Physical distancing reduced the incidence of influenza and supports a favorable impact on SARS-CoV-2 spread in Mexico

Introduction: Physical distancing preventive measures were implemented in Mexico as a response to the coronavirus disease 2019 (CoViD-19) pandemic. School closures occurred on March 16, 2020, in 10 out of 32 Mexican states, and one week later in the remaining states. Because the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the influenza virus have similar transmission mechanisms, we aimed to evaluate the impact of physical distancing on the incidence of influenza as a proxy of the impact on SARS-CoV-2 contagion. Methodology: A national flu surveillance system was cross-sectionally analyzed and daily average percent changes (APCs) of incidence rates were calculated throught Poisson regression models. Results: Greater decreasing trends (APCs -8.8, 95% CI: -12.5, -4.5; vs. -6.0, 95% CI: -9.9, -2.0; p = 0.026) were documented in the states with earlier school closures and across age groups, suggesting that earlier implementation of physical distance results in reduced SARS-CoV-2 spread. Conclusions: Physical distancing policies decrease the incidence of influenza infections in Mexico; its favorable impact on the spread of SARS-CoV-2 is commendable.

Download Full-text

POS0774 INFLUENZA INFECTION AS A TRIGGER FOR SYSTEMIC LUPUS ERYTHEMATOSUS FLARES RESULTING IN HOSPITALIZATION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3409 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 641.1-641

Author(s):

Y. B. Joo ◽

Y. J. Park

Keyword(s):

Systemic Lupus Erythematosus ◽

Confidence Interval ◽

Lupus Erythematosus ◽

Influenza Infection ◽

Age Groups ◽

Case Series ◽

Incidence Rates ◽

Systemic Lupus ◽

Control Interval ◽

The Impact

Background:Infections have been associated with a higher risk of systemic lupus erythematosus (SLE) flares, but the impact of influenza infection on SLE flares has not been evaluated.Objectives:We evaluated the association between influenza infection and SLE flares resulting in hospitalization.Methods:SLE flares resulting in hospitalization and influenza cases were ascertained from the Korean national healthcare insurance database (2014-2018). We used a self-controlled case series design. We defined the risk interval as the first 7 days after the influenza index date and the control interval was defined as all other times during the observation period of each year. We estimated the incidence rates of SLE flares resulting in hospitalization during the risk interval and control interval and compared them using a Poisson regression model.Results:We identified 1,624 influenza infections among the 1,455 patients with SLE. Among those, there were 98 flares in 79 patients with SLE. The incidence ratio (IR) for flares during the risk interval as compared with the control interval was 25.75 (95% confidence interval 17.63 – 37.59). This significantly increased the IRs for flares during the risk interval in both women (IR 27.65) and men (IR 15.30), all age groups (IR 17.00 – 37.84), with and without immunosuppressive agent (IR 24.29 and 28.45, respectively), and with and without prior respiratory diseases (IR 21.86 and 26.82, respectively).Conclusion:We found significant association between influenza infection and SLE flares resulting in hospitalization. Influenza infection has to be considered as a risk factor for flares in all SLE patients regardless of age, sex, medications, and comorbidities.References:[1]Kwong, J. C. et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018:378;345-353.Table 1.Incidence ratios for SLE flares resulting in hospitalization after influenza infectionRisk intervalIncidence ratio95% CIDuring risk interval for 7 days / control interval25.7517.63 – 37.59Days 1-3 / control interval21.8114.71 – 32.35Days 4-7 / control interval7.563.69 – 15.47SLE, systemic lupus erythematosus; CI, confidence intervalDisclosure of Interests:None declared

Download Full-text

Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

Clinical Infectious Diseases ◽

10.1093/cid/ciab791 ◽

2021 ◽

Author(s):

Milou Ohm ◽

Susan J M Hahné ◽

Arie van der Ende ◽

Elizabeth A M Sanders ◽

Guy A M Berbers ◽

...

Keyword(s):

The Netherlands ◽

Incidence Rate ◽

Vaccination Programme ◽

Screening Method ◽

Age Groups ◽

Incidence Rates ◽

Age Group ◽

Mass Campaign ◽

Conjugate Vaccination ◽

The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

Download Full-text

Tuberculosis in Saudi Arabia: Prevalence between Saudis and Non-Saudis from 2013 to 2018 with a special concern about regions of the KSA

Journal of Clinical & Experimental Immunology ◽

10.33140/jcei.04.06.02 ◽

2019 ◽

Vol 4 (6) ◽

Keyword(s):

Saudi Arabia ◽

Migrant Workers ◽

Action Plan ◽

Age Groups ◽

Incidence Rates ◽

Arab Countries ◽

Surveillance Data ◽

Significance Level ◽

Chi Squared ◽

The Impact

The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p< 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan.

Download Full-text

Possible Impact of Wide-scale Vaccination Against Serogroup B Neisseria Meningitidis on Gonorrhea Incidence Rates in One Region of Quebec, Canada

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx180.002 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S734-S735 ◽

Cited By ~ 7

Author(s):

Jean Longtin ◽

Rejean Dion ◽

Marc Simard ◽

Jean-Francois Betala Belinga ◽

Yves Longtin ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Vaccine Coverage ◽

Vaccination Campaign ◽

Age Groups ◽

Incidence Rates ◽

Study Objective ◽

Grant Recipient ◽

Invasive Infections ◽

Wide Scale ◽

The Impact

Abstract Background Owing to a persistent increase of serogroup B Neisseria meningitidis (Nm) invasive infections in the Saguenay-Lac-Saint-Jean (SLSJ) region of the province of Quebec (Canada) since 2006, a wide-scale vaccination campaign of individuals aged 6 months to 20 years was conducted between May and December 2014 using the 4-component protein-based meningococcus serogroup B vaccine (4CMenB). Components of this vaccine have shown to potentially cross-react with Neisseria gonorrhoeae (Ng). The study objective was to assess the impact of the vaccination campaign on Ng incidence rate (IR). Methods Ng cases notified to public health authorities during prevaccination period (January 2006 to June 2014) and postvaccination period (July 2014 to June 2017) were analyzed. The impact of this mass campaign was estimated by a Poisson regression model, including the year (11 July–June categories), age (14–20 vs. 21 years and older), and the intervention (0 by default and 1 in those 14–20 years in the period of July 2014 to June 2017). Results Overall vaccine coverage was 82% in the target group. A total of 231 Ng cases were reported among persons 14 years and older (IR: 8.4/100,000 person-years) of the SLSJ region from January 2006 to June 2017. A decrease in the Ng number of cases and IR among individuals 14–20 years was observed during the post-vaccination period whereas it increased in those 21 years and older (figure). Estimate of vaccination impact was an Ng risk reduction of 59% (95% CI: −22% to 84%; P = 0.1). During the same period, Chlamydia trachomatis (Ct) infections increased among persons of both age groups in the SLSJ region. Conclusion Although the estimate of the impact of the campaign was not statistically significant, possibly due to limited size of the study population and the low incidence of the disease, it is congruent with results of a case–control study in New Zealand showing an OMV-MeNZB vaccine effectiveness of 31%. A higher effectiveness of 4CMenB is a plausible hypothesis as three additional proteins also found in Ng are included in the vaccine used in the SLSJ region. The results of this ecologic study suggest cross-protection of 4CMenB vaccine against Ng infections. Further studies on this topic are warranted. Disclosures P. De Wals, GlaxoSmithKline: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Pfizer: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Sanofi-Pasteur: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Novartis: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses.

Download Full-text

A simulation study on the relative role of age groups under differing pertussis transmission scenarios

10.1101/247007 ◽

2018 ◽

Cited By ~ 2

Author(s):

Ana I. Bento ◽

Aaron A. King ◽

Pejman Rohani

Keyword(s):

Herd Immunity ◽

Age Groups ◽

Transmission Model ◽

Relative Role ◽

Older Individuals ◽

Age Cohorts ◽

Relative Risks ◽

Transmission Mechanisms ◽

Acellular Vaccines ◽

The Impact

AbstractPertussis has resurged in many countries where it was once regarded as under control, with the recent outbreaks showing a shift in incidence towards teens and older individuals. Here, using an age-stratified transmission model, we tested two potential causes for underlying changes in pertussis transmission dynamics. We did so assuming hypothesized mechanisms supporting present-day pertussis epidemiology: (I) improved diagnostics, (II) acellular vaccines leading to asymptomatic transmission (III) both. We used the relative risks and odds ratio methods to examine the impact of these differing assumptions on signatures of relative roles of key age groups through time, allowing us to explore those age cohorts that disproportionately account for transmission. Our findings show that for epidemics after the vaccine switch, a scenario with increased adult reporting and no asymptomatic transmission reflect a loss of signal, where no age group appears to be key. While scenarios with asymptomatic transmission, reflect a population where children (1-10 years old) are still disproportionally at risk. These results demonstrate that understanding the underlying transmission mechanisms in a population are paramount for vaccination policies in attaining herd immunity and eventually eradication.

Download Full-text

Children Coping, Contextual Risk and their Interplay during the COVID-19 Pandemic: a Spanish Case

10.31234/osf.io/bt6kr ◽

2020 ◽

Author(s):

Beatriz Domínguez-Álvarez ◽

Laura López-Romero ◽

Aimé Isdahl-Troye ◽

José Antonio Gómez-Fraguela ◽

Estrella Romero

Keyword(s):

Psychosocial Adjustment ◽

Age Groups ◽

Well Being ◽

Risk And Resilience ◽

School Closures ◽

Contextual Risk ◽

Study Results ◽

Child Coping ◽

Age Dependent ◽

The Impact

The COVID-19 pandemic has changed the lives of millions of people around the globe and some of the unprecedent emerged disruptions, are likely to have been particularly challenging for young children (e.g., school closures, social distancing measures, movement restrictions). Studying the impact of such extraordinary circumstances on their well-being is crucial to identify processes leading to risk and resilience. To better understand how Spanish children have adapted (or fail to) to the stressful disruptions resulting from the pandemic outbreak, we examined the effects of child coping and its interactions with contextual stressors (pandemic and family-related) on child adjustment, incorporating in our analysis a developmental perspective. Data was collected in April 2020, through parent-reports, during the acute phase of the pandemic and, temporarily coinciding with the mandatory national quarantine period imposed by the Spanish Government. A sample of 1,123 Spanish children (50% girls) aged three to 12 (Mage = 7.26; SD = 2.39) participated in the study. Results showed differences in the use of specific strategies by children in different age groups (i.e., 3-6, 7-9 and 10-12-year-olds). Despite the uncontrollable nature of the pandemic-related stressors, child disengagement coping was distinctively associated to negative outcomes (i.e., higher levels of behavioral and emotional difficulties), whereas engagement coping predicted psychosocial adjustment across all age groups. Moreover, interactively with child coping, parent fear of the future and parent dispositional resilience appear as relevant contextual factors to predict both negative and positive outcomes, but their effects seem to be age dependent, suggesting a higher contextual vulnerability for younger children. These findings might have implications for identifying individual and contextual risk and informing potential preventive interventions aimed to reduce the impact of future pandemic outbreaks on children of different ages.

Download Full-text

Pneumococcal vaccine and serotype replacement in England: the bias of increased reporting

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1257 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Chiavenna ◽

A Presanis ◽

A Charlett ◽

S Ladhani ◽

D De Angelis

Keyword(s):

Pneumococcal Vaccine ◽

Pneumococcal Disease ◽

Model Building ◽

Age Groups ◽

Statistical Modelling ◽

Incidence Rates ◽

Synthetic Control ◽

Serotype Replacement ◽

Vaccine Type ◽

The Impact

Abstract Background Increased incidence of invasive pneumococcal disease (IPD) attributable to non-vaccine serotypes (NVT) has been reported in several countries following introduction of PCV7 and PCV13 vaccines, concurrently with a reduction in vaccine-type IPD. Such serotype replacement has, importantly, emerged in England, offsetting the benefit of PCV introduction. We scrutinise most recent findings to assess if the estimated increase in NVT disease might result from surveillance artefacts. Methods Using IPD surveillance for 2000-2018, we estimate the impact of PCV7 and PCV13 introduction on age-serotype-specific incidence rates through a synthetic control regression model, building counterfactuals by combining age-specific incidences reported for pathogens unaffected by PCVs. Results Following the introduction of PCV7 and PCV13 (pre-2006 vs post-2011), total IPD incidence declined by 57% and by 76% in children younger than 5. PCV7-IPD decreased by 93% in all age groups, whereas PCV13-IPD declined by 68% since PCV13 was introduced. Importantly, NVT-IPD increased by 43% after PCV7, with non-significant statistical increases in most age groups. Conclusions Through appropriate statistical modelling, we disentangled the impact of vaccine and improved surveillance on the changes in IPD incidence rates. By controlling for the confounding effects of improved surveillance, we are able to estimate a lower serotype replacement. Key messages Pneumococcal vaccine has been beneficial despite serotype replacement. Adequate statistical methods are needed to disentangle the two phenomena.

Download Full-text

One-Dose Human Papillomavirus Vaccination and the Risk of Genital Warts: A Danish Nationwide Population-based Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1067 ◽

2020 ◽

Author(s):

Louise Baandrup ◽

Christian Dehlendorff ◽

Susanne K Kjaer

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccination ◽

Age Groups ◽

Genital Warts ◽

Population Based ◽

Incidence Rates ◽

Real World Data ◽

Calendar Time ◽

Human Papillomavirus Vaccination ◽

The Impact

Abstract Background Increasing evidence suggests that 1-dose human papillomavirus (HPV) vaccination may protect significantly against HPV-related disease. We provide nationwide, real-world data on the risk of genital warts (GWs) after <3 vaccine doses. Methods All Danish women born in 1985–2003 were identified, and individual-level vaccination data were retrieved. The cohort was followed up for first occurrence of GWs until 31 December 2016. Using Poisson regression, we calculated incidence rates (IRs) of GWs per 100 000 person-years and IR ratios (IRRs) with corresponding 95% confidence intervals (CIs) for GWs, according to vaccination status, age at first dose, and calendar time. Results The cohort comprised 1 076 945 girls and women, of whom 485 408 were vaccinated. For girls initiating vaccination at age 12–14 years and 15–16 years, 1-dose vaccine effectiveness (VE) was 71% (IRR = 0.29; 95% CI, .22–.38) and 62% (0.38; .29–.49), respectively, compared with unvaccinated girls. In the same age groups, 2-dose VE was 78% (IRR, 0.22; 95% CI, .18–.26) and 68% (0.32; .26–.38), respectively. After 2009, the IRRs for 3 versus 1 dose and 2 versus 1 dose increased towards unity over calendar time, being 0.69 (95% CI, .57–.84) and 0.86 (.68–1.08) in 2016, respectively. Conclusions In this study, 1 or 2 doses of quadrivalent HPV vaccine was associated with substantial protection against GWs in girls vaccinated at age ≤16 years. The 1-dose VE approached that of 3 or 2 doses over calendar time, probably reflecting the impact of herd protection.

Download Full-text

Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study

Psychological Medicine ◽

10.1017/s0033291715000744 ◽

2015 ◽

Vol 45 (13) ◽

pp. 2781-2791 ◽

Cited By ~ 7

Author(s):

K. L. Musliner ◽

B. B. Trabjerg ◽

B. L. Waltoft ◽

T. M. Laursen ◽

P. B. Mortensen ◽

...

Keyword(s):

Psychiatric Diagnosis ◽

Affective Disorders ◽

Age Groups ◽

Unipolar Depression ◽

Parental Psychopathology ◽

Incidence Rates ◽

Psychiatric Diagnoses ◽

Parental History ◽

History Of ◽

The Impact

BackgroundDepression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups.MethodWe established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or ‘other’ psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions.ResultsParental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p < 0.0001; paternal: IRR 1.68, p < 0.0001) and inpatient (maternal: IRR 1.99, p < 0.0001; paternal: IRR 1.83, p < 0.0001) depression relative to no parental history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29–3.96 in the youngest age group to 1.53–1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51–1.90).ConclusionsParental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

Download Full-text

Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1258 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Marrella ◽

A Casuccio ◽

E Amodio ◽

F Vitale

Keyword(s):

Vaccination Coverage ◽

Age Groups ◽

Incidence Rates ◽

Varicella Vaccination ◽

Age Group ◽

Annual Percent Change ◽

High Coverage ◽

Joint Point ◽

Hospitalization Rates ◽

The Impact

Abstract Introduction The present study summarizes evidences of the impact of varicella vaccination (VV) on hospitalization rates attributable to this infectious disease in Italy. Methods We have carried out a retrospective observational study that analysed hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Health Ministry. All hospitalizations with the presence of an ICD-9 CM 059.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis. Results Hospitalization rates showed a decreasing risk by age: children aged <1 year were the most affected age group in each region (42.56/100,000 per year), whereas lower incidence rates were found in older age groups (23.76/100,000 in 1 to 5 years age group and <4/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.42 vs. 2.67 per 100,000; P < 0.001). During the first five years after vaccination introduction hospitalization rates showed a statistically significant decrease especially for infants aged <1 year (AAPC -34.98%; p < 0.001) and 1 to 5 years old (AAPC -35.22%; P < 0.01). VV coverage was strongly correlated with hospitalization rates decrease over each paediatric age group (R-squared 0.38 in aged <1 year, p < 0.001; 0.71 in 1 to 5 years old, p < 0.001; 0.93 in 6 to 14 years old, p < 0.0001). Conclusions All the previously reported findings confirm that hospitalization rates are strictly related to both the number of years since vaccination introduction and the vaccination coverage. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool for reducing the risk of complications. Key messages This study adds update findings to the literature and shows that varicella hospitalizations in Italy, from 2003 to 2018, have reduced their burden, that was high in years before varicella vaccination. Varicella vaccination introduction and high coverage are powerful tools for reducing the risk of varicella complications and related hospitalizations in the general population.

Download Full-text