patients with suspected acute respiratory infections (ARI), and obtained nasopharyngeal swabs for RT-PCR. We compared the performance characteristics for identifying laboratory-confirmed influenza and RSV severe acute respiratory infection (SARI), defined as persons admitted with measured or reported fever and cough within 10 days of illness, to three other case definitions: 1. reported fever and cough or shortness of breath, 2. cough and shortness of breath, or 3. cough.During April-September 2012-2016, SHIVERS identified 16,055 admissions with ARI; of 6374 cases consented and tested for influenza or RSV, 5437 (85%) had SARI and 937 (15%) did not. SARI had the highest specificity in detecting influenza (40.6%) and RSV (40.8%) but the lowest sensitivity (influenza 78.8%, RSV 60.3%) among patients of all ages. Cough or shortness of breath had the highest sensitivity (influenza 99.3%, RSV 99.9%) but the lowest specificity (influenza 1.6%, RSV 1.9%). SARI sensitivity among children aged3 months was 60.8% for influenza and 43.6% for RSV-both lower than in other age groups.While SARI had the highest specificity, its sensitivity was limited, especially among children aged3 months. Cough or shortness of breath was the most sensitive.
- Published
- 2021
18. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand
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Q. Sue Huang, Tim Wood, Lauren Jelley, Tineke Jennings, Sarah Jefferies, Karen Daniells, Annette Nesdale, Tony Dowell, Nikki Turner, Priscilla Campbell-Stokes, Michelle Balm, Hazel C. Dobinson, Cameron C. Grant, Shelley James, Nayyereh Aminisani, Jacqui Ralston, Wendy Gunn, Judy Bocacao, Jessica Danielewicz, Tessa Moncrieff, Andrea McNeill, Liza Lopez, Ben Waite, Tomasz Kiedrzynski, Hannah Schrader, Rebekah Gray, Kayla Cook, Danielle Currin, Chaune Engelbrecht, Whitney Tapurau, Leigh Emmerton, Maxine Martin, Michael G. Baker, Susan Taylor, Adrian Trenholme, Conroy Wong, Shirley Lawrence, Colin McArthur, Alicia Stanley, Sally Roberts, Fahimeh Rahnama, Jenny Bennett, Chris Mansell, Meik Dilcher, Anja Werno, Jennifer Grant, Antje van der Linden, Ben Youngblood, Paul G. Thomas, NPIsImpactOnFlu Consortium, and Richard J. Webby
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0301 basic medicine ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Epidemiology ,Science ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Psychological intervention ,General Physics and Astronomy ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Influenza, Human ,Pandemic ,medicine ,Humans ,030212 general & internal medicine ,Respiratory system ,Intensive care medicine ,Pandemics ,Respiratory Tract Infections ,Multidisciplinary ,SARS-CoV-2 ,business.industry ,Nouvelle zelande ,Pandemic influenza ,COVID-19 ,virus diseases ,General Chemistry ,030112 virology ,Hospitalization ,Viral infection ,Communicable Disease Control ,Epidemiological Monitoring ,Public Health ,Prevention control ,Influenza virus ,business ,New Zealand - Abstract
Stringent nonpharmaceutical interventions (NPIs) such as lockdowns and border closures are not currently recommended for pandemic influenza control. New Zealand used these NPIs to eliminate coronavirus disease 2019 during its first wave. Using multiple surveillance systems, we observed a parallel and unprecedented reduction of influenza and other respiratory viral infections in 2020. This finding supports the use of these NPIs for controlling pandemic influenza and other severe respiratory viral threats., New Zealand has been relatively successful in controlling COVID-19 due to implementation of strict non-pharmaceutical interventions. Here, the authors demonstrate a striking decline in reports of influenza and other non-influenza respiratory pathogens over winter months in which the interventions have been in place.
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- 2020
19. Activated CD4
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Sook-San, Wong, Christine M, Oshansky, Xi-Zhi J, Guo, Jacqui, Ralston, Timothy, Wood, Gary E, Reynolds, Ruth, Seeds, Lauren, Jelley, Ben, Waite, Trushar, Jeevan, Mark, Zanin, Marc-Alain, Widdowson, Q Sue, Huang, Paul G, Thomas, Richard J, Webby, and Cecilia, Dela Cruz
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CD4-Positive T-Lymphocytes ,immune correlate ,Lipopolysaccharide Receptors ,cellular immunity ,CD8-Positive T-Lymphocytes ,Antibodies, Viral ,Monocytes ,infection ,respiratory virus ,Orthomyxoviridae Infections ,Influenza A virus ,Influenza Vaccines ,Report ,antibody ,humoral immunity ,Antibody Formation ,Influenza, Human ,Humans ,mucosal immunity ,influenza ,Immunity, Mucosal ,seroconversion - Abstract
Summary The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts., Graphical abstract, Highlights Post-infection seroconversion is associated with severity of influenza virus infection Seroconverters have early proliferation and activation of CD4+ T cells CD8+ T cells are unaffected CD14hiCD16+ monocytes in the blood and nasal mucosa is associated with antibody response, Wong et al. show that antibody responsiveness after influenza virus infection is associated with CD4+ T cells and CD14hiCD16+ monocytes. CD14hiCD16+ monocytes are also important in the mucosal antibody response. This demonstrates that seroconversion failure after infection is a definable immunological phenomenon, an important consideration for diagnostics and epidemiological studies.
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- 2020
20. Modelling the impact of respiratory syncytial virus (RSV) vaccine and immunoprophylaxis strategies in New Zealand
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Namrata Prasad, Alexandra B. Hogan, E Claire Newbern, Cameron C. Grant, Q. Sue Huang, Chris P. Jewell, Jonathan M. Read, Ben Waite, Adrian Trenholme, and Imperial College LOndon
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Rsv vaccine ,Surveillance data ,Population ,Respiratory Syncytial Virus Infections ,Respiratory syncytial virus ,medicine.disease_cause ,Virus ,Immunoprophylaxis ,03 medical and health sciences ,0302 clinical medicine ,Virology ,07 Agricultural and Veterinary Sciences ,030225 pediatrics ,medicine ,Respiratory Syncytial Virus Vaccines ,Humans ,030212 general & internal medicine ,education ,Child ,11 Medical and Health Sciences ,Disease burden ,education.field_of_study ,Maternal vaccine ,Mathematical modelling ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Transmission (medicine) ,Public Health, Environmental and Occupational Health ,RSV ,Infant ,06 Biological Sciences ,Hospitalization ,Infectious Diseases ,Respiratory syncytial virus (RSV) ,Respiratory Syncytial Virus, Human ,Immunology ,Molecular Medicine ,Disease prevention ,Immunization ,business ,New Zealand - Abstract
Background Mathematical models of respiratory syncytial virus (RSV) transmission can help describe seasonal epidemics and assess the impact of potential vaccines and immunoprophylaxis with monoclonal antibodies (mAb). Methods We developed a deterministic, compartmental model for RSV transmission, which was fitted to population-based RSV hospital surveillance data from Auckland, New Zealand. The model simulated the introduction of either a maternal vaccine or a seasonal mAb among infants aged less than 6 months and estimated the reduction in RSV hospitalizations for a range of effectiveness and coverage values. Results The model accurately reproduced the annual seasonality of RSV epidemics in Auckland. We found that a maternal vaccine with effectiveness of 30–40% in the first 90 days and 15–20% for the next 90 days could reduce RSV hospitalizations by 18–24% in children younger than 3 months, by 11–14% in children aged 3–5 months, and by 2–3% in children aged 6–23 months. A seasonal infant mAb with 40–60% effectiveness for 150 days could reduce RSV hospitalizations by 30–43%, 34–48% and by 14–21% in children aged 0–2 months, 3–5 months and 6–23 months, respectively. Conclusions Our results suggest that either a maternal RSV vaccine or mAb would effectively reduce RSV hospitalization disease burden in New Zealand. Overall, a seasonal mAb resulted in a larger disease prevention impact than a maternal vaccine.
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- 2020
21. Respiratory syncytial virus hospitalisations among young children: a data linkage study – Erratum
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Namrata Prasad, E. Claire Newbern, Adrian A. Trenholme, Tim Wood, Mark G. Thompson, Nayyereh Aminisani, Q. Sue Huang, and Cameron C. Grant
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Infectious Diseases ,Epidemiology ,Erratum - Published
- 2020
22. The health and economic burden of respiratory syncytial virus associated hospitalizations in adults
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Lauren Jelley, Nayyereh Aminisani, Cameron C. Grant, Mark G. Thompson, Adrian Trenholme, Q. Sue Huang, E Claire Newbern, Conroy Wong, Namrata Prasad, and Colin McArthur
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0301 basic medicine ,RNA viruses ,Male ,Pediatrics ,Viral Diseases ,Pulmonology ,Epidemiology ,viruses ,Disease ,Pathology and Laboratory Medicine ,Geographical locations ,0302 clinical medicine ,Cost of Illness ,Interquartile range ,Medicine and Health Sciences ,030212 general & internal medicine ,Multidisciplinary ,Incidence (epidemiology) ,Respiratory infection ,virus diseases ,respiratory system ,Hospitals ,Hospitalization ,Infectious Diseases ,Medical Microbiology ,Viral Pathogens ,Viruses ,Medicine ,Female ,Seasons ,Pathogens ,Research Article ,Adult ,medicine.medical_specialty ,Infectious Disease Control ,Science ,Oceania ,Respiratory Syncytial Virus Infections ,Disease Surveillance ,Microbiology ,Ethnic Epidemiology ,03 medical and health sciences ,medicine ,Adults ,Humans ,Microbial Pathogens ,Disease burden ,Retrospective Studies ,Biology and life sciences ,business.industry ,Organisms ,Retrospective cohort study ,030112 virology ,Confidence interval ,Influenza ,Health Care ,Age Groups ,Health Care Facilities ,Infectious Disease Surveillance ,People and Places ,Respiratory Infections ,Paramyxoviruses ,Population Groupings ,Respiratory Syncytial Virus ,business ,New Zealand - Abstract
BackgroundRespiratory syncytial virus (RSV) is increasingly recognized as an important cause of illness in adults; however, data on RSV disease and economic burden in this age group remain limited. We aimed to provide comprehensive estimates of RSV disease burden among adults aged ≥18 years.MethodsDuring 2012-2015, population-based, active surveillance of acute respiratory infection (ARI) hospitalizations enabled estimation of the seasonal incidence of RSV hospitalizations and direct health costs in adults aged ≥18 years in Auckland, New Zealand.ResultsOf 4,600 ARI hospitalizations tested for RSV, 348 (7.6%) were RSV positive. The median (interquartile range) length of hospital stay for RSV positive patients was 4 (2-6) days. The seasonal incidence rate (IR) of RSV hospitalizations, corrected for non-testing, was 23.6 (95% confidence intervals [CI] 21.0-26.1) per 100,000 adults aged ≥18 years. Hospitalization risk increased with age with the highest incidence among adults aged ≥80 years (IR 190.8 per 100,000, 95% CI 137.6-244.0). Being of Māori or Pacific ethnicity or living in a neighborhood with low socioeconomic status (SES) were independently associated with increased RSV hospitalization rates. We estimate RSV-associated hospitalizations among adults aged ≥18 years to cost on average NZD $4,758 per event.ConclusionsRSV infection is associated with considerable disease and economic cost in adults. RSV disproportionally affects adult sub-groups defined by age, ethnicity, and neighborhood SES. An effective RSV vaccine or RSV treatment may offer benefits for older adults.
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- 2020
23. Hemagglutinin and Neuraminidase Antibodies Are Induced in an Age- and Subtype-Dependent Manner after Influenza Virus Infection
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Ruth Seeds, Q. Sue Huang, Jacqui Ralston, E. Claire Newbern, G Edwin Reynolds, Mark G. Thompson, Ben Waite, Shivers Investigation Team, Tim Wood, Richard J. Webby, and Sook-San Wong
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Adult ,Male ,Adolescent ,Immunology ,Neuraminidase ,hemagglutination inhibition ,serology ,Hemagglutinin (influenza) ,Hemagglutinin Glycoproteins, Influenza Virus ,Biology ,Antibodies, Viral ,Polymerase Chain Reaction ,Microbiology ,Virus ,Serology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Seroepidemiologic Studies ,Immunity ,antibody ,Virology ,Influenza, Human ,Humans ,030212 general & internal medicine ,Seroconversion ,Child ,030304 developmental biology ,0303 health sciences ,Hemagglutination assay ,neuraminidase inhibition ,Age Factors ,Infant, Newborn ,Infant ,3. Good health ,Influenza B virus ,Influenza A virus ,Child, Preschool ,Insect Science ,biology.protein ,Pathogenesis and Immunity ,Female ,Antibody ,influenza ,Immunologic Memory ,New Zealand - Abstract
Data on the immunologic responses to neuraminidase (NA) is lacking compared to what is available on hemagglutinin (HA) responses, despite growing evidence that NA immunity can be protective and broadly cross-reactive. Understanding these NA responses during natural infection is key to exploiting these properties for improving influenza vaccines. Using two community-acquired influenza cohorts, we showed that the induction of both HA and NA antibodies after infection is influenced by age and subtypes. Such response dynamics suggest the influence of immunological memory, and understanding how this process is regulated will be critical to any vaccine effort targeting NA immunity., Despite evidence that antibodies targeting the influenza virus neuraminidase (NA) protein can be protective and are broadly cross-reactive, the immune response to NA during infection is poorly understood compared to the response to hemagglutinin (HA) protein. As such, we compared the antibody profile to HA and NA in two naturally infected human cohorts in Auckland, New Zealand: (i) a serosurvey cohort, consisting of pre- and post-influenza season sera from PCR-confirmed influenza cases (n = 50), and (ii) an immunology cohort, consisting of paired sera collected after PCR-confirmation of infection (n = 94). The induction of both HA and NA antibodies in these cohorts was influenced by age and subtype. Seroconversion to HA was more frequent in those
- Published
- 2020
24. Respiratory Syncytial Virus-Associated Hospitalizations Among Adults With Chronic Medical Conditions
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Colin McArthur, Ben Waite, E Claire Newbern, Conroy A Wong, Tiffany A Walker, Namrata Prasad, Adrian Trenholme, Tim Wood, Michael G Baker, Q. Sue Huang, and Cameron C. Grant
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Microbiology (medical) ,Adult ,medicine.medical_specialty ,Population ,Disease ,Respiratory Syncytial Virus Infections ,Rate ratio ,Internal medicine ,Diabetes mellitus ,Influenza, Human ,medicine ,Humans ,education ,Asthma ,COPD ,education.field_of_study ,Respiratory tract infections ,business.industry ,Respiratory disease ,Infant ,medicine.disease ,Hospitalization ,Infectious Diseases ,Respiratory Syncytial Virus, Human ,Chronic Disease ,business - Abstract
Background In contrast with respiratory disease caused by influenza, information on the risk of respiratory syncytial virus (RSV) disease among adults with chronic medical conditions (CMCs) is limited. Methods We linked population-based surveillance of acute respiratory illness hospitalizations to national administrative data to estimate seasonal RSV hospitalization rates among adults aged 18–80 years with the following preexisting CMCs: chronic obstructive pulmonary disease (COPD), asthma, congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), diabetes mellitus (DM), and end-stage renal disease (ESRD). Age- and ethnicity-adjusted rates stratified by age group were estimated. Results Among 883 999 adult residents aged 18–80 years, 281 RSV-positive hospitalizations were detected during 2012–2015 winter seasons. Across all ages, RSV hospitalization rates were significantly higher among adults with COPD, asthma, CHF, and CAD compared with those without each corresponding condition. RSV hospitalization rates were significantly higher among adults with ESRD aged 50–64 years and adults with DM aged 18–49 years and 65–80 years compared with adults in each age group without these conditions. No increased risk was seen for adults with CVA. The CMC with the highest risk of RSV hospitalization was CHF (incidence rate ratio [IRR] range, 4.6–36.5 across age strata) and COPD (IRR range, 9.6–9.7). Among RSV-positive adults, CHF and COPD were independently associated with increased length of hospital stay. Conclusions Adults with specific CMCs are at increased risk of RSV hospitalizations. Age affects this relationship for some CMCs. Such populations maybe relevant for future RSV prevention strategies.
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- 2020
25. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study.
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Emma Taylor, Kathryn Haven, Peter Reed, Ange Bissielo, Dave Harvey, Colin McArthur, Cameron Bringans, Simone Freundlich, R. Joan H. Ingram, David Perry, Francessa Wilson, David N. Milne, Lucy Modahl, Q. Sue Huang, Diane Gross, Marc-Alain Widdowson, and Cameron Grant
- Published
- 2015
- Full Text
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26. Defining cellular correlates of protection and vaccine failure to influenza across two human cohorts
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Robert C Mettelman, Aisha Souquette, Lee-Ann Van de Velde, E. Kaitlynn Allen, Timothy Wood, Florian Krammer, Joshua G Petrie, Emily T Martin, Arnold S Monto, Q. Sue Huang, and Paul Glyndwr Thomas
- Subjects
Immunology ,Immunology and Allergy - Abstract
Influenza viruses are endemic viral pathogens causing mild to severe respiratory illness in humans. Immunologic protection against influenza is determined by immune correlates of protection– factors associated with reduced infection or severe disease. While antibodies specific to viral surface proteins are known correlates, waning seasonal vaccine efficacy and reported infection of patients despite elevated antibody titers suggest that humoral responses alone do not provide complete protective immunity. Indeed, evidence points to a larger role for cell-mediated immunity (CMI; innate cells and antigen-specific T cells) in conferring protection. CMI correlates, which act independently from humoral responses, have yet to be identified. Here, we analyzed samples from adult human subjects across two influenza infection and vaccination cohorts to identify distinct CMI correlates of protection to influenza. We profiled CMI responses using high-dimension flow cytometry from PBMCs collected pre- and post-exposure to influenza infection or vaccination. Statistical comparison of cell frequency and infection status identified candidate CMI correlates, which were validated using logistic regression accounting for vaccination, demographic (age, sex, BMI), and serologic (antibody) covariates. We identified 9 individual and 6 cell clusters across myeloid and lymphoid compartments associated with protection. The strongest correlations were observed in Th17, cTfh, and subsets of NK and dendritic cells. Further, AUROC models identified 3 baseline CMI infection classifiers. Lastly, our study identified correlates of vaccine failure– pre-exposure CMI profiles correlated with positive infection status despite vaccination.
- Published
- 2021
27. Modelled seasonal influenza mortality shows marked differences in risk by age, sex, ethnicity and socioeconomic position in New Zealand
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Q. Sue Huang, Michael G Baker, Jane Zhang, Trang Q.T. Khieu, Nevil Pierse, and Lucy Telfar-Barnard
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Adult ,Male ,Microbiology (medical) ,Gerontology ,Epidemiology not elsewhere classified ,Adolescent ,030231 tropical medicine ,Ethnic group ,Psychological intervention ,medicine.disease_cause ,Rate ratio ,White People ,03 medical and health sciences ,symbols.namesake ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Influenza, Human ,Influenza A virus ,medicine ,Humans ,030212 general & internal medicine ,Poisson regression ,Disease burden ,Aged ,Models, Statistical ,business.industry ,Mortality rate ,Age Factors ,Middle Aged ,Vaccination ,Influenza B virus ,Infectious Diseases ,Socioeconomic Factors ,symbols ,Regression Analysis ,Female ,Seasons ,business ,New Zealand ,Demography - Abstract
Objectives: Influenza is responsible for a large number of deaths which can only be estimated using modelling methods. Such methods have rarely been applied to describe the major socio-demographic characteristics of this disease burden. Methods: We used quasi Poisson regression models with weekly counts of deaths and isolates of influenza A, B and respiratory syncytial virus for the period 1994 to 2008. Results: The estimated average mortality rate was 13.5 per 100,000 people which was 1.8% of all deaths in New Zealand. Influenza mortality differed markedly by age, sex, ethnicity and socioeconomic position. Relatively vulnerable groups were males aged 65-79 years (Rate ratio (RR) = 1.9, 95% CI: 1.9, 1.9 compared with females), Maori (RR = 3.6, 95% CI: 3.6, 3.7 compared with European/Others aged 65-79 years), Pacific (RR = 2.4, 95% CI: 2.4, 2.4 compared with European/Others aged 65e79 years) and those living in the most deprived areas (RR = 1.8, 95% CI: 1.3, 2.4) for New Zealand Deprivation (NZDep) 9&10 (the most deprived) compared with NZDep 1&2 (the least deprived). Conclusions: These results support targeting influenza vaccination and other interventions to the most vulnerable groups, in particular Maori and Pacific people and men aged 65e79 years and those living in the most deprived areas.
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- 2019
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28. Heterogeneity in influenza seasonality and vaccine effectiveness in Australia, Chile, New Zealand and South Africa: early estimates of the 2019 influenza season
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Maria Fernanda Olivares, Viviana Sotomayor, Lauren Jelley, Judy Bocacao, Rodrigo Fasce, Monique Bm Chilver, Natalia Vergara, Allen C. Cheng, Q. Sue Huang, Sibongile Walaza, Stefano Tempia, Cecilia Gonzalez, Vivian K.Y. Leung, Kylie S. Carville, Cheryl Cohen, Andrea McNeill, Carmen S. Arriola, Patricia Bustos, Sheena G. Sullivan, Johanna M. McAnerney, Heidi Peck, Anne von Gottberg, Liza Lopez, Pamela Burgos, Nathalie El Omeiri, Yi Mo Deng, Tim Wood, and Orienka Hellferscee
- Subjects
Adult ,Male ,Adolescent ,Epidemiology ,sentinel surveillance ,Influenza season ,South Africa ,Influenza A Virus, H1N1 Subtype ,Virology ,influenza vaccines ,Influenza, Human ,Outcome Assessment, Health Care ,medicine ,Humans ,Chile ,Child ,Southern Hemisphere ,Vaccine Potency ,vaccine effectiveness ,southern hemisphere ,Reverse Transcriptase Polymerase Chain Reaction ,Influenza A Virus, H3N2 Subtype ,Vaccination ,Public Health, Environmental and Occupational Health ,Northern Hemisphere ,Australia ,virus diseases ,Seasonality ,Middle Aged ,medicine.disease ,Influenza B virus ,Geography ,Population Surveillance ,Female ,Seasons ,influenza ,Rapid Communication ,Demography ,New Zealand - Abstract
We compared 2019 influenza seasonality and vaccine effectiveness (VE) in four southern hemisphere countries: Australia, Chile, New Zealand and South Africa. Influenza seasons differed in timing, duration, intensity and predominant circulating viruses. VE estimates were also heterogeneous, with all-ages point estimates ranging from 7–70% (I2: 33%) for A(H1N1)pdm09, 4–57% (I2: 49%) for A(H3N2) and 29–66% (I2: 0%) for B. Caution should be applied when attempting to use southern hemisphere data to predict the northern hemisphere influenza season.
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- 2019
29. Respiratory syncytial virus hospitalisations among young children: a data linkage study
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Q. Sue Huang, Namrata Prasad, Mark G. Thompson, Tim Wood, Cameron C. Grant, Nayyereh Aminisani, E. Claire Newbern, and Adrian Trenholme
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Male ,Epidemiology ,viruses ,respiratory syncytial virus ,Information Storage and Retrieval ,Respiratory Syncytial Virus Infections ,Disease ,Risk Assessment ,Virus ,paediatrics ,Cohort Studies ,respiratory infections ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,030225 pediatrics ,Hospital discharge ,Humans ,Medicine ,030212 general & internal medicine ,Hospital Costs ,Sex Distribution ,Respiratory system ,Child ,Data Linkage ,Retrospective Studies ,Original Paper ,business.industry ,Incidence (epidemiology) ,Infant ,Respiratory infection ,Confidence interval ,3. Good health ,Hospitalization ,Infectious Diseases ,Child, Preschool ,Population Surveillance ,Respiratory Syncytial Virus, Human ,Female ,Seasons ,business ,Infectious disease epidemiology ,New Zealand ,Demography - Abstract
We aimed to provide comprehensive estimates of laboratory-confirmed respiratory syncytial virus (RSV)-associated hospitalisations. Between 2012 and 2015, active surveillance of acute respiratory infection (ARI) hospitalisations during winter seasons was used to estimate the seasonal incidence of laboratory-confirmed RSV hospitalisations in children aged
- Published
- 2019
30. Severe influenza is characterized by prolonged immune activation: results from the SHIVERS Cohort Study
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Xi-zhi J. Guo, Tim Wood, Jacqui Ralston, Sook-San Wong, Gary Reynolds, Q. Sue Huang, Shivers Investigation Team, Christine M. Oshansky, Ben Waite, Richard J. Webby, Marc-Alain Widdowson, Ruth Seeds, Paul G. Thomas, and Claire Newbern
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0301 basic medicine ,Adult ,Male ,Epidemiology not elsewhere classified ,Adolescent ,medicine.medical_treatment ,Adaptive Immunity ,Immunology not elsewhere classified ,Monocytes ,Article ,Proinflammatory cytokine ,Cohort Studies ,03 medical and health sciences ,Young Adult ,Immune system ,Influenza, Human ,medicine ,Immunology and Allergy ,Humans ,Lymphocytes ,Child ,Interleukin 4 ,Interleukin 3 ,Aged ,Inflammation ,Immunity, Cellular ,business.industry ,Humoural immunology and immunochemistry ,virus diseases ,Dendritic Cells ,Middle Aged ,Immunity, Innate ,Interleukin 10 ,030104 developmental biology ,Infectious Diseases ,Cytokine ,Interleukin 13 ,Immunology ,Interleukin 12 ,Cytokines ,Female ,business ,Health care administration - Abstract
Background. The immunologic factors underlying severe influenza are poorly understood. To address this, we compared the immune responses of influenza-confirmed hospitalized individuals with severe acute respiratory illness (SARI) to those of nonhospitalized individuals with influenza-like illness (ILI).Methods. Peripheral blood lymphocytes were collected from 27 patients with ILI and 27 with SARI, at time of enrollment and then 2 weeks later. Innate and adaptive cellular immune responses were assessed by flow cytometry, and serum cytokine levels were assessed by a bead-based assay. Results. During the acute phase, SARI was associated with significantly reduced numbers of circulating myeloid dendritic cells, CD192+ monocytes, and influenza virus–specific CD8+ and CD4+ T cells as compared to ILI. By the convalescent phase, however, most SARI cases displayed continued immune activation characterized by increased numbers of CD16+ monocytes and proliferating, and influenza virus–specific, CD8+ T cells as compared to ILI cases. SARI was also associated with reduced amounts of cytokines that regulate T-cell responses (ie, interleukin 4, interleukin 13, interleukin 12, interleukin 10, and tumor necrosis factor β) and hematopoiesis (interleukin 3 and granulocyte-macrophage colony-stimulating factor) but increased amounts of a proinflammatory cytokine (tumor necrosis factor α), chemotactic cytokines (MDC, MCP-1, GRO, and fractalkine), and growth-promoting cytokines (PDGFBB/AA, VEGF, and EGF) as compared to ILI.Conclusions. Severe influenza cases showed a delay in the peripheral immune activation that likely led prolonged inflammation, compared with mild influenza cases.
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- 2019
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31. What can we learn from our 2021 respiratory syncytial virus experience?
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Grant, Cameron C., Q. Sue Huang, Trenholme, Adrian, Taylor, Susan, Wood, Tim, and Huang, Qiu Sue
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- 2021
32. Influenza vaccine effectiveness for hospital and community patients using control groups with and without non-influenza respiratory viruses detected, Auckland, New Zealand 2014
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Ange Bissielo, Heath Kelly, Mark G. Thompson, Q. Sue Huang, Sarah Radke, Michael G Baker, Nicola Turner, and Nevil Pierse
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Adult ,Male ,0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Influenza vaccine ,General Practice ,Respiratory Tract Diseases ,030106 microbiology ,Population ,Virus ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Influenza, Human ,Humans ,Medicine ,030212 general & internal medicine ,Respiratory system ,Young adult ,Child ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Vaccination ,Public Health, Environmental and Occupational Health ,Infant ,Middle Aged ,Control Groups ,Hospitalization ,Infectious Diseases ,Vaccines, Inactivated ,Influenza Vaccines ,Child, Preschool ,Molecular Medicine ,Pacific islanders ,Respiratory virus ,Female ,business ,Sentinel Surveillance ,New Zealand - Abstract
Background We aimed to estimate the protection afforded by inactivated influenza vaccine, in both community and hospital settings, in a well characterised urban population in Auckland during 2014. Methods We used two different comparison groups, all patients who tested negative for influenza and only those patients who tested negative for influenza and had a non-influenza respiratory virus detected, to calculate the vaccine effectiveness in a test negative study design. Estimates were made separately for general practice outpatient consultations and hospitalised patients, stratified by age group and by influenza type and subtype. Vaccine status was confirmed by electronic record for general practice patients and all respiratory viruses were detected by real time polymerase chain reaction. Results 1039 hospitalised and 1154 general practice outpatient consultations met all the study inclusion criteria and had a respiratory sample tested for influenza and other respiratory viruses. Compared to general practice patients, hospitalised patients were more likely to be very young or very old, to be Māori or Pacific Islander, to have a low income and to suffer from chronic disease. Vaccine effectiveness (VE) adjusted for age and other participant characteristics using all influenza negative controls was 42% (95% CI: 16 to 60%) for hospitalised and 56% (95% CI: 35 to 70%) for general practice patients. The vaccine appeared to be most effective against the influenza A(H1N1)pdm09 strain with an adjusted VE of 62% (95% CI:38 to 77%) for hospitalised and 59% (95% CI:36 to 74%) for general practice patients, using influenza virus negative controls. Similar results found when patients testing positive for a non-influenza respiratory virus were used as the control group. Conclusion This study contributes to validation of the test negative design and confirms that inactivated influenza vaccines continue to provide modest but significant protection against laboratory-confirmed influenza.
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- 2016
33. Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study
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Nikki Turner, Emma Collis, Wendy Gunn, Jacqui Ralston, E Claire Newbern, Diane Gross, Colin McArthur, Marc-Alain Widdowson, Conroy Wong, Q. Sue Huang, Anne McNicholas, Amanda Retter, John Cameron, Graham Mackereth, Edwin G Reynolds, Mark G. Thompson, Tim Wood, Surveillance (Shivers) Investigation Team, Michael G Baker, Cameron C. Grant, Namrata Prasad, Sook-San Wong, Barbara McArdle, Ruth Seeds, Richard J. Webby, Shirley Lawrence, Paul G. Thomas, Judy Bocacao, Susan Taylor, Ange Bissielo, Angela Todd, Adrian Trenholme, Thomas Metz, Jennifer Haubrock, Ben Waite, Sally Roberts, Lauren Jelley, Jazmin Duque, and Don Bandaranayake
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Attack rate ,Population ,Neuraminidase ,medicine.disease_cause ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,Seroepidemiologic Studies ,Internal medicine ,Influenza, Human ,Influenza A virus ,Immunology and Allergy ,Medicine ,Humans ,030212 general & internal medicine ,Seroconversion ,education ,Child ,Aged ,education.field_of_study ,Hemagglutination assay ,biology ,business.industry ,Influenza A Virus, H3N2 Subtype ,Infant, Newborn ,virus diseases ,Infant ,Hemagglutination Inhibition Tests ,Middle Aged ,030104 developmental biology ,Infectious Diseases ,Influenza Vaccines ,Child, Preschool ,Antibody Formation ,biology.protein ,Female ,Seasons ,business ,Cohort study ,New Zealand - Abstract
Background Understanding the attack rate of influenza infection and the proportion who become ill by risk group is key to implementing prevention measures. While population-based studies of antihemagglutinin antibody responses have been described previously, studies examining both antihemagglutinin and antineuraminidase antibodies are lacking. Methods In 2015, we conducted a seroepidemiologic cohort study of individuals randomly selected from a population in New Zealand. We tested paired sera for hemagglutination inhibition (HAI) or neuraminidase inhibition (NAI) titers for seroconversion. We followed participants weekly and performed influenza polymerase chain reaction (PCR) for those reporting influenza-like illness (ILI). Results Influenza infection (either HAI or NAI seroconversion) was found in 321 (35% [95% confidence interval, 32%-38%]) of 911 unvaccinated participants, of whom 100 (31%) seroconverted to NAI alone. Young children and Pacific peoples experienced the highest influenza infection attack rates, but overall only a quarter of all infected reported influenza PCR-confirmed ILI, and one-quarter of these sought medical attention. Seroconversion to NAI alone was higher among children aged
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- 2018
34. Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012-2015
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Namrata Prasad, Shivers Investigation Team, Q. Sue Huang, Nicola Turner, Colin McArthur, Jazmin Duque, Nevil Pierse, Michael G Baker, Mark G. Thompson, and E. Claire Newbern
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Critical Care ,Influenza vaccine ,030106 microbiology ,medicine.disease_cause ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Influenza A Virus, H1N1 Subtype ,law ,Internal medicine ,Intensive care ,Influenza, Human ,medicine ,Influenza A virus ,Humans ,030212 general & internal medicine ,Young adult ,Aged ,Aged, 80 and over ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Influenza A Virus, H3N2 Subtype ,Vaccination ,Public Health, Environmental and Occupational Health ,Pneumonia ,Middle Aged ,Intensive care unit ,Confidence interval ,Hospitalization ,Infectious Diseases ,Influenza Vaccines ,Propensity score matching ,Molecular Medicine ,Female ,Seasons ,business ,Sentinel Surveillance ,New Zealand - Abstract
Little is known about inactivated influenza vaccine effectiveness (IVE) in preventing very severe disease, including influenza-associated intensive care unit (ICU) admissions.The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project enrolled adults (aged ≥ 18 years) with acute respiratory illness (ARI) in general ward (GW) hospital settings (n = 3034) and ICUs (n = 101) during 2012-2015. IVE was assessed using a test-negative design comparing the odds of influenza vaccination among influenza positives vs. negatives (confirmed by real-time reverse transcription polymerase chain reaction). All models were adjusted for season, weeks from season peak, and a vaccination propensity score.Influenza virus infection was confirmed in 28% of GW hospital and 41% of ICU patients; influenza vaccination was documented for 56% and 41%, respectively. Across seasons, IVE was 37% (95% confidence intervals [CI] = 23-48%) among GW patients and 82% (95% CI = 45-94%) among ICU patients. IVE point estimates were 70% against ICU influenza and consistently higher than IVE against GW influenza when stratified by season, by virus (sub)types, and for adults with or without chronic medical conditions and for both adults aged65 and ≥65 years old. Among hospitalized influenza positives, influenza vaccination was associated with a 59% reduction in the odds of ICU admission (aOR = 0.41, 95% CI = 0.18-0.96) and with shorter ICU lengths of stay (LOS), but not with radiograph-confirmed pneumonia or GW hospital LOS.Inactivated influenza vaccines prevented influenza-associated ICU admissions, may have higher effectiveness in ICU than GW hospital settings, and appeared to reduce the risk of severe disease among those who are infected despite vaccination.
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- 2018
35. Estimating the contribution of influenza to hospitalisations in New Zealand from 1994 to 2008
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Q. Sue Huang, Lucy Telfar-Barnard, Nevil Pierse, Trang Q.T. Khieu, and Michael G Baker
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Adult ,Male ,Adolescent ,Discharge data ,Population health ,Disease ,Young Adult ,Influenza, Human ,Humans ,Medicine ,Vulnerable population ,Young adult ,Child ,Aged ,Aged, 80 and over ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Middle Aged ,medicine.disease ,Hospitalization ,Pneumonia ,Infectious Diseases ,Child, Preschool ,Molecular Medicine ,Female ,Medical emergency ,National average ,business ,New Zealand ,Demography - Abstract
Background Influenza has a substantially but poorly measured impact on population health. Estimating its true contribution to hospitalisations remains a challenge. Methods We used simple and comprehensive negative binomial regression models with weekly counts of hospitalisations and isolates of influenza A, B and respiratory syncytial virus for the period 1994– 2008. Results The estimated annual national average number of hospitalisations attributable to influenza was 822.1(95% CI: 815.3, 828.9) for pneumonia and influenza, 1861.3 (95% CI: 1842.9, 1879.7) for respiratory illness, 12.1 (95% CI: 2.6, 21.6) for circulatory illness, 2260.0 (95% CI: 2212.2, 2307.8) for all medical illness and 2419.9 (95% CI: 2356.4, 2483.4) for all causes. The contribution of influenza to total hospitalisations was about nine times larger than indicated by routine discharge data. New Zealanders 80 years of age and older had the highest annual excess rates of influenza-related hospitalisations (327.8 per 100,000); followed by infants under 1 year (244.5 per 100,000). Estimated influenza hospitalisation rates were also markedly higher in Pacific (83.3 per 100,000) and Māori (80.0 per 100,000) compared with European/Others (58.1 per 100,000). Respiratory illness was the major contributor to all cause hospitalisations attributed to influenza accounting for 77%. Influenza hospitalisations included only a negligible contribution from circulatory illness. Conclusion These findings support efforts to reduce the impact of influenza, particularly for the most vulnerable population groups highlighted here. Analysis of the cost-effectiveness of such interventions needs to consider these higher modelled estimates of disease impact.
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- 2015
36. The effectiveness of seasonal trivalent inactivated influenza vaccine in preventing laboratory confirmed influenza hospitalisations in Auckland, New Zealand in 2012
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Nevil Pierse, Nicola Turner, Michael G Baker, Heath Kelly, Ange Bissielo, Q. Sue Huang, and Marc-Alain Widdowson
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Adult ,Male ,Adolescent ,Influenza vaccine ,Population ,medicine.disease_cause ,Article ,Young Adult ,Influenza A Virus, H1N1 Subtype ,Influenza, Human ,Influenza A virus ,Humans ,Medicine ,Child ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Influenza A Virus, H3N2 Subtype ,Public Health, Environmental and Occupational Health ,Infant ,Middle Aged ,Ethnically diverse ,Virology ,Hospitalization ,Vaccination ,Infectious Diseases ,Vaccines, Inactivated ,Influenza Vaccines ,Child, Preschool ,Molecular Medicine ,Female ,business ,Sentinel Surveillance ,New Zealand - Abstract
Few studies report the effectiveness of trivalent inactivated influenza vaccine (TIV) in preventing hospitalisation for influenza-confirmed respiratory infections. Using a prospective surveillance platform, this study reports the first such estimate from a well-defined ethnically diverse population in New Zealand (NZ).A case test-negative design was used to estimate propensity adjusted vaccine effectiveness. Patients with a severe acute respiratory infection (SARI), defined as a patient of any age requiring hospitalisation with a history of a fever or a measured temperature ≥38°C and cough and onset within the past 7 days, admitted to public hospitals in South and Central Auckland were eligible for inclusion in the study. Cases were SARI patients who tested positive for influenza, while non-cases (controls) were SARI patients who tested negative. Results were adjusted for the propensity to be vaccinated and the timing of the influenza season.The propensity and season adjusted vaccine effectiveness (VE) was estimated as 39% (95% CI 16;56). The VE point estimate against influenza A (H1N1) was lower than for influenza B or influenza A (H3N2) but confidence intervals were wide and overlapping. Estimated VE was 59% (95% CI 26;77) in patients aged 45-64 years but only 8% (-78;53) in those aged 65 years and above.Prospective surveillance for SARI has been successfully established in NZ. This study for the first year, the 2012 influenza season, has shown low to moderate protection by TIV against influenza positive hospitalisation.
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- 2014
37. Implementing hospital-based surveillance for severe acute respiratory infections caused by influenza and other respiratory pathogens in New Zealand
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Diane Gross, Conroy Wong, Deborah A Williamson, Marc-Alain Widdowson, Lyndsay LeComte, Tim Wood, Richard J. Webby, Graham Mackereth, Michael G Baker, Colin McArthur, Mark G. Thompson, Nikki Turner, Q. Sue Huang, Cameron C. Grant, Ange Bissielo, Adrian Trenholme, Paul G. Thomas, Nevil Pierse, Sally Roberts, Jazmin Duque, Ruth Seeds, Don Bandaranayake, and Susan Taylor
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medicine.medical_specialty ,lcsh:Medicine ,Influenza A Virus, H7N9 Subtype ,Severe Acute Respiratory Syndrome ,medicine.disease_cause ,Severity of Illness Index ,Influenza A Virus, H1N1 Subtype ,other respiratory pathogens ,hospital-based SARI surveillance ,Influenza, Human ,Influenza prevention ,Severity of illness ,Prevalence ,medicine ,Influenza A virus ,Humans ,Prospective Studies ,Epidemics ,Prospective cohort study ,Intensive care medicine ,Case report form ,Disease burden ,Other Topic ,business.industry ,lcsh:Public aspects of medicine ,Incidence ,Incidence (epidemiology) ,lcsh:R ,Respiratory disease ,lcsh:RA1-1270 ,General Medicine ,medicine.disease ,Hospitals ,Hospitalization ,Population Surveillance ,SARI ,Communicable Disease Control ,Seasons ,business ,New Zealand - Abstract
Background: Recent experience with pandemic influenza A(H1N1)pdm09 highlighted the importance of global surveillance for severe respiratory disease to support pandemic preparedness and seasonal influenza control. Improved surveillance in the southern hemisphere is needed to provide critical data on influenza epidemiology, disease burden, circulating strains and effectiveness of influenza prevention and control measures. Hospital-based surveillance for severe acute respiratory infection (SARI) cases was established in New Zealand on 30 April 2012. The aims were to measure incidence, prevalence, risk factors, clinical spectrum and outcomes for SARI and associated influenza and other respiratory pathogen cases as well as to understand influenza contribution to patients not meeting SARI case definition. Methods/Design: All inpatients with suspected respiratory infections who were admitted overnight to the study hospitals were screened daily. If a patient met the World Health Organization’s SARI case definition, a respiratory specimen was tested for influenza and other respiratory pathogens. A case report form captured demographics, history of presenting illness, co-morbidities, disease course and outcome and risk factors. These data were supplemented from electronic clinical records and other linked data sources. Discussion: Hospital-based SARI surveillance has been implemented and is fully functioning in New Zealand. Active, prospective, continuous, hospital-based SARI surveillance is useful in supporting pandemic preparedness for emerging influenza A(H7N9) virus infections and seasonal influenza prevention and control.
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- 2014
38. Evaluation of rapid and simple techniques for the enrichment of viruses prior to metagenomic virus discovery
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Angela Todd, Jing Wang, Richard J. Hall, Nicole E. Moore, Q. Sue Huang, Seiha Yen, Philip E. Carter, Matthew Peacey, Hugo Strydom, Ange Bissielo, and Xiaoyun Ren
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viruses ,Computational biology ,Biology ,Real-Time Polymerase Chain Reaction ,Article ,Virus ,Specimen Handling ,Metagenomic ,chemistry.chemical_compound ,Viral envelope ,Virology ,Animals ,Humans ,Purification methods ,Purification ,RNA ,Human enterovirus ,Enrichment ,Capsid ,chemistry ,Metagenomics ,Viruses ,DNA - Abstract
Highlights • The effect of simple virus enrichment methods were tested on a metagenomics dataset. • Centrifugation, filtration or nuclease-treatment was evaluated. • A multi-step enrichment method increased the proportion of virus sequences. • This evaluation guides researchers in their choice of enrichment methodology., The discovery of new or divergent viruses using metagenomics and high-throughput sequencing has become more commonplace. The preparation of a sample is known to have an effect on the representation of virus sequences within the metagenomic dataset yet comparatively little attention has been given to this. Physical enrichment techniques are often applied to samples to increase the number of viral sequences and therefore enhance the probability of detection. With the exception of virus ecology studies, there is a paucity of information available to researchers on the type of sample preparation required for a viral metagenomic study that seeks to identify an aetiological virus in an animal or human diagnostic sample. A review of published virus discovery studies revealed the most commonly used enrichment methods, that were usually quick and simple to implement, namely low-speed centrifugation, filtration, nuclease-treatment (or combinations of these) which have been routinely used but often without justification. These were applied to a simple and well-characterised artificial sample composed of bacterial and human cells, as well as DNA (adenovirus) and RNA viruses (influenza A and human enterovirus), being either non-enveloped capsid or enveloped viruses. The effect of the enrichment method was assessed by both quantitative real-time PCR and metagenomic analysis that incorporated an amplification step. Reductions in the absolute quantities of bacteria and human cells were observed for each method as determined by qPCR, but the relative abundance of viral sequences in the metagenomic dataset remained largely unchanged. A 3-step method of centrifugation, filtration and nuclease-treatment showed the greatest increase in the proportion of viral sequences. This study provides a starting point for the selection of a purification method in future virus discovery studies, and highlights the need for more data to validate the effect of enrichment methods on different sample types, amplification, bioinformatics approaches and sequencing platforms. This study also highlights the potential risks that may attend selection of a virus enrichment method without any consideration for the sample type being investigated.
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- 2014
39. The epidemiological signature of influenza B virus and its B/Victoria and B/Yamagata lineages in the 21st century
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John Paget, Olga Bessonova, Joseph S. Bresee, Norosoa Harline Razanajatovo, Saverio Caini, Binay Thapa, Francisco José de Paula Júnior, Jenny Lara Araya, Florette K. Treurnicht, Walquiria Aparecida Ferreira de Almeida, Brechla Moreno Arévalo, Zhibin Peng, Raquel Guiomar, Gabriela Kusznierz, Q. Sue Huang, Herman Kosasih, Antonino Bella, Doménica de Mora, Rakhee Palekar, Olha Holubka, Maria R. Castrucci, Rudevelinda Rivera, Phuong Vu Mai Hoang, Gideon O. Emukule, Rodrigo Fasce, Rocio Higueros, Sandra S. Chaves, Fatima el Falaki, Mai T. Q. Le, Herve A. Kadjo, Patricia Bustos, Luzhao Feng, Ainash Makusheva, Vernon J. Lee, Richard Njouom, Ana Paula Rodrigues, Coulibaly Daouda, Gé Donker, Alfredo Bruno, Alla Mironenko, Cheryl Cohen, Jean-Michel Heraud, Li Wei Ang, Sonam Wangchuk, Mónica Jeannette Barahona de Gámez, Maria Zambon, Clotilde El Guerche-Séblain, Angel Balmaseda, Lynnette Brammer, Amal Barakat, Richard Pebody, Adam Meijer, Verònica Vera Garate, Tim Wood, Netherlands Institute for Health Services Research [Utrecht] (NIVEL), Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni [Santa Fe, Argentina] (INER), Ministry of Health [Bhoutan], Ministry of Health [Brasília, Brazil], Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur (RIIP), Instituto de Salud Pública de Chile (ISP), Chinese Center for Disease Control and Prevention, Ministry of Health [Costa Rica], Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador] (INSPI), Ministerio de Salud de El Salvador (MINSAL), Public Health England [London], Ministerio de Salud Publica y Asistencia Social [Guatemala] (MSPAS), Ministry of Health [Honduras] (SESAL), US Naval Medical Research Unit No.2 [Jakarta, Indonesia] (NAMRU-2), Naval Medical Research Center [Silver Spring, USA] (NMRC), Istituto Superiore di Sanita [Rome], Institut Pasteur de Côte d'Ivoire, Institut National de Santé Publique d'Abidjan-INSP, Ministry of Healthcare [Kazakhstan], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, Centers for Disease Control and Prevention [Kenya], Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Institut National d'Hygiène [Maroc], National Institute for Public Health and the Environment [Bilthoven] (RIVM), Institute of Environmental Science and Research (ESR), Ministry of Health [Nicaragua] (MINSA), Pan American Health Organization [Washington] (PAHO), Instituto Conmemorativo Gorgas de Estudios de la Salud [Panamá], Instituto Nacional de Saùde Dr Ricardo Jorge [Portugal] (INSA), Ministry of Health [Singapore], National Institute for Communicable Diseases [Johannesburg] (NICD), University of the Witwatersrand [Johannesburg] (WITS), National Academy of Sciences of Ukraine (NASU), National Institute of Hygiene and Epidemiology [Hanoi, Vietnam] (NIHE), Sanofi Pasteur [Lyon, France], The study is supported by a research grant from Sanofi Pasteur: the ‘Global Epidemiology of Influenza B’ research project. The funder provided support in the form of salaries for two authors (CEGS and JP) but did not have any additional role in the data collection, analysis, decision to publish, or preparation of the manuscript., The 'Global Influenza B Study team' (group authorship) includes the following scientists: Juan Manuel Rudi (jmrudi@anlis.gov.ar), National Institute of Respiratory Diseases 'Emilio Coni', Santa Fe, Argentina, Dorji Wangchuk (dorjiwangchuk@health.gov.bt) and Sangay Zangmo (szangmo@health.gov.bt), Royal Centre for Disease Control, Department of Public Health, Ministry of Health, Thimphu, Bhutan, Daiana Araujo da Silva (daiana.silva@saude.gov.br), Ministry of Health, Department of Surveillance of Transmissible Diseases, Brasília/DF, Brazil, Winston Andrade (wandrade@ispch.cl), Sub-Department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile, Jiandong Zheng (zhengjd@chinacdc.cn) and Ying Qin (qinying@chinacdc.cn), Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China, Joanna Ellis (joanna.ellis@phe.gov.uk), Public Health England, London, United Kingdom, Simona Puzelli (simona.puzelli@iss.it), National Influenza Center, Department of Infectious Diseases, National Institute of Health, Rome, Italy, Caterina Rizzo (rizzocaterina@gmail.com), Bambino Gesù Children's Hospital, Rome, Italy, Linus Ndegwa (ikf7@cdc.gov), Influenza Program, Centers for Disease Control and Prevention, Nairobi, Kenya, Marit MA de Lange (marit.de.lange@rivm.nl) and Anne C. Teirlinck (anne.teirlinck@rivm.nl), National Institute for Public Health and the Environment, Centre for Infectious Diseases, Epidemiology and Surveillance, Bilthoven, The Netherlands, Jeffery Cutter (jeffery_cutter@moh.gov.sg) and Raymond Tzer Pin Lin (raymond_lin@moh.gov.sg), Public Health Group, Ministry of Health, Singapore, Singapore, Than T. Le (lmot82@yahoo.com), National Institute of Hygiene and Epidemiology, Hanoi, Vietnam, and Peter Kinuthia 42 (polorien@gmail.com), IHRC Inc., Atlanta, USA.
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RNA viruses ,Male ,Infecções Respiratórias ,0301 basic medicine ,Viral Diseases ,medicine.disease_cause ,MESH: Influenza Vaccines ,Seasonal influenza ,Influenza A Virus, H1N1 Subtype ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Epidemiology ,Medicine and Health Sciences ,Influenza A virus ,030212 general & internal medicine ,MESH: Influenza B virus ,Pathology and laboratory medicine ,Northern Hemisphere ,Vaccines ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Multidisciplinary ,Geography ,MESH: Influenza, Human ,virus diseases ,Medical microbiology ,3. Good health ,Infectious Diseases ,Influenza Vaccines ,Population Surveillance ,Viruses ,Epidemiological Monitoring ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Medicine ,Southern Hemisphere ,Female ,Age distribution ,Seasons ,Pathogens ,MESH: History, 21st Century ,Research Article ,medicine.medical_specialty ,Infectious Disease Control ,Science ,MESH: Influenza A virus ,Biology ,Microbiology ,History, 21st Century ,Virus ,MESH: Population Surveillance ,MESH: Influenza A Virus, H1N1 Subtype ,03 medical and health sciences ,Age Distribution ,Population Metrics ,Influenza, Human ,medicine ,Influenza viruses ,Humans ,Epidemics ,MESH: Epidemics ,Disease burden ,MESH: Humans ,Biology and life sciences ,Population Biology ,Organisms ,Viral pathogens ,[SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology ,Estados de Saúde e de Doença ,Virology ,Influenza ,MESH: Male ,Microbial pathogens ,Earth sciences ,Influenza B virus ,Vaccine mismatch ,030104 developmental biology ,Virus type ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH: Epidemiological Monitoring ,Geographic areas ,MESH: Seasons ,MESH: Female ,Orthomyxoviruses - Abstract
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31513690/ We describe the epidemiological characteristics, pattern of circulation, and geographical distribution of influenza B viruses and its lineages using data from the Global Influenza B Study. We included over 1.8 million influenza cases occurred in thirty-one countries during 2000-2018. We calculated the proportion of cases caused by influenza B and its lineages; determined the timing of influenza A and B epidemics; compared the age distribution of B/Victoria and B/Yamagata cases; and evaluated the frequency of lineage-level mismatch for the trivalent vaccine. The median proportion of influenza cases caused by influenza B virus was 23.4%, with a tendency (borderline statistical significance, p = 0.060) to be higher in tropical vs. temperate countries. Influenza B was the dominant virus type in about one every seven seasons. In temperate countries, influenza B epidemics occurred on average three weeks later than influenza A epidemics; no consistent pattern emerged in the tropics. The two B lineages caused a comparable proportion of influenza B cases globally, however the B/Yamagata was more frequent in temperate countries, and the B/Victoria in the tropics (p = 0.048). B/Yamagata patients were significantly older than B/Victoria patients in almost all countries. A lineage-level vaccine mismatch was observed in over 40% of seasons in temperate countries and in 30% of seasons in the tropics. The type B virus caused a substantial proportion of influenza infections globally in the 21st century, and its two virus lineages differed in terms of age and geographical distribution of patients. These findings will help inform health policy decisions aiming to reduce disease burden associated with seasonal influenza. info:eu-repo/semantics/publishedVersion
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- 2019
40. Seroepidemiologic Effects of Influenza A(H1N1)pdm09 in Australia, New Zealand, and Singapore
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Q. Sue Huang, James M. Trauer, Jodie McVernon, Jen Kok, Don Bandaranayake, Mark I-Cheng Chen, Dominic E. Dwyer, Peter Markey, Vernon J. Lee, Scott R. Walter, Robert Booy, Gary K Dowse, Michelle Cretikos, Gulam Khandaker, Karen L. Laurie, and Michael E. Greenberg
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Male ,Native Hawaiian or Other Pacific Islander ,Epidemiology ,Attack rate ,influenza A(H1N1)pdm09 ,serology ,lcsh:Medicine ,Antibodies, Viral ,medicine.disease_cause ,Serology ,Influenza A Virus, H1N1 Subtype ,Pregnancy ,Seroepidemiologic Studies ,Pandemic ,Influenza A virus ,Medicine ,Child ,Aged, 80 and over ,Singapore ,education.field_of_study ,Incidence ,Incidence (epidemiology) ,Age Factors ,Middle Aged ,humanities ,Infectious Diseases ,Child, Preschool ,Female ,Adult ,Microbiology (medical) ,Adolescent ,education ,Population ,lcsh:Infectious and parasitic diseases ,Influenza, Human ,Humans ,viruses ,lcsh:RC109-216 ,human ,Pandemics ,Aged ,Hemagglutination assay ,business.industry ,Research ,pandemic ,lcsh:R ,Australia ,Infant ,Hemagglutination Inhibition Tests ,Virology ,Influenza ,H1N1 subtype ,population groups ,business ,New Zealand ,Population Groups, viruses ,Demography - Abstract
Temperate regions, school-aged children, and native peoples were particularly susceptible to the first wave of a novel influenza strain., To estimate population attack rates of influenza A(H1N1)pdm2009 in the Southern Hemisphere during June–August 2009, we conducted several serologic studies. We pooled individual-level data from studies using hemagglutination inhibition assays performed in Australia, New Zealand, and Singapore. We determined seropositive proportions (titer >40) for each study region by age-group and sex in pre- and postpandemic phases, as defined by jurisdictional notification data. After exclusions, the pooled database consisted of, 4,414 prepandemic assays and 7,715 postpandemic assays. In the prepandemic phase, older age groups showed greater seropositive proportions, with age-standardized, community-based proportions ranging from 3.5% in Singapore to 11.9% in New Zealand. In the postpandemic phase, seropositive proportions ranged from 17.5% in Singapore to 30.8% in New Zealand, with highest proportions seen in school-aged children. Pregnancy and residential care were associated with lower postpandemic seropositivity, whereas Aboriginal and Torres Strait Islander Australians and Pacific Peoples of New Zealand had greater postpandemic seropositivity.
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- 2013
41. Estimating age-specific cumulative incidence for the 2009 influenza pandemic: a meta-analysis of A(H1N1)pdm09 serological studies from 19 countries
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Peter Horby, Babasaheb Vishwanath Tandale, Jodie McVernon, Mohsen Moghadami, Christl Donnelly, Q. Sue Huang, Steven Riley, Daniel Levy-Bruhl, Anneke Steens, Naveed Janjua, Maria Van Kerkhove, Ilkka Julkunen, Jen-Ren Wang, Pia Hardelid, Artemis Koukounari, Caterina Rizzo, Fabrice Carrat, Ajit Lalvani, Saranya Sridhar, Sayda Abid, Niina Ikonen, Mark Chen, Joseph Tsz Kei Wu, Global Influenza Programme, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Imperial College London, Medical Research Council (MRC), and National Institute for Health Research
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Epidemiology ,ANTIBODY-RESPONSE ,Review Article ,medicine.disease_cause ,Antibodies, Viral ,Serology ,0302 clinical medicine ,Influenza A Virus, H1N1 Subtype ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Seroepidemiologic Studies ,Case fatality rate ,Pandemic ,Influenza A virus ,Influenza A Virus ,H1N1pdm ,Medicine ,Cumulative incidence ,A/H1N1 ,030212 general & internal medicine ,Viral ,0303 health sciences ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,seroprevalence ,Age Factors ,Part 2 Pandemic H1N1 Papers ,3. Good health ,PREVALENCE ,Infectious Diseases ,A(H1N1)pdm09 ,cross-reactive antibodies ,1117 Public Health And Health Services ,INFECTIONS ,Cohort ,A H1N1 VIRUS ,Life Sciences & Biomedicine ,Human ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,cross‐reactive antibodies ,H1N1pdm serology working group ,Antibodies ,03 medical and health sciences ,Virology ,Influenza, Human ,Seroprevalence ,Humans ,COHORT ,H1N1 Subtype ,Pandemics ,cumulative incidence ,030304 developmental biology ,Science & Technology ,business.industry ,Public Health, Environmental and Occupational Health ,1103 Clinical Sciences ,HEMAGGLUTINATION INHIBITION ,HOUSEHOLD TRANSMISSION ,Influenza ,United States ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,HONG-KONG ,business ,Demography - Abstract
International audience; BACKGROUND: The global impact of the 2009 influenza A(H1N1) pandemic (H1N1pdm) is not well understood. OBJECTIVES: We estimate overall and age-specific prevalence of cross-reactive antibodies to H1N1pdm virus and rates of H1N1pdm infection during the first year of the pandemic using data from published and unpublished H1N1pdm seroepidemiological studies.METHODS: Primary aggregate H1N1pdm serologic data from each study were stratified in standardized age groups and evaluated based on when sera were collected in relation to national or subnational peak H1N1pdm activity. Seropositivity was assessed using well-described and standardized hemagglutination inhibition (HI titers ≥ 32 or ≥ 40) and microneutralization (MN ≥ 40) laboratory assays. The prevalence of cross-reactive antibodies to the H1N1pdm virus was estimated for studies using sera collected prior to the start of the pandemic (between 2004 and April 2009); H1N1pdm cumulative incidence was estimated for studies in which collected both pre- and post-pandemic sera; and H1N1pdm seropositivity was calculated from studies with post-pandemic sera only (collected between December 2009-June 2010).RESULTS: Data from 27 published/unpublished studies from 19 countries/administrative regions - Australia, Canada, China, Finland, France, Germany, Hong Kong SAR, India, Iran, Italy, Japan, Netherlands, New Zealand, Norway, Reunion Island, Singapore, United Kingdom, United States, and Vietnam - were eligible for inclusion. The overall age-standardized pre-pandemic prevalence of cross-reactive antibodies was 5% (95%CI 3-7%) and varied significantly by age with the highest rates among persons ≥ 65 years old (14% 95%CI 8-24%). Overall age-standardized H1N1pdm cumulative incidence was 24% (95%CI 20-27%) and varied significantly by age with the highest in children 5-19 (47% 95%CI 39-55%) and 0-4 years old (36% 95%CI 30-43%).CONCLUSIONS: Our results offer unique insight into the global impact of the H1N1 pandemic and highlight the need for standardization of seroepidemiological studies and for their inclusion in pre-pandemic preparedness plans. Our results taken together with recent global pandemic respiratory-associated mortality estimates suggest that the case fatality ratio of the pandemic virus was approximately 0.02%.
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- 2016
42. Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?
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Marietjie Venter, Juan Yang, Simona Puzelli, Antonino Bella, Joshua A. Mott, Rodrigo Fasce, Coulibaly Daouda, Jenny Lara, Hongjie Yu, Winston Andrade, Selim Badur, Cláudio Maierovitch Pessanha Henriques, François G. Schellevis, Jean-Michel Heraud, Akerke Ospanova, Sonam Wangchuk, Brechla Moreno, Herve A. Kadjo, Raymond T. P. Lin, Juan Manuel Rudi, Walquiria Aparecida Ferreira de Almeida, Gabriela Kusznierz, Joseph S. Bresee, Cheryl Cohen, Mai thi Quynh Le, Rhonda Owen, Maria Zambon, Maria Luisa Matute, Kunzang Dorji, Kate Pennington, Global Influenza B Study, Herman Kosasih, Nurhayati, Alla Mironenko, Ming Li, Angel Balmaseda, Alexey Clara, Alfredo Bruno, Richard Njouom, Phuong Vu Mai Hoang, Ana Paula Rodrigues, Celina de Lozano, Luzhao Feng, Olha Holubka, Amal Barakat, Lyazzat Kiyanbekova, Norosoa Harline Razanajatovo, Saverio Caini, Meral Akcay Ciblak, Raquel Guiomar, Richard Pebody, Leticia Castillo, Gideon O. Emukule, Liza Lopez, Doménica de Mora, Jeffery Cutter, Q. Sue Huang, Marie-Astrid Vernet, Abderrahman Bimohuen, John Paget, Lynnette Brammer, General practice, EMGO - Quality of care, Netherlands Institute for Health Services Research, Instituto de Salud Pública de Chile (ISP), Istanbul University, Ministry of Health [Nicaragua] (MINSA), Ministry of Health [Morocco], Istituto Superiore di Sanita [Rome], Centers for Disease Control and Prevention [Atlanta] (CDC), Centers for Disease Control and Prevention, Instituto Nacional de Investigación en Salud Pública [Guayaquil, Ecuador] (INSPI), Ministerio de Salud Publica y Asistencia Social [Guatemala] (MSPAS), US Centers for Disease Control, University of the Witwatersrand [Johannesburg] (WITS), Ministry of Health, Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Ministerio de Salud de El Salvador (MINSAL), Ministry of Health [Bhoutan], US Centers for Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Instituto nacional de saude, Unité de Virologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), National Academy of Medical Sciences of Ukraine, Institute of Environmental Science and Research (ESR), Astana Center of Sanitary Epidemiology Expertise, US Naval Medical Research Unit n°2, Instituto Nacional de Enfermedades Respiratorias 'Dr. Emilio Coni', Ministry of Health [Costa Rica], National Institute of Hygiene and Epidemiology [Hanoi, Vietnam] (NIHE), Ministry of Health [Honduras] (SESAL), National Influenza Center, Centre Pasteur du Cameroun, Office of Health Protection, Woden, ACT, Australia (DHAISS), Public Health England [London], National Institute of Health, University of Pretoria [South Africa], The Global Influenza B Study is supported by an unrestricted research grant from Sanofi Pasteur. The study sponsor had no role in the design of the study, in the collection, analysis, and interpretation of data, in the writing of the report, and and in the decision to submit the paper for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The study sponsor had no access to the data in the study.
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Infecções Respiratórias ,Influenza Viruses ,Epidemiology ,Gripe ,Pathology and Laboratory Medicine ,Geographical locations ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,DRIVERS ,Estados de Saúde ,Public and Occupational Health ,SUB-SAHARAN AFRICA ,lcsh:Science ,MESH: Influenza B virus ,Northern Hemisphere ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Geography ,MESH: Influenza, Human ,Vaccination ,virus diseases ,3. Good health ,Global Influenza B Study ,MESH: Tropical Climate ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Science & Technology - Other Topics ,Immunology ,Disease Surveillance ,SEASONAL INFLUENZA ,Microbiology ,Influenza Vaccin ,03 medical and health sciences ,Influenza Vaccination ,SURVEILLANCE ,Humans ,Microbial Pathogens ,Retrospective Studies ,MESH: Humans ,Science & Technology ,lcsh:R ,Organisms ,Correction ,Influenza a ,MESH: Retrospective Studies ,[SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology ,medicine.disease ,Virology ,Influenza ,MADAGASCAR ,lcsh:Q ,Preventive Medicine ,People and places ,Demography ,RNA viruses ,Viral Diseases ,lcsh:Medicine ,medicine.disease_cause ,Tropical climate ,Medicine and Health Sciences ,Influenza A virus ,030212 general & internal medicine ,Multidisciplinary ,Medical microbiology ,Vaccination and Immunization ,Multidisciplinary Sciences ,Infectious Diseases ,Viruses ,Human mortality from H5N1 ,Southern Hemisphere ,Seasons ,Pathogens ,Brazil ,Research Article ,Infectious Disease Control ,General Science & Technology ,030231 tropical medicine ,MESH: Influenza A virus ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,MD Multidisciplinary ,Influenza, Human ,Temperate climate ,medicine ,Tropical Climate ,Biology and life sciences ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Viral pathogens ,Tropics ,MESH: Vaccination ,South America ,Seasonality ,Earth sciences ,Influenza B virus ,Infectious Disease Surveillance ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Geographic areas ,MESH: Seasons ,Orthomyxoviruses - Abstract
Erratum in - Correction: Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination? PLoS One. 2016 May 2;11(5):e0155089. doi: 10.1371/journal.pone.0155089. Introduction: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. Methods: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with 80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics. Results: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics. Discussion: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate. The Global Influenza B Study is supported by an unrestricted research grant from Sanofi Pasteur. info:eu-repo/semantics/publishedVersion
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- 2016
43. Five years of non-prescription oseltamivir: effects on resistance, immunization and stockpiling
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Chris Frampton, Lance C. Jennings, Q. Sue Huang, and Natalie Gauld
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Microbiology (medical) ,Oseltamivir ,medicine.medical_specialty ,viruses ,pharmacists ,Pharmacist ,antiviral treatment ,Pharmacy ,Drug resistance ,Antiviral Agents ,chemistry.chemical_compound ,Influenza A Virus, H1N1 Subtype ,Pandemic ,Drug Resistance, Viral ,Influenza, Human ,medicine ,Humans ,Pharmacology (medical) ,Medical prescription ,Original Research ,Pharmacology ,Response rate (survey) ,non-prescription drugs ,business.industry ,pandemic ,Vaccination ,virus diseases ,Virology ,self-medication ,respiratory tract diseases ,Infectious Diseases ,chemistry ,Immunization ,Influenza Vaccines ,Emergency medicine ,business ,New Zealand - Abstract
Received 29 March 2012; returned 11 June 2012; revised 19 July 2012; accepted 24 July 2012Objectives: In 2007 New Zealand (NZ) became the first country to make oseltamivir (Tamifluw) available off-prescription. This study investigated the extent of pharmacist supply of oseltamivir over 5 years, includingduring the influenza A(H1N1) pandemic, and the impact of pharmacist supply of oseltamivir on influenzavirus oseltamivir susceptibility, personal stockpiling and influenza vaccine uptake.Methods: Randomly selected community pharmacies in NZ reported oseltamivir provision by prescription andthrough pharmacist supply from 1 January 2007 to 15 September 2011. Oseltamivir resistance data on influ-enza viruses isolated during influenza surveillance from 2008 to 2011 were obtained, along with influenzavaccine uptake data from 2005 to 2011 and influenza detection data.Results: Seventy of 85 eligible pharmacies completed the study (82% response rate). Most supplies of oselta-mivir throughout the 5 years were dispensed against a prescription rather than pharmacist supplied, withpharmacist supply responsible for 11% of supplies during the pandemic years (2009–10) versus 27% and31% during 2007 and 2008, respectively. Pharmacist-supplied oseltamivir did not appear to be associatedwith the development of resistance, with identified likelystockpiling or with a decline in influenza immunization.Pharmacist supplies largely matched the timing of influenza in the community and peaked in June 2009, as didprescription supplies.Conclusions: Five years of non-prescription oseltamivir in NZ has resulted in no significant change in the devel-opment of resistance or rates of influenza immunization. Supplies remained modest and significant consumerstockpiling through pharmacist supply has not occurred, even during the influenza A(H1N1)pdm09 pandemicin 2009 and 2010. Pharmacists could be better utilized in ensuring fast distribution of antivirals to influenzasufferers during a pandemic.Keywords: non-prescription drugs, pharmacists, self-medication, antiviral treatment, pandemic
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- 2012
44. Comparison of the pandemic H1N1 2009 experience in the Southern Hemisphere with pandemic expectations
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Q. Sue Huang, James E Fielding, David Smith, Dale Carcione, Kristina A Grant, Lisa Lopez, Heath Kelly, and G. N. Mercer
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Veterinary medicine ,medicine.medical_specialty ,education.field_of_study ,business.industry ,pandemic ,lcsh:Public aspects of medicine ,Population ,Public Health, Environmental and Occupational Health ,virus diseases ,lcsh:RA1-1270 ,Seasonal influenza ,H1n1 pandemic ,Pandemic ,Epidemiology ,Human mortality from H5N1 ,surveillance ,Medicine ,business ,education ,influenza ,Southern Hemisphere ,Demography - Abstract
Objective: To describe the epidemiological characteristics of the 2009 H1N1 pandemic virus (pH1N1) over the 2009 and 2010 influenza seasons in Australia and New Zealand (NZ) and compare them with expectations based on previous pandemics. Methods: Laboratory-confirmed influenza and influenza-like illness (ILI) data were collected from established general practitioner sentinel surveillance schemes in NZ, Victoria and Western Australia (WA) throughout the 2009 and 2010 winter influenza seasons. Respiratory swabs from a sample of ILI patients were tested for influenza type and subtype. ILI rates and laboratory-confirmed influenza data were analysed by age group and over time. Morbidity, mortality and reproductive number data were collated from the published literature. Results: Peak ILI rates and the percentage of influenza-positive swabs from ILI patients from all sentinel surveillance schemes were considerably lower in 2010 than 2009. Compared to the population, cases of ILI were over-represented in the young. While the age distributions in NZ and WA remained consistent, ILI cases were significantly younger in Victoria in 2009 compared to 2010. In Victoria, laboratory-confirmed pH1N1 comprised up to 97% of influenza-positive swabs in 2009 but only 56–87% in 2010. Mortality and hospitalisations were lower in 2010. The effective reproduction number (R) for pH1N1 was estimated to be 1.2–1.5 in NZ and WA, similar to estimated R values for seasonal influenza. Data from the surveillance systems indicated differences in the epidemiology of pH1N1 compared to expectations based on previous pandemics. In particular, there was no evidence of a second pandemic wave associated with increased mortality, and complete influenza strain replacement did not occur. Implications: Pandemic planning needs to accommodate the potential for influenza viruses to produce pandemics of various infectiousness and degrees of severity.
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- 2012
45. Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa
- Author
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Alejandra Burgos, Ayanda Cengimbo, Linda Quick, Andrea Olea, Chuma Makunga, Adrian Puren, Marietjie Venter, Fatima Ghani, Jennifer Michalove, Winston Andrade, Rodrigo Fasce, Anthony W. Mounts, Jo McAnerney, Patricia Bustos, Luis O. Carlino, Brett N. Archer, Claudia González, Joseph S. Bresee, Bev Paterson, Osvaldo Uez, Julia Fitzner, Rhonda Owen, Liza Lopez, Thais dos Santos, Cheryl Cohen, Colin McArthur, Mary Chamberland, Katelijn Vandemaele, Sabine Mall, Vilma Savy, Sonja J. Olsen, Judith Mora, Lance C. Jennings, Graciela Torres, Q. Sue Huang, Lucille Blumberg, Manuel Nájera De Ferrari, Viviana Sotomayor, Juno Thomas, Barry D. Schoub, Veerle Msimang, Malcolm Macfarlane, Andrea M. Forde, Elsa Baumeister, Maria D. Van Kerkhove, Darren Hunt, Dhamari Naidoo, and Marc-Alain Widdowson
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Pulmonary and Respiratory Medicine ,education.field_of_study ,medicine.medical_specialty ,Epidemiology ,Mortality rate ,Population ,Public Health, Environmental and Occupational Health ,medicine.disease_cause ,Infectious Diseases ,Geography ,Environmental protection ,Pandemic ,Human mortality from H5N1 ,medicine ,Influenza A virus ,Data reporting ,education ,Southern Hemisphere ,Demography - Abstract
Please cite this paper as: Van Kerkhove et al. (2011) Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa. Influenza and Other Respiratory Viruses 5(6), e487–e498. Introduction and Setting Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory-confirmed H1N1pdm patients between 1 April 2009 - 31 January 2010 from five temperate countries in the Southern Hemisphere–Argentina, Australia, Chile, New Zealand, and South Africa. Objective We evaluate transmission dynamics, indicators of severity, and describe the co-circulation of H1N1pdm with seasonal influenza viruses. Results In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza-like illness (ILI) activity in four of the five countries was 3-6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2–1.6. The median age of patients in all countries increased with increasing severity of disease, 4–14% of all hospitalized cases required critical care, and 26–68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population-based hospitalization rates among children
- Published
- 2011
46. Environmental Poliovirus Surveillance during Oral Poliovirus Vaccine and Inactivated Poliovirus Vaccine Use in Córdoba Province, Argentina
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Laura C. Martinez, Silvia Nates, Brad D. Gessner, Q. Sue Huang, Patricia A. Barril, Joanne Hewitt, Viviane Morel, Judy Bocacao, Jean Balanant, Judith E. Mueller, Maël Bessaud, and Francis Delpeyroux
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Serotype ,viruses ,Molecular Sequence Data ,Argentina ,Mutation, Missense ,Public Health Microbiology ,Biology ,medicine.disease_cause ,Applied Microbiology and Biotechnology ,Virus ,medicine ,Humans ,Viral shedding ,Base Sequence ,Sewage ,Ecology ,Poliovirus ,medicine.disease ,Virology ,Virus Shedding ,Poliomyelitis ,Vaccination ,Poliovirus Vaccine, Inactivated ,Poliovirus Vaccine, Oral ,Inactivated Poliovirus Vaccine ,Enterovirus ,Capsid Proteins ,Sequence Alignment ,Food Science ,Biotechnology - Abstract
This study compares the presence of environmental poliovirus in two Argentinean populations using oral poliovirus vaccine (OPV) or inactivated poliovirus vaccine (IPV). From January 2003 to December 2005, Córdoba City used IPV in routine infant immunizations, with the exception of intermittent OPV use in August 2005. Between May 2005 and April 2006, we collected weekly wastewater samples in Córdoba City and the province's three major towns, which continued OPV use at all times. Wastewater samples were processed and analyzed for the presence of poliovirus according to WHO guidelines. During the months of IPV use in Córdoba City, the overall proportion of poliovirus-positive samples was 19%. During an intermittent switch from IPV to OPV, this proportion increased to 100% within 2 months. During the 3 months when IPV was reintroduced to replace OPV, a substantial proportion of samples (25%) remained positive for poliovirus. In the OPV-using sites, on average, 54% of samples were poliovirus positive. Seventy-seven percent of poliovirus isolates showed at least one mutation in the VP1-encoding sequence; the maximum genetic divergence from the Sabin strain was 0.7%. Several isolates showed mutations on attenuation markers in the VP1-encoding sequence. The frequency or type of virus mutation did not differ between periods of IPV and OPV use or by virus serotypes. This study indicates that the sustained transmission of OPV viruses was limited during IPV use in a middle-income country with a temperate climate. The continued importation of poliovirus and genetic instability of vaccine strains even in the absence of sustained circulation suggest that high poliovirus vaccine coverage has to be maintained for all countries until the risk of reintroduction of either wild or vaccine-derived poliovirus is close to zero worldwide.
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- 2009
47. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study
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Diane Gross, Kathryn Haven, Cameron Bringans, David Perry, Lucy Modahl, Peter W. Reed, Dave Harvey, Emma Taylor, R. Joan H. Ingram, David Milne, Ange Bissielo, Simone Freundlich, Colin McArthur, Q. Sue Huang, Marc-Alain Widdowson, Francessa Wilson, and Cameron C. Grant
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Radiography ,Thoracic ,Pneumonia, Viral ,Sensitivity and Specificity ,Severity of Illness Index ,Betacoronavirus ,COVID-19 Testing ,Intensive care ,Internal medicine ,Severity of illness ,Epidemiology ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Intensive care medicine ,Child ,Pandemics ,Respiratory Tract Infections ,Aged ,medicine.diagnostic_test ,Respiratory tract infections ,business.industry ,Clinical Laboratory Techniques ,SARS-CoV-2 ,Infant, Newborn ,Respiratory infection ,COVID-19 ,Infant ,Middle Aged ,Influenza ,3. Good health ,Coronavirus ,Validation studies ,Radiology Nuclear Medicine and imaging ,Child, Preschool ,Acute Disease ,Female ,Radiography, Thoracic ,business ,Chest radiograph ,Coronavirus Infections ,Kappa ,Research Article - Abstract
Background The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity scoring system. Methods We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes. Initially, four radiologists scored CXRs independently. Subsequently, a pediatrician, physician, two residents, two medical students, and a research nurse independently scored CXR reports. Inter-observer reliability was determined using a weighted Kappa (κ) for comparisons between radiologists; radiologists and clinicians; and clinicians. Agreement was defined as moderate (κ > 0.4–0.6), good (κ > 0.6–0.8) and very good (κ > 0.8–1.0). Results Agreement between the two pediatric radiologists was very good (κ = 0.83, 95 % CI 0.65–1.00) and between the two adult radiologists was good (κ = 0.75, 95 % CI 0.57–0. 93). Agreement of the clinicians with the radiologists was moderate-to-good (pediatrician:κ = 0.65; pediatric resident:κ = 0.69; physician:κ = 0.68; resident:κ = 0.67; research nurse:κ = 0.49, medical students: κ = 0.53 and κ = 0.56). Agreement between clinicians was good-to-very good (pediatrician vs. physician:κ = 0.85; vs. pediatric resident:κ = 0.81; vs. medicine resident:κ = 0.76; vs. research nurse:κ = 0.75; vs. medical students:κ = 0.63 and 0.66). Following review of discrepant CXR report scores by clinician pairs, κ values for radiologist-clinician agreement ranged from 0.59 to 0.70 and for clinician-clinician agreement from 0.97 to 0.99. Conclusions This five-point CXR scoring tool, suitable for use in poorly- and well-resourced settings and by clinicians of varying experience levels, reliably describes SARI severity. The resulting numerical data enables epidemiological comparisons of SARI severity between different countries and settings.
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- 2015
48. Author response: The contrasting phylodynamics of human influenza B viruses
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David E. Wentworth, Yi-Mo Deng, Denise Kühnert, Xudong Lin, Tanja Stadler, William D. Rawlinson, Lance C. Jennings, Timothy B. Stockwell, Natalie Spirason, Bin Zhou, Sebastian Maurer-Stroh, Veronika Boskova, Udayan Joseph, Aeron C. Hurt, Edward C. Holmes, Anna-Maria Costa, Yvonne C. F. Su, Q. Sue Huang, Raphael Tc Lee, Rebecca A. Halpin, Dhanasekaran Vijaykrishna, Nadia Fedorova, Vithiagaran Gunalan, Mathieu Fourment, Gavin J. D. Smith, Ian G. Barr, Sheena G. Sullivan, and Dominic E. Dwyer
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Viral phylodynamics ,Human influenza ,Biology ,Virology - Published
- 2015
49. The contrasting phylodynamics of human influenza B viruses
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Rebecca A. Halpin, William D. Rawlinson, Mathieu Fourment, Edward C. Holmes, Dhanasekaran Vijaykrishna, Vithiagaran Gunalan, Nadia Fedorova, Aeron C. Hurt, Bin Zhou, Natalie Spirason, Yvonne C. F. Su, David E. Wentworth, Lance C. Jennings, Anna-Maria Costa, Udayan Joseph, Ian G. Barr, Sheena G. Sullivan, Dominic E. Dwyer, Gavin J. D. Smith, Q. Sue Huang, Yi-Mo Deng, Denise Kühnert, Sebastian Maurer-Stroh, Veronika Boskova, Raphael T.C. Lee, Xudong Lin, Tanja Stadler, Timothy B. Stockwell, and School of Biological Sciences
- Subjects
Models, Molecular ,Glycosylation ,Time Factors ,Hemagglutinin Glycoproteins, Influenza Virus ,medicine.disease_cause ,influenza virus ,Madin Darby Canine Kidney Cells ,Science::Biological sciences::Human anatomy and physiology [DRNTU] ,Evolution of influenza ,Influenza A virus ,Biology (General) ,Antigens, Viral ,Phylogeny ,Microbiology and Infectious Disease ,General Neuroscience ,General Medicine ,Genomics and Evolutionary Biology ,Viral evolution ,Medicine ,epidemiology ,Asparagine ,Reassortant Viruses ,Research Article ,Victoria ,QH301-705.5 ,Science ,Genome, Viral ,Biology ,H5N1 genetic structure ,General Biochemistry, Genetics and Molecular Biology ,Antigenic drift ,Virus ,Evolution, Molecular ,Age Distribution ,Dogs ,Influenza, Human ,evolution ,medicine ,Animals ,Humans ,viruses ,human ,Selection, Genetic ,antigenic drift ,General Immunology and Microbiology ,Genetic Variation ,Virology ,Influenza B virus ,Viral phylodynamics ,New Zealand - Abstract
A complex interplay of viral, host, and ecological factors shapes the spatio-temporal incidence and evolution of human influenza viruses. Although considerable attention has been paid to influenza A viruses, a lack of equivalent data means that an integrated evolutionary and epidemiological framework has until now not been available for influenza B viruses, despite their significant disease burden. Through the analysis of over 900 full genomes from an epidemiological collection of more than 26,000 strains from Australia and New Zealand, we reveal fundamental differences in the phylodynamics of the two co-circulating lineages of influenza B virus (Victoria and Yamagata), showing that their individual dynamics are determined by a complex relationship between virus transmission, age of infection, and receptor binding preference. In sum, this work identifies new factors that are important determinants of influenza B evolution and epidemiology., eLife, 4, ISSN:2050-084X
- Published
- 2015
- Full Text
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50. Rotavirus hospitalisation in New Zealand children under 3 years of age
- Author
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Ralph Pinnock, I. Gosling, William R Nicholson, Q. Sue Huang, Diana Lennon, Philip Leadbitter, Sarah Hook, Teele D, David Graham, Catheine Cohet, Keith Grimwood, and Alan Farrell
- Subjects
Diarrhea ,Male ,Rotavirus ,Pediatrics ,medicine.medical_specialty ,Population ,Enzyme-Linked Immunosorbent Assay ,Antibodies, Viral ,medicine.disease_cause ,Rotavirus Infections ,Feces ,Age Distribution ,Epidemiology ,medicine ,Hospital discharge ,Humans ,Sex Distribution ,education ,Acute diarrhoea ,education.field_of_study ,business.industry ,Infant, Newborn ,Infant ,Acute gastroenteritis ,Gastroenteritis ,Hospitalization ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Seasons ,medicine.symptom ,business ,New Zealand - Abstract
Objective: To describe the epidemiology of severe rotavirus gastroenteritis and to estimate the hospitalisation rates of this illness in New Zealand children under 3 years of age. Methods: Children under 3 years of age with acute diarrhoea admitted to 1 of 8 study hospitals between 1 May 1998 and 30 April 2000 were surveyed. Their socio-demographic, treatment and length-of-stay data were recorded and stool samples tested by a rotavirus-specific enzyme-linked immunoassay. National hospital discharge data for infectious diarrhoea (International Classification of Diseases, ninth revision, 003–009) were reviewed, allowing population-based estimates for rotavirus-related hospitalisation in New Zealand. Results: Of 2019 enrolled children, 1138 (56.4%) provided stools for testing, and of these 485 (42.6%) tested rotavirus positive. Rotavirus detection varied significantly by age (26.8% for 0 to 5 months, 42.5% for 6 to 11 months and 52.1% for children aged 12 to 35 months; P < 0.001), and by season (51.2% in winter/spring vs. 24.5% in summer/autumn; P < 0.001). While those infected with rotavirus were more likely to be dehydrated (50.6% vs. 37.4%; P < 0.001), their median hospital stay was similar (1.0 vs. 2.0 days; P = 0.09) to other children with acute gastroenteritis. The estimated national hospitalisation rate for rotavirus diarrhoea in children under 3 years, standardised for age and season, was 634 (95% CI 597, 672) per 100 000. In New Zealand, rotaviruses result in 1 in 52 children being hospitalised by 3 years of age. Conclusions: Rotavirus diarrhoea is an important, potentially vaccine-preventable cause of hospitalisation in New Zealand children, especially during winter and spring seasons.
- Published
- 2006
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