Seasonal influenza during the COVID-19 pandemic in Bangladesh

Introduction During the 2019 novel coronavirus infectious disease (COVID-19) pandemic in 2020, limited data from several countries suggested reduced seasonal influenza viruses’ circulation. This was due to community mitigation measures implemented to control the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used sentinel surveillance data to identify changes in the 2020 influenza season compared with previous seasons in Bangladesh. Methods We used hospital-based influenza surveillance (HBIS) data of Bangladesh that are generated year-round and are population-representative severe acute respiratory infection (SARI) data for all age groups from seven public and two private tertiary care level hospitals data from 2016 to 2019. We applied the moving epidemic method (MEM) by using R language (v4.0.3), and MEM web applications (v2.14) on influenza-positive rates of SARI cases collected weekly to estimate an average seasonal influenza curve and establish epidemic thresholds. Results The 2016–2019 average season started on epi week 18 (95% CI: 15–25) and lasted 12.5 weeks (95% CI: 12–14 weeks) until week 30.5. The 2020 influenza season started on epi week 36 and ended at epi week 41, lasting for only five weeks. Therefore, influenza epidemic started 18 weeks later, was 7.5 weeks shorter, and was less intense than the average epidemic of the four previous years. The 2020 influenza season started on the same week when COVID-19 control measures were halted, and 13 weeks after the measures were relaxed. Conclusion Our findings suggest that seasonal influenza circulation in Bangladesh was delayed and less intense in 2020 than in previous years. Community mitigation measures may have contributed to this reduction of seasonal influenza transmission. These findings contribute to a limited but growing body of evidence that influenza seasons were altered globally in 2020.

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What will the next influenza season bring about: seasonal influenza or the new A(H1N1)v? An analysis of German influenza surveillance data

Eurosurveillance ◽

10.2807/ese.14.32.19303-en ◽

2009 ◽

Vol 14 (32) ◽

Author(s):

H Uphoff ◽

S Geis ◽

A Grüber ◽

A M Hauri

Keyword(s):

Influenza A ◽

Seasonal Influenza ◽

Influenza Season ◽

Influenza Viruses ◽

Moderate Intensity ◽

Influenza Surveillance ◽

Influenza B ◽

Low Intensity ◽

Influenza A H1n1 ◽

Using Data

For the next influenza season (winter 2009-10) the relative contributions to virus circulation and influenza-associated morbidity of the seasonal influenza viruses A(H3N2), A(H1N1) and B, and the new influenza A(H1N1)v are still unknown. We estimated the chances of seasonal influenza to circulate during the upcoming season using data of the German influenza sentinel scheme from 1992 to 2009. We calculated type and subtype-specific indices for past exposure and the corresponding morbidity indices for each season. For the upcoming season 2009-10 our model suggests that it is unlikely that influenza A(H3N2) will circulate with more than a low intensity, seasonal A(H1N1) with more than a low to moderate intensity, and influenza B with more than a low to median intensity. The probability of a competitive circulation of seasonal influenza A with the new A(H1N1)v is low, increasing the chance for the latter to dominate the next influenza season in Germany.

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National influenza mid-season report, 2020–2021

Canada Communicable Disease Report ◽

10.14745/ccdr.v47i01a01 ◽

2021 ◽

Vol 47 (1) ◽

pp. 1-4

Author(s):

Lisa Lee ◽

Kelly Butt ◽

Steven Buckrell ◽

Andrea Nwosu ◽

Claire Sevenhuysen ◽

...

Keyword(s):

Influenza A ◽

Seasonal Influenza ◽

Influenza Season ◽

Influenza Viruses ◽

Resistance Testing ◽

Influenza Surveillance ◽

Influenza B ◽

Strain Characterization ◽

Influenza Activity ◽

Low Levels

Canada's national influenza season typically starts in the latter half of November (week 47) and is defined as the week when at least 5% of influenza tests are positive and a minimum of 15 positive tests are observed. As of December 12, 2020 (week 50), the 2020-2021 influenza season had not begun. Only 47 laboratory-confirmed influenza detections were reported from August 23 to December 12, 2020; an unprecedentedly low number, despite higher than usual levels of influenza testing. Of this small number of detections, 64% were influenza A and 36% were influenza B. Influenza activity in Canada was at historically low levels compared with the previous five seasons. Provinces and territories reported no influenza-associated adult hospitalizations. Fewer than five hospitalizations were reported by the paediatric sentinel hospitalization network. With little influenza circulating, the National Microbiology Laboratory had not yet received samples of influenza viruses collected during the 2020-2021 season for strain characterization or antiviral resistance testing. The assessment of influenza vaccine effectiveness, typically available in mid-March, is expected to be similarly limited if low seasonal influenza circulation persists. Nevertheless, Canada's influenza surveillance system remains robust and has pivoted its syndromic, virologic and severe outcomes system components to support coronavirus disease 2019 (COVID-19) surveillance. Despite the COVID-19 pandemic, the threat of influenza epidemics and pandemics persists. It is imperative 1) to maintain surveillance of influenza, 2) to remain alert to unusual or unexpected events and 3) to be prepared to mitigate influenza epidemics when they resurge.

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Influenza-associated excess mortality in southern Brazil, 1980–2008

Epidemiology and Infection ◽

10.1017/s0950268812002221 ◽

2012 ◽

Vol 141 (8) ◽

pp. 1731-1740 ◽

Cited By ~ 15

Author(s):

F. T. M. FREITAS ◽

L. R. O. SOUZA ◽

E. AZZIZ-BAUMGARTNER ◽

P. Y. CHENG ◽

H. ZHOU ◽

...

Keyword(s):

Regression Models ◽

Excess Mortality ◽

Influenza Season ◽

Age Groups ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Mortality Data ◽

Southern Brazil ◽

Northern Brazil ◽

Vaccination Campaigns

SUMMARYIn order to estimate influenza-associated excess mortality in southern Brazil, we applied Serfling regression models to monthly mortality data from 1980 to 2008 for pneumonia/influenza- and respiratory/circulatory-coded deaths for all ages and for those aged ⩾60 years. According to viral data, 73·5% of influenza viruses were detected between April and August in southern Brazil. There was no clear influenza season for northern Brazil. In southern Brazil, influenza-associated excess mortality was 1·4/100 000 for all ages and 9·2/100 000 person-years for persons aged ⩾60 years using underlying pneumonia/influenza-coded deaths and 10·0/100 000 for all ages and 86·6/100 000 person-years for persons aged ⩾60 years using underlying respiratory/circulatory-coded deaths. Influenza-associated excess mortality rates for southern Brazil are similar to those published for other countries. Our data support the need for continued influenza surveillance to guide vaccination campaigns to age groups most affected by this virus in Brazil.

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Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

Infection Control and Hospital Epidemiology ◽

10.1086/501891 ◽

2001 ◽

Vol 22 (4) ◽

pp. 211-216 ◽

Cited By ~ 25

Author(s):

Tariq A. Madani ◽

Nabeela A. Al-Abdullah ◽

Ali A. Al-Sanousi ◽

Tawfik M. Ghabrah ◽

Shadia Z. Afandi ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Saudi Arabia ◽

Tertiary Care ◽

Age Groups ◽

Clinical Manifestations ◽

Total Mortality ◽

Control Measures ◽

Methicillin Resistant ◽

Mrsa Infection ◽

Tertiary Care Hospitals

AbstractObjective:To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.Design:Retrospective review for the year 1998.Setting:Two tertiary-care hospitals.Methods:Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.Results:Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.Conclusions:The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

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H3N2 Virus as Causative Agent of ARDS Requiring Extracorporeal Membrane Oxygenation Support

Case Reports in Medicine ◽

10.1155/2014/560208 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Adriano Peris ◽

Giovanni Zagli ◽

Pasquale Bernardo ◽

Massimo Bonacchi ◽

Morena Cozzolino ◽

...

Keyword(s):

Intensive Care Unit ◽

Extracorporeal Membrane Oxygenation ◽

Influenza A ◽

Seasonal Influenza ◽

Influenza Season ◽

Influenza Viruses ◽

H3n2 Virus ◽

Membrane Oxygenation ◽

Viral Aetiology ◽

Increased Risk

Pandemic influenza virus A(H1N1) 2009 was associated with a higher risk of viral pneumonia in comparison with seasonal influenza viruses. The influenza season 2011-2012 was characterized by the prevalent circulation of influenza A(H3N2) viruses. Whereas most H3N2 patients experienced mild, self-limited influenza-like illness, some patients were at increased risk for influenza complications because of age or underlying medical conditions. Cases presented were patients admitted to the Intensive Care Unit (ICU) of ECMO referral center (Careggi Teaching Hospital, Florence, Italy). Despite extracorporeal membrane oxygenation treatment (ECMO), one patient with H3N2-induced ARDS did not survive. Our experience suggests that viral aetiology is becoming more important and hospitals should be able to perform a fast differential diagnosis between bacterial and viral aetiology.

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Utility of Nontraditional Data Sources for Early Detection of Influenza

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7636 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Shari Barlow ◽

Jonathan Temte ◽

Yenlik Zheteyeva ◽

Ashley Fowlkes ◽

Carrie Reed ◽

...

Keyword(s):

Age Groups ◽

School Closure ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

School Absenteeism ◽

School Closures ◽

School Based ◽

Influenza Transmission ◽

Influenza Outbreaks

ObjectiveThis session will provide an overview of the current systemsfor influenza surveillance; review the role of schools in influenzatransmission; discuss relationships between school closures, schoolabsenteeism, and influenza transmission; and explore the usefulnessof school absenteeism and unplanned school closure monitoring forearly detection of influenza in schools and broader communities.IntroductionInfluenza surveillance is conducted through a complex networkof laboratory and epidemiologic systems essential for estimatingpopulation burden of disease, selecting influenza vaccine viruses,and detecting novel influenza viruses with pandemic potential (1).Influenza surveillance faces numerous challenges, such as constantlychanging influenza viruses, substantial variability in the number ofaffected people and the severity of disease, nonspecific symptoms,and need for laboratory testing to confirm diagnosis. Exploringadditional components that provide morbidity information mayenhance current influenza surveillance.School-aged children have the highest influenza incidence ratesamong all age groups. Due to the close interaction of children inschools and subsequent introduction of influenza into households,it is recognized that schools can serve as amplification points ofinfluenza transmission in communities. For this reason, pandemicpreparedness recommendations include possible pre-emptive schoolclosures, before transmission is widespread within a school system orbroader community, to slow influenza transmission until appropriatevaccines become available. During seasonal influenza epidemics,school closures are usually reactive, implemented in response tohigh absenteeism of students and staff after the disease is alreadywidespread in the community. Reactive closures are often too late toreduce influenza transmission and are ineffective.To enhance timely influenza detection, a variety of nontraditionaldata sources have been explored. School absenteeism was suggestedby several research groups to improve school-based influenzasurveillance. A study conducted in Japan demonstrated that influenza-associated absenteeism can predict influenza outbreaks with highsensitivity and specificity (2). Another study found the use of all-causes absenteeism to be too nonspecific for utility in influenzasurveillance (3). Creation of school-based early warning systemsfor pandemic influenza remains an interest, and further studies areneeded. The panel will discuss how school-based surveillance cancomplement existing influenza surveillance systems.

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Prescribing Pattern of Drugs in Acute Respiratory Tract Infection in Children aged 1 To 5 Years At Tertiary Care Teaching Hospital

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1563 ◽

2018 ◽

Vol 11 (4) ◽

pp. 1903-1911 ◽

Cited By ~ 1

Author(s):

Sujata Jadhav ◽

Chitra Khanwelkar

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Tertiary Care ◽

Age Groups ◽

Essential Medicine ◽

Influenza Viruses ◽

Brand Names ◽

World Health ◽

Prescribing Pattern ◽

Tract Infections

Acute respiratory tract infections (ARTI) are very common in all age groups. Childhood respiratory tract infections are responsible for considerable morbidity and mortality. It is significant health problem in India also. The World Health Organization (WHO) estimates that 2 million children under five years of age die due to pneumonia. Majority of ARTIs have viral etiology. Rhinoviruses, respiratory syncytial viruses, parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses are main causative agents. Among bacteria, group A streptococci, Corynebacterium diphtheriae, N. meningitides, H. influenzae, pneumococcus and Staphylococcus aureus are responsible for ARTIs. Drug utilization studies help to understand the pattern of prescription in that particular area for specific conditions.We included children from one to five years of age, diagnosed as ARTI and evaluated 298 prescriptions given to these children. Analysis of these prescriptions was done as well as they are compared with WHO prescription indicators. Cough (96%), fever (93%) and rhinitis (82.5%) were common symptoms observed, but sore throat, earache and breathlessness were also present in these children. Average number of drugs prescribed was 4.1/patient. Following drugs were prescribed, Antipyretics 98.3%, antimicrobials 91.3%, antihistaminics and cough syrups in 75.2%, Leukotriene antagonist in 25.1% patients, Vitamin B complex 11% and glucocorticoids 4.6%. All drugs were prescribed by brand names and not by generic name. 97.3% prescribed drugs were from national list of essential medicine. We found overuse of antimicrobials in our study. Educational programs are needed in order to bring rational use of antimicrobials. At the same time awareness in parents also should be done regarding antimicrobial use.

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Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214958 ◽

2021 ◽

Vol 8 (1) ◽

pp. 39

Author(s):

Mohan M. Desai ◽

Deven R. Kuruwa ◽

Easwar Elango ◽

Roshan Wade

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Age Groups ◽

Control Measures ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Treatment Protocols ◽

Female Ratio ◽

Femur Fractures

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.

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H1N1 INFLUENZA VERSUS SEASONAL INFLUENZA MORBIDITY AND MORTALITY: A PROSPECTIVE STUDY IN AL-KINDY TEACHING HOSPITAL/ IRAQ-BAGHDAD

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v12i2.292 ◽

2016 ◽

Vol 12 (2) ◽

pp. 18-21

Author(s):

Ismail A. Hussain AL-Ameri ◽

Baker Fadel ◽

Ali Sajid ◽

Imad Kareem

Keyword(s):

Teaching Hospital ◽

Seasonal Influenza ◽

Influenza Pandemic ◽

Age Groups ◽

H1n1 Influenza ◽

Influenza Viruses ◽

Morbidity And Mortality ◽

Severe Illness ◽

Wide Range ◽

Symptoms And Signs

Background: H1N1 influenza pandemic or swine flu was an influenza pandemic first described in Iraq in October 2009 .The virus appeared to be anew strain of H1N1 causes wide range of morbidity and mortality among different genders and age groups as part of worldwide pandemics.Seasonal flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccine each year. Objectives: Is to determine the morbidity and mortality in different age groups in patients with H1N1 influenza versus those patients with seasonal influenza who were admitted at the same time to AL-kindy teaching hospital during pandemic 2009. Type of the study: A retrospective observational study. Methods: A total number of 210 cases with influenza symptoms and signs were included in this study which was conducted at AL-kindy teaching hospital , Baghdad, Iraq at inpatient medical wards over a period from October to December 2009. All cases were tested by real time PCR for H1N1 influenza virus by taking nasal and throat swab in addition to monitoring symptoms and signs of influenza and chest radiographs. Results: Out of 210 cases, 90 (42.85%) cases were positive for H1N1 influenza and 120 (57.14%) cases had negative test are considered having seasonal influenza. Of the positive cases(64.44%) were males and (35.55%) were females. Of negative cases(seasonal flu)male gender were (61.66%) , while female gender were (38.33%). 57.77% of positive cases developed flue like illness compared with 54.16% of negative while 25.55% of positive developed pneumonia compared with 22.5% of negative.5.55% of positive cases developed ARDS compared with 5% only in negative cases.11.11% had different presentation in positive cases (bronchitis ,gastroenteritis) while 18.33%of negative. Mortality in positive cases are 14.4% compared with only 10% in negative cases. Conclusions: Influenza A/H1N1had same symptoms and signs of epidemic seasonal influenza but run aggressive and short course of morbidity in 3-5 days with high percentage of complication and high mortality compared with seasonal epidemic influenza with rare affection above 65 years old, both groups had same incidence of complication with pneumonia and ARDS

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Contemporary H3N2 influenza viruses have a glycosylation site that alters binding of antibodies elicited by egg-adapted vaccine strains

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1712377114 ◽

2017 ◽

Vol 114 (47) ◽

pp. 12578-12583 ◽

Cited By ~ 231

Author(s):

Seth J. Zost ◽

Kaela Parkhouse ◽

Megan E. Gumina ◽

Kangchon Kim ◽

Sebastian Diaz Perez ◽

...

Keyword(s):

Seasonal Influenza ◽

Influenza Season ◽

Antigenic Site ◽

Glycosylation Site ◽

Influenza Viruses ◽

Antibody Responses ◽

H3n2 Virus ◽

Viral Strain ◽

H3n2 Influenza ◽

H3n2 Vaccine

H3N2 viruses continuously acquire mutations in the hemagglutinin (HA) glycoprotein that abrogate binding of human antibodies. During the 2014–2015 influenza season, clade 3C.2a H3N2 viruses possessing a new predicted glycosylation site in antigenic site B of HA emerged, and these viruses remain prevalent today. The 2016–2017 seasonal influenza vaccine was updated to include a clade 3C.2a H3N2 strain; however, the egg-adapted version of this viral strain lacks the new putative glycosylation site. Here, we biochemically demonstrate that the HA antigenic site B of circulating clade 3C.2a viruses is glycosylated. We show that antibodies elicited in ferrets and humans exposed to the egg-adapted 2016–2017 H3N2 vaccine strain poorly neutralize a glycosylated clade 3C.2a H3N2 virus. Importantly, antibodies elicited in ferrets infected with the current circulating H3N2 viral strain (that possesses the glycosylation site) and humans vaccinated with baculovirus-expressed H3 antigens (that possess the glycosylation site motif) were able to efficiently recognize a glycosylated clade 3C.2a H3N2 virus. We propose that differences in glycosylation between H3N2 egg-adapted vaccines and circulating strains likely contributed to reduced vaccine effectiveness during the 2016–2017 influenza season. Furthermore, our data suggest that influenza virus antigens prepared via systems not reliant on egg adaptations are more likely to elicit protective antibody responses that are not affected by glycosylation of antigenic site B of H3N2 HA.

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