Epidemiology of Severe Acute Respiratory Infection (SARI) Cases at a sentinel site in Egypt, 2013–15

Abstract Background Sentinel surveillance for severe acute respiratory infection (SARI) in Egypt began in 2006 and occurs at eight sites. Avian influenza is endemic, and human cases of influenza A (H5N1) have been reported annually since 2006. This study aimed to describe the epidemiology of SARI at a major sentinel site in the country. Methods Data included in the study were collected from a major SARI sentinel site in Egypt during three consecutive years (2013–15). Results A total of 1254 SARI patients conforming to the WHO case definition were admitted to the sentinel site, representing 5.6% of admitted patients for all causes and 36.6% of acute respiratory infection patients. A total of 99.7% of the patients were tested, and 21.04% tested positive; 48.7% of cases involved influenza A viruses, while 25% involved influenza B. The predominant age group was under 5 years of age, accounting for 443 cases. The seasonality of the influenza data conformed to the Northern Hemisphere pattern. Conclusions The present study’s results show that SARI leads to substantial morbidity in Egypt. There is a great need for high-quality data from the SARI surveillance system in Egypt, especially with endemic respiratory threats such as influenza A (H5N1) in Egypt.

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Surveillance for Severe Acute Respiratory Infection as one approach to enhance Global Health Security in Indonesia

Health Science Journal of Indonesia ◽

10.22435/hsji.v9i1.473 ◽

2018 ◽

Vol 9 (1) ◽

pp. 8-13

Author(s):

Ira Wignjadiputro ◽

Ni Ketut Susilarini ◽

Catharina Yekti Praptiningsih ◽

Elvieda Sariwati ◽

Vivi Setiawaty ◽

...

Keyword(s):

Global Health ◽

Respiratory Infection ◽

Surveillance System ◽

Acute Respiratory Infection ◽

Influenza A ◽

Influenza Surveillance ◽

Influenza B ◽

Global Health Security ◽

Health Security ◽

Severe Acute Respiratory Infection

Latar Belakang: Sistem surveilans nasional untuk infeksi saluran pernafasan akut berat (SARI) dapatmemberikan informasi penting tentang sirkulasi virus influenza, menyediakan sistem untuk mengendalikankejadian luar biasa yang mengancam keamanan dan keselamatan masyarakat serta menyediakandata untuk sistem surveilans influenza global (GISRS). Kemampuan Indonesia untuk mendeteksi dan mengendalikanpenyakit menular penting untuk keamanan kesehatan dunia. Penelitian ini bertujuan untukmenilai sistem surveilans ISPA berat Indonesia (SIBI) dan pemanfaatan untuk memantau patogen prioritaslainnya sebagai upaya meningkatkan keamanan kesehatan global. Metode: penilaian atribut surveilans melalui review laporan, analisis data dan interview staff yang terlibatdalam sistem surveilans. Semua kasus yang memenuhi kriteria SARI pada bulan Mei 2013 – April 2015 ikutserta dalam penelitian. Data epidemiologi dan virologi dianalisis. Kelengkapan dan kemudahan sistem untukmencapai tujuan surveilans influenza dan mendukung surveilans penyakit infeksi baru (emerging) dikaji. Hasil: Sebanyak 1,806 kasus SARI dan 1,697 (94%) spesimen dilakukan pemeriksaan virus influenza.Sebanyak 200 (12%) positif influenza, terdiri dari 46% influenza A(H3N2), 18% A(H1N1)pdm09 dan 37%influenza B. Hasil penilaian terhadap sistem surveilans didapatkan kesesuaian pelaksanaan untuk semuaatribut surveilans melebihi target >80%, kelengkapan laporan online 95%, kesesuaian kasus terhadapdefinisi kasus 100%, kasus yang diambil spesimen 94% dan hasil laboratorium diinput ke database secaraonline 100%. Sistem surveilans untuk dengue dan infeksi arbovirus lainnya sudah terlaksana di unitrawat jalan dan gawat darurat di sentinel SARI surveilans. Kesimpulan: SIBI dapat disesuaikan untuk menggabungkan surveilans penyakit lain yang menunjukkankegunaan dan fleksibilitas dalam mendukung keamanan kesehatan global. Kata kunci: keamanan kesehatan global, surveilans, influenza, Indonesia AbstractBackground: The existing national surveillance system for severe acute respiratory infection (SARI) providescritical information on influenza virus circulation, provides a system to control influenza outbreaks that threatenthe safety and security of the population and feeds data into the global influenza surveillance and responsesystem (GISRS). Indonesia’s ability to detect and control communicable diseases is critical for global healthsecurity. The aim of this study was to assess the SARI surveillance system and utility for monitoring other prioritypathogens as an effort to enhance global health security. Methods: Surveillance attributes were assessed by reviewing records, data analysis and through interviewedwith staffs involved in the surveillance system. All patients at six sentinel hospitals who meet the SARI casedefinition during May 2013 – April 2015 were enrolled. Epidemiological and virological data were analyzed.The surveillance system utility for its influenza surveillance objectives and flexibility to support surveillance ofemerging infectious diseases were assessed. Resuts: A total of 1,806 SARI cases were reported of which 1,697 (94%) had specimens tested for influenza viruses.Of those tested, 200 (12%) were positive, of which 46% were influenza A(H3N2), 18% A(H1N1)pdm09and 37% influenza B viruses. The system exceeded the targets of >80% adherence for most attributes: 95% forcompleteness of online reporting, 100% for cases adhering to the case definition, 94% for cases with specimenscollected and 100% of laboratory results uploaded to the online database. A surveillance system for dengue andother arbovirus infections was established in the outpatient/emergency units at the SARI surveillance sentinel.Conclusion: SIBI was adjusted to incorporate surveillance for other priority diseases indicating its utility andflexibility to support global health security Keywords: Global Health Security, surveillance, influenza, Indonesia

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Circulation of influenza A viruses among patients hospitalized for severe acute respiratory infection in a tertiary care hospital in Romania in the 2018/19 season

Medicine ◽

10.1097/md.0000000000028460 ◽

2021 ◽

Vol 100 (52) ◽

pp. e28460

Author(s):

Anca Cristina Drăgănescu ◽

Victor Daniel Miron ◽

Anca Streinu-Cercel ◽

Dragoş Florea ◽

Ovidiu Vlaicu ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Influenza A Viruses ◽

Severe Acute Respiratory Infection

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Severe morbidity among hospitalised adults with acute influenza and other respiratory infections: 2014–2015 and 2015–2016

Epidemiology and Infection ◽

10.1017/s0950268818001486 ◽

2018 ◽

Vol 146 (11) ◽

pp. 1350-1358 ◽

Cited By ~ 7

Author(s):

H. E. Segaloff ◽

J. G. Petrie ◽

R. E. Malosh ◽

C. K. Cheng ◽

E. J. McSpadden ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Hospital Length Of Stay ◽

Charlson Score ◽

Neuraminidase Inhibitors ◽

Icu Admission ◽

Hospitalised Patients ◽

Severe Acute Respiratory Infection ◽

The Impact

AbstractOur objective was to identify predictors of severe acute respiratory infection in hospitalised patients and understand the impact of vaccination and neuraminidase inhibitor administration on severe influenza. We analysed data from a study evaluating influenza vaccine effectiveness in two Michigan hospitals during the 2014–2015 and 2015–2016 influenza seasons. Adults admitted to the hospital with an acute respiratory infection were eligible. Through patient interview and medical record review, we evaluated potential risk factors for severe disease, defined as ICU admission, 30-day readmission, and hospital length of stay (LOS). Two hundred sixteen of 1119 participants had PCR-confirmed influenza. Frailty score, Charlson score and tertile of prior-year healthcare visits were associated with LOS. Charlson score >2 (OR 1.5 (1.0–2.3)) was associated with ICU admission. Highest tertile of prior-year visits (OR 0.3 (0.2–0.7)) was associated with decreased ICU admission. Increasing tertile of visits (OR 1.5 (1.2–1.8)) was associated with 30-day readmission. Frailty and prior-year healthcare visits were associated with 30-day readmission among influenza-positive participants. Neuraminidase inhibitors were associated with decreased LOS among vaccinated participants with influenza A (HR 1.6 (1.0–2.4)). Overall, frailty and lack of prior-year healthcare visits were predictors of disease severity. Neuraminidase inhibitors were associated with reduced severity among vaccine recipients.

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Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

International Journal of STD & AIDS ◽

10.1177/0956462419882587 ◽

2020 ◽

Vol 31 (2) ◽

pp. 100-108 ◽

Cited By ~ 1

Author(s):

AC Pecego ◽

RT Amâncio ◽

DM Costa ◽

FA Bozza ◽

MM Siqueira ◽

...

Keyword(s):

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Cd4 Cell Count ◽

Risk Of Death ◽

Severe Acute Respiratory Infection ◽

Living With Hiv ◽

Epidemiological Characteristics

People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11–30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm3, median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p = 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p = 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.

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Influenza Surveillance Among Children With Pneumonia Admitted to a District Hospital in Coastal Kenya, 2007–2010

The Journal of Infectious Diseases ◽

10.1093/infdis/jis536 ◽

2012 ◽

Vol 206 (suppl_1) ◽

pp. S61-S67 ◽

Cited By ~ 18

Author(s):

Clayton O. Onyango ◽

Regina Njeru ◽

Sidi Kazungu ◽

Rachel Achilla ◽

Wallace Bulimo ◽

...

Keyword(s):

Virus Infection ◽

Influenza A Virus ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

District Hospital ◽

Severe Pneumonia ◽

Influenza B Virus ◽

Influenza B ◽

Virus Subtype

Abstract Background Influenza data gaps in sub-Saharan Africa include incidence, case fatality, seasonal patterns, and associations with prevalent disorders. Methods Nasopharyngeal samples from children aged <12 years who were admitted to Kilifi District Hospital during 2007–2010 with severe or very severe pneumonia and resided in the local demographic surveillance system were screened for influenza A, B, and C viruses by molecular methods. Outpatient children provided comparative data. Results Of 2002 admissions, influenza A virus infection was diagnosed in 3.5% (71), influenza B virus infection, in 0.9% (19); and influenza C virus infection, in 0.8% (11 of 1404 tested). Four patients with influenza died. Among outpatients, 13 of 331 (3.9%) with acute respiratory infection and 1 of 196 without acute respiratory infection were influenza positive. The annual incidence of severe or very severe pneumonia, of influenza (any type), and of influenza A, was 1321, 60, and 43 cases per 100 000 <5 years of age, respectively. Peak occurrence was in quarters 3–4 each year, and approximately 50% of cases involved infants: temporal association with bacteremia was absent. Hypoxia was more frequent among pneumonia cases involving influenza (odds ratio, 1.78; 95% confidence interval, 1.04–1.96). Influenza A virus subtypes were seasonal H3N2 (57%), seasonal H1N1 (12%), and 2009 pandemic H1N1 (7%). Conclusions The burden of influenza was small during 2007–2010 in this pediatric hospital in Kenya. Influenza A virus subtype H3N2 predominated, and 2009 pandemic influenza A virus subtype H1N1 had little impact.

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Enhancement of the Influenza Surveillance System in the Russian Federation: the Main Results of the Sentinel Surveillance for Influenza and other Acute Respiratory Viral Infections

Epidemiology and Vaccinal Prevention ◽

10.31631/2073-3046-2017-16-1-7-15 ◽

2017 ◽

Vol 16 (1) ◽

pp. 7-15 ◽

Cited By ~ 2

Author(s):

A. A. Sominina ◽

E. A. Smorodintseva ◽

K. A. Stolyarov ◽

A. A. Mel'nikova

Keyword(s):

Respiratory Infection ◽

Surveillance System ◽

Acute Respiratory Infection ◽

Influenza A ◽

Hospitalized Patients ◽

Sentinel Surveillance ◽

Influenza Surveillance ◽

Influenza B Virus ◽

Influenza B ◽

Influenza A H1n1

Existing influenza surveillance system is constantly improved to obtain comprehensive information for understanding of continuously changing situation with the influenza, which is a consequence of the highest variability of the pathogen, its ability to reassortment and the imminence of emergence a new shift-variants of the virus that could cause the next pandemic events. For this purpose, since the 2010 - 2011 epidemic season, in addition to the traditional surveillance system (TS) a new well standardized sentinel surveillance system (SS) for rapid clinical and epidemiological data obtaining was introduced in Russia. A total 7812 hospitalized patients with severe acute respiratory infection (SARI) and 9854 outpatients with influenza-like illness and acute respiratory infection (ILI/ARI) were investigated during the 6-year period in SS. Percent of SARI among all hospitalized patients ranged from 1.7 to 3.1%; about 5.3 - 7.5% SARI patients were placed in the Intensive Care Unit. Etiological monitoring using PCR showed influenza spread trends in SS similar to those registered in the TS: a clear predominance of influenza A (H1N1) pdm09 among SARI and ILI/ARI in 2010 - 2011 and 2015 - 2016 epidemic seasons, influenza A (H3N2) in the epidemic seasons 2011 - 2012 and 2014 - 2015, the co-circulation of these pathogens in 2012 - 2013, 2013 - 2014 seasons in Russia. SARI caused by influenza B virus were detected less frequently than influenza A but increased influenza B activity was registered in the epidemic of 2014 -2015, when Yamagata lineage changed suddenly for the Victorian one. The average frequency of influenza diagnosis among SARI between the seasons varied in the range 12.5 - 27.1%, at the peak of the epidemic it reached 44.8 - 73.5% and was the highest during the season with active circulation of influenza A (H1N1) pdm09 virus. The rate of influenza diagnosis among ILI/ARI has always been lower than that among SARI. Studies have also shown the importance of rhinovirus, RS-virus and parainfluenza infections in SARI development. The frequency of registration of coronaviruses, metapneumovirus and bocavirus infection was very low in SARI and ILI/ARI. It was found that in all studied seasons most of SARI patients with influenza have not been vaccinated. Among ILI/ARI outpatients with influenza, the frequency of vaccinated individuals for the entire period of the study was estimated as 10.1%, which was 4.2 times higher than that in SARI, where only 2.4% of patients were vaccinated. In addition, it was found that for all six seasons the SARI patients with influenza were treated with antivirals drugs 2 times less often compared to outpatients. Analysis of data on concomitant diseases and conditions in SARI patients with influenza confirmed the leading role of pregnancy as a risk factor for hospitalization in all influenza epidemics, irrespective of their etiology. In addition, diabetes and cardiovascular disease were recognized as risk factors for influenza associated SARI development.

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Epidemiological and clinical features of acute respiratory infections occurring in St. Petersburg during the 2017–2018 and 2018–2019 epidemic seasons

Journal Infectology ◽

10.22625/2072-6732-2021-13-2-53-60 ◽

2021 ◽

Vol 13 (2) ◽

pp. 53-60

Author(s):

D. A. Guzhov ◽

E. A. Elpaeva ◽

M. A. Egorova ◽

V. A. Eder ◽

I. L. Baranovskya ◽

...

Keyword(s):

Clinical Features ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Bacterial Infections ◽

Respiratory Infections ◽

Influenza B Virus ◽

Influenza B ◽

Acute Respiratory Infections ◽

Pharyngeal Wall

Objective: to analyze the epidemiological and clinical features of acute respiratory infections occurring during the St. Petersburg 2017-2018 and 2018-2019 epidemic seasons.Materials and methods: the study included 457 patients, treated in St. Petersburg clinics from 2017-2019, displaying symptoms of acute respiratory infection (ARI), including evaluation of their clinical histories. Pathogen types were determined by polymerase chain reaction (PCR). Data analysis was carried out using mathematical statistics methods using the Statistica 10 software package (StatSoft Inc.).Results: in this study, we examined the epidemiological and clinical features of acute respiratory infections in St. Petersburg occurring during two epidemic seasons, 2017-2018 and 2018-2019. The 2017-2018 season was characterized by a prevalence of infections caused by influenza B viruses and influenza A subtype H3N2 viruses. In the 2018-2019 season, there was a greater number of acute respiratory viral infections (ARVIs) and infections caused by influenza A subtype H1N1pdm; influenza B virus was detected only in isolated cases. In the 2017-2018 sore throats and muscle aches were a characteristic symptom of influenza A H1N1pdm infections, of bacterial infections – only sore throats. It was shown that throat pain and vasodilation of the scleral and soft palate vessels were significantly more frequent in the 2017-2018 season, compared to the 2018-2019 season. Cough and redness of the posterior pharyngeal wall were hallmark signs of ARVIs in the 2018-2019 season.Conclusion: according to the data, each epidemic season is characterized not only by its own type-specific acute respiratory infection frequencies, but also by different clinical manifestation frequencies. For global monitoring, treatment effectiveness evaluation, and refined study of acute respiratory infection clinical features, it is advisable to use approaches which incorporate accurate, specific, and rapid molecular biological methods capable of identifying a broad range of pathogens.

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Epidemiological and clinical features of acute respiratory infections occurring in St. Petersburg during the 2017–2018 and 2018–2019 epidemic seasons

Journal Infectology ◽

10.22625/2072-6732-2020-12-4-65-71 ◽

2020 ◽

Vol 12 (4) ◽

pp. 65-71

Author(s):

D. A. Guzhov ◽

E. A. Elpaeva ◽

M. A. Egorova ◽

V. A. Eder ◽

I. L. Baranovskaya ◽

...

Keyword(s):

Clinical Features ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Influenza A ◽

Bacterial Infections ◽

Respiratory Infections ◽

Influenza B Virus ◽

Influenza B ◽

Acute Respiratory Infections ◽

Pharyngeal Wall

Objective: to analyze the epidemiological and clinical features of acute respiratory infections occurring during the St. Petersburg 2017–2018 and 2018–2019 epidemic seasons.Materials and methods: the study included 457 patients, treated in St. Petersburg clinics from 2017–2019, displaying symptoms of acute respiratory infection (ARI), including evaluation of their clinical histories. Pathogen types were determined by polymerase chain reaction (PCR). Data analysis was carried out using mathematical statistics methods using the Statistica 10 software package (StatSoft Inc.).Results: in this study, we examined the epidemiological and clinical features of acute respiratory infections in St. Petersburg occurring during two epidemic seasons, 2017–2018 and 2018–2019. The 2017–2018 season was characterized by a prevalence of infections caused by influenza B viruses and influenza A subtype H3N2 viruses. In the 2018–2019 season, there was a greater number of acute respiratory viral infections (ARVIs) and infections caused by influenza A subtype H1N1pdm; influenza B virus was detected only in isolated cases. In the 2017–2018 sore throats and muscle aches were a characteristic symptom of influenza A H1N1pdm infections, of bacterial infections – only sore throats. It was shown that throat pain and vasodilation of the scleral and soft palate vessels were significantly more frequent in the 2017–2018 season, compared to the 2018–2019 season. Cough and redness of the posterior pharyngeal wall were hallmark signs of ARVIs in the 2018–2019 season.Conclusion: according to the data, each epidemic season is characterized not only by its own type-specific acute respiratory infection frequencies, but also by different clinical manifestation frequencies. For global monitoring, treatment effectiveness evaluation, and refined study of acute respiratory infection clinical features, it is advisable to use approaches which incorporate accurate, specific, and rapid molecular biological methods capable of identifying a broad range of pathogens.

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