scholarly journals Influenza-Associated Pediatric Deaths in the United States, 2010–2015

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Mei Shang ◽  
Lenee Blanton ◽  
Sonja Olsen ◽  
Alicia Fry ◽  
Lynnette Brammer
Keyword(s):  
United States ◽  
Vaccination Coverage ◽  
Influenza A ◽  
The United States ◽  
H3n2 Virus ◽  
Severe Illness ◽  
Influenza B Virus ◽  
Influenza B ◽  
Healthy Children ◽  
B Virus

ObjectiveTo characterize and describe influenza-associated pediatric deathsin the United States over five influenza seasons, 2010–11 through2014–15.IntroductionCommunity influenza infection rates are highest among children.In children, influenza can cause severe illness and complicationsincluding, respiratory failure and death. Annual influenza vaccinationis recommended for all persons aged≥6 months. In 2004, influenza-associated deaths in children became a notifiable condition.MethodsDeaths that occurred in children aged <18 years with laboratory-confirmed influenza virus infection were reported from states andterritories to the Centers for Disease Control and Prevention on astandard case report form. We used population estimates from theU.S. Census Bureau, 2011 to 2015, to calculate age group-adjustedincidence. We used Wilcoxon-rank-sum test to compare medians andchi-square and Mantel-Haenszel chi-square to compare differencesbetween proportions of two groups.ResultsFrom October 2010 through September 2015, 590 influenza-associated pediatric deaths were reported. The median age at timeof death was 6 years (interquartile range, 1–12 years). Half of thechildren (285/572) had at least one underlying medical condition.Neurologic conditions (26%) and development delay (21%) weremost commonly reported. The average annual incidence rate was0.16 per 100,000 children (95% confidence interval [CI]: 0.15–0.17)and was highest among children aged <6 months (0.75, 95% CI,0.60–0.94 per 100,000 children), followed by children aged6–23 months (0.34, 95% CI, 0.28–0.41 per 100,000 children). Only21% (87/409) of pediatric deaths in children≥6 months had evidenceof full influenza vaccination. Vaccination coverage was lower inchildren aged 6–23 months (15%) and 5–8 years (17%) than withthose aged 2–4 years and 9–17 years (25%, p<0.01). The majorityof children aged <2 years who died had no underlying medicalconditions (63%, 105/167); this proportion was significantly higherthan that in children aged≥2 years (45%, 182/405, p<0.01).Overall 65% (383) of pediatric deaths had influenza A virusdetected, and 33% had influenza B virus detected. Children infectedwith influenza B virus had a higher frequency of sepsis/shock(41%, 72/174), acute respiratory distress syndrome (ARDS, 33%,58/174), and hemorrhagic pneumonia/pneumonitis (8%, 14/174) thanchildren infected with either influenza A(H1N1) pdm09 or influenzaA(H3N2) virus (p=0.01, 0.03, 0.03, respectively).Overall 81% (421/521) of children had an influenza-associatedcomplication; the most commonly reported were pneumonia (40%),sepsis/shock (31%) and ARDS (29%). Among those with testingreported, invasive bacteria coinfections were identified in 43%(139/322);β-hemolyticStreptococcus(20%) andStaphylococcusaureus(17%) were reported most frequently.Most children (39%, 212/548) died within 3 days of symptomonset, 28% died 4–7 days after onset, and 34% died≥8 days afteronset. The median days from illness onset to death for children withan underlying condition was significantly longer than the time forpreviously healthy children (7 versus 4 days, p<0.01).ConclusionsEach year, a substantial number of influenza-associated deathsoccur among U.S. children, with rates highest among those aged<2 years. While half of the deaths were among children withunderlying conditions, the majority of children <2 years who diedwere previously healthy. Vaccination coverage was very low.Influenza vaccination among pregnant women, young children andchildren with high-risk underlying conditions should be encouragedand could reduce influenza-associated mortality among children.

scholarly journals DRIFT OF INFLUENA A(H3N2) VIRUS: BIOLOGICAL, ANTIGENIC AND GENETIC PROPERTIES IN EPIDEMIC SEASON 2016-2017 IN RUSSIA AND COUNTRIES OF THE NOTHERN HEMYSPHERE

2018 ◽  
Vol 63 (2) ◽  
pp. 61-68 ◽  
Author(s):  
D. K. Lvov ◽  
E. I. Burtseva ◽  
E. S. Kirillova ◽  
L. V. Kolobukhina ◽  
E. A. Mukasheva ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Northern Hemisphere ◽  
Influenza A ◽  
H3n2 Virus ◽  
Research Centre ◽  
Federal State ◽  
Influenza B Virus ◽  
Influenza B ◽  
Epidemic Season ◽  
B Virus

The article presents the features of the influenza virus circulation for the period from October 2016 to May 2017 in some territories of Russia collaborating with the D.I. Ivanovsky Institute of Virology, Federal State Budgetary Institution “N.F. Gamaleya Federal Research Centre for Epidemiology and Microbiology”, Ministry of Health of the Russian Federation. One of the 2016-2017 season’s peculiarities in Russia and countries of the Northern hemisphere was the earlier start of an increase in ARD morbidity with peak indexes reached towards the end of December 2016 - January 2017. First, influenza A(H3N2) virus was predominant; then, it was followed by influenza B virus activity observed until the end of the season. The indexes of morbidity were higher than in the previous season, while the rates of hospitalization and mortality were lower, lethal cases being detected in persons 65 years old and older. Epidemic strains of influenza A(H3N2) virus belonged to 3c.2a genetic group, reference strain A/Hong Hong/4408/2014, and its subgroup 3c.2a1, reference A/Bolzano/7/2016, that are antigenically similar. Strains of influenza B virus were antigenically similar to the B/Brisbane/60/2008 vaccine virus. Strains were sensitive to oseltamivir and zanamivir. The share participation of non-influenza ARI viruses was similar to preliminary epidemic seasons. WHO has issued recommendations for influenza virus vaccines composition for 2017-2018 for the Northern hemisphere.

scholarly journals Surveillance for Neuraminidase Inhibitor Resistance among Human Influenza A and B Viruses Circulating Worldwide from 2004 to 2008

2008 ◽  
Vol 52 (9) ◽  
pp. 3284-3292 ◽  
Author(s):  
Tiffany G. Sheu ◽  
Varough M. Deyde ◽  
Margaret Okomo-Adhiambo ◽  
Rebecca J. Garten ◽  
Xiyan Xu ◽  
...  
Keyword(s):  
United States ◽  
Influenza A ◽  
Neuraminidase Inhibitor ◽  
The United States ◽  
H3n2 Virus ◽  
Influenza B ◽  
Close Monitoring ◽  
Oseltamivir Resistance ◽  
H3n2 Influenza ◽  
Inhibitor Resistance

ABSTRACT The surveillance of seasonal influenza virus susceptibility to neuraminidase (NA) inhibitors was conducted using an NA inhibition assay. The 50% inhibitory concentration values (IC50s) of 4,570 viruses collected globally from October 2004 to March 2008 were determined. Based on mean IC50s, A(H3N2) viruses (0.44 nM) were more sensitive to oseltamivir than A(H1N1) viruses (0.91 nM). The opposite trend was observed with zanamivir: 1.06 nM for A(H1N1) and 2.54 nM for A(H3N2). Influenza B viruses exhibited the least susceptibility to oseltamivir (3.42 nM) and to zanamivir (3.87 nM). To identify potentially resistant viruses (outliers), a threshold of a mean IC50 value + 3 standard deviations was defined for type/subtype and drug. Sequence analysis of outliers was performed to identify NA changes that might be associated with reduced susceptibility. Molecular markers of oseltamivir resistance were found in six A(H1N1) viruses (H274Y) and one A(H3N2) virus (E119V) collected between 2004 and 2007. Some outliers contained previously reported mutations (e.g., I222T in the B viruses), while other mutations [e.g., R371K and H274Y in B viruses and H274N in A(H3N2) viruses) were novel. The R371K B virus outlier exhibited high levels of resistance to both inhibitors (>100 nM). A substantial variance at residue D151 was observed among A(H3N2) zanamivir-resistant outliers. The clinical relevance of newly identified NA mutations is unknown. A rise in the incidence of oseltamivir resistance in A(H1N1) viruses carrying the H274Y mutation was detected in the United States and in other countries in the ongoing 2007 to 2008 season. As of March 2008, the frequency of resistance among A(H1N1) viruses in the United States was 8.6% (50/579 isolates). The recent increase in oseltamivir resistance among A(H1N1) viruses isolated from untreated patients raises public health concerns and necessitates close monitoring of resistance to NA inhibitors.

Reye's Syndrome in the United States in 1977-1978, a Non-Influenza B Virus Year

1979 ◽  
Vol 140 (3) ◽  
pp. 436-439 ◽  
Author(s):  
D. B. Nelson ◽  
E. S. Hurwitz ◽  
J. Z. Sullivan-Bolyai ◽  
D. M. Morens ◽  
L. B. Schonberger
Keyword(s):  
United States ◽  
The United States ◽  
Influenza B Virus ◽  
Influenza B ◽  
Reye's Syndrome ◽  
B Virus

scholarly journals Development of an Alternative Modified Live Influenza B Virus Vaccine

2017 ◽  
Vol 91 (12) ◽  
Author(s):  
Jefferson J. S. Santos ◽  
Courtney Finch ◽  
Troy Sutton ◽  
Adebimpe Obadan ◽  
Isabel Aguirre ◽  
...  
Keyword(s):  
Influenza A ◽  
The United States ◽  
Influenza B Virus ◽  
Influenza B ◽  
Temperature Sensitive ◽  
Complete Protection ◽  
C Terminus ◽  
B Virus

ABSTRACT Influenza B virus (IBV) is considered a major human pathogen, responsible for seasonal epidemics of acute respiratory illness. Two antigenically distinct IBV hemagglutinin (HA) lineages cocirculate worldwide with little cross-reactivity. Live attenuated influenza virus (LAIV) vaccines have been shown to provide better cross-protective immune responses than inactivated vaccines by eliciting local mucosal immunity and systemic B cell- and T cell-mediated memory responses. We have shown previously that incorporation of temperature-sensitive (ts) mutations into the PB1 and PB2 subunits along with a modified HA epitope tag in the C terminus of PB1 resulted in influenza A viruses (IAV) that are safe and effective as modified live attenuated (att) virus vaccines (IAV att). We explored whether analogous mutations in the IBV polymerase subunits would result in a stable virus with an att phenotype. The PB1 subunit of the influenza B/Brisbane/60/2008 strain was used to incorporate ts mutations and a C-terminal HA tag. Such modifications resulted in a B/Bris att strain with ts characteristics in vitro and an att phenotype in vivo. Vaccination studies in mice showed that a single dose of the B/Bris att candidate stimulated sterilizing immunity against lethal homologous challenge and complete protection against heterologous challenge. These studies show the potential of an alternative LAIV platform for the development of IBV vaccines. IMPORTANCE A number of issues with regard to the effectiveness of the LAIV vaccine licensed in the United States (FluMist) have arisen over the past three seasons (2013–2014, 2014–2015, and 2015–2016). While the reasons for the limited robustness of the vaccine-elicited immune response remain controversial, this problem highlights the critical importance of continued investment in LAIV development and creates an opportunity to improve current strategies so as to develop more efficacious vaccines. Our laboratory has developed an alternative strategy, the incorporation of 2 amino acid mutations and a modified HA tag at the C terminus of PB1, which is sufficient to attenuate the IBV. As a LAIV, this novel vaccine provides complete protection against IBV strains. The availability of attenuated IAV and IBV backbones based on contemporary strains offers alternative platforms for the development of LAIVs that may overcome current limitations.

PECULIARITIES OF THE INFLUENZA EPIDEMICS DURING 2015–2016, 2016–2017 AND 2017–2018 SEASONS IN THE REPUBLIC OF SAKHA (YAKUTIA)

2019 ◽  
pp. 28-33
Author(s):  
M.E. Ignat’eva ◽  
I.Yu. Samoilova ◽  
L.V. Budatsyrenova ◽  
T.V. Korita ◽  
O.E. Trotsenko
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Influenza Viruses ◽  
H3n2 Virus ◽  
Influenza B Virus ◽  
Influenza B ◽  
Epidemic Season ◽  
B Virus ◽  
Respiratory Viral Infections ◽  
The Republic

We analyzed the epidemiological situations on influenza and acute respiratory viral infections during the 2015–2016, 2016–2017 and 2017–2018 epidemic seasons in the Republic of Sakha (Yakutia). The 2015–2016 and 2016–2017 epidemic seasons differed from the previous ones by a rather high intensity of the epidemic process, moderate duration of the epidemic awareness with a two-wave pattern of the course, high morbidity of the population at the epidemic peak and the absence of the disease’s severe forms in those vaccinated against influenza. During the 2015–2016 epidemic season, the influenza A (H1N1) virus was the dominant pathogen in Yakutia. During the 2016–2017 epidemic season, the first morbidity awareness was caused by the influenza A (H3N2) virus, the second morbidity awareness was caused by the influenza B virus. In contrast to previous two seasons the 2017–2018 epidemic season is characterized by lower intensity, a significant morbidity decrease of influenza and acute respiratory viral infections in different age groups of the population and a low level of influenza viruses' circulation. Influenza A (H3N2) virus dominated and joined influenza B virus circulation was registered subsequently during the 2017–2018 epidemic season.

scholarly journals Prevention of Influenza Hospitalization Among Adults in the United States, 2015–2016: Results From the US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN)

2018 ◽  
Vol 220 (8) ◽  
pp. 1265-1275 ◽  
Author(s):  
Jill M Ferdinands ◽  
Manjusha Gaglani ◽  
Emily T Martin ◽  
Don Middleton ◽  
Arnold S Monto ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza A ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Severe Illness ◽  
Influenza B Virus ◽  
Influenza B ◽  
Negative Case ◽  
Influenza A H1n1 ◽  
The Us

Abstract Background Evidence establishing effectiveness of influenza vaccination for prevention of severe illness is limited. The US Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) is a multiyear test-negative case-control study initiated in 2015–2016 to estimate effectiveness of vaccine in preventing influenza hospitalization among adults. Methods Adults aged ≥18 years admitted to 8 US hospitals with acute respiratory illness and testing positive for influenza by polymerase chain reaction were cases; those testing negative were controls. Vaccine effectiveness was estimated with logistic regression adjusting for age, comorbidities, and other confounding factors and stratified by frailty, 2-year vaccination history, and clinical presentation. Results We analyzed data from 236 cases and 1231 controls; mean age was 58 years. More than 90% of patients had ≥1 comorbidity elevating risk of influenza complications. Fifty percent of cases and 70% of controls were vaccinated. Vaccination was 51% (95% confidence interval [CI], 29%–65%) and 53% (95% CI, 11%–76%) effective in preventing hospitalization due to influenza A(H1N1)pdm09 and influenza B virus infection, respectively. Vaccine was protective for all age groups. Conclusions During the 2015–2016 US influenza A(H1N1)pdm09–predominant season, we found that vaccination halved the risk of influenza-association hospitalization among adults, most of whom were at increased risk of serious influenza complications due to comorbidity or age.

Severe Influenza Virus Infection in Children Admitted to the PICU: Comparison of Influenza A and Influenza B Virus Infection

2021 ◽  
Author(s):  
Pınar YAZICI ÖZKAYA ◽  
Eşe Eda TURANLI ◽  
Hamdi METİN ◽  
Ayça Aydın UYSAL ◽  
Candan ÇİÇEK ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Influenza A ◽  
Influenza Virus Infection ◽  
Influenza B Virus ◽  
Influenza B ◽  
Severe Influenza ◽  
B Virus

scholarly journals Clinical Investigations. Comparison of Directigen Flu A+B with Real Time PCR in the Diagnosis of Influenza / Сравнение Иммунохроматографического Метода (Directigen Flu A+B) И Теста RT-PCR При Инфекциях Гриппа

Folia Medica ◽  
2015 ◽  
Vol 57 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Golubinka Bosevska ◽  
Nikola Panovski ◽  
Elizabeta Janceska ◽  
Vladimir Mikik ◽  
Irena Kondova Topuzovska ◽  
...  
Keyword(s):  
Real Time ◽  
Influenza A Virus ◽  
Real Time Pcr ◽  
Influenza A ◽  
Age Groups ◽  
Influenza Viruses ◽  
Influenza B Virus ◽  
Influenza B ◽  
B Virus ◽  
Nose And Throat

AbstractEarly diagnosis and treatment of patients with influenza is the reason why physicians need rapid high-sensitivity influenza diagnostic tests that require no complex lab equipment and can be performed and interpreted within 15 min. The Aim of this study was to compare the rapid Directigen Flu A+B test with real time PCR for detection of influenza viruses in the Republic of Macedonia. MATERIALS AND METHODS: One-hundred-eight respiratory samples (combined nose and throat swabs) were routinely collected for detection of influenza virus during influenza seasons. Forty-one patients were pediatric cases and 59 were adult. Their mean age was 23 years. The patients were allocated into 6 age groups: 0 - 4 yrs, 5 - 9 yrs, 10 - 14 yrs, 15 - 19 yrs, 20-64 yrs and > 65 yrs. Each sample was tested with Directigen Flu A+B and CDC real time PCR kit for detection and typisation/subtypisation of influenza according to the lab diagnostic protocol. RESULTS: Directigen Flu A+B identified influenza A virus in 20 (18.5%) samples and influenza B virus in two 2 (1.9%) samples. The high specificity (100%) and PPV of Directigen Flu A+B we found in our study shows that the positive results do not need to be confirmed. The overall sensitivity of Directigen Flu A+B is 35.1% for influenza A virus and 33.0% for influenza B virus. The sensitivity for influenza A is higher among children hospitalized (45.0%) and outpatients (40.0%) versus adults. CONCLUSION: Directigen Flu A+B has relatively low sensitivity for detection of influenza viruses in combined nose and throat swabs. Negative results must be confirmed.

scholarly journals Haemagglutination-inhibition antibodies against influenza A and influenza B in maternal and neonatal sera

1978 ◽  
Vol 80 (1) ◽  
pp. 13-19 ◽  
Author(s):  
N. Masurel ◽  
J. I. de Bruijne ◽  
H. A. Beuningh ◽  
H. J. A. Schouten
Keyword(s):  
Influenza Virus ◽  
Maternal Age ◽  
Influenza A ◽  
Haemagglutination Inhibition ◽  
Influenza Viruses ◽  
Influenza B Virus ◽  
Influenza B ◽  
B Virus ◽  
Duration Of Pregnancy ◽  
Pregnancy And Birth

SUMMARYHaemagglutination inhibition (HI) antibodies against the influenza viruses A/Hong Kong/8/68 (H3N2) and B/Nederland/77/66 were determined in 420 paired sera from mothers and newborns (umbilical cord sera), sampled in 1970–1.A higher concentration of antibodies against influenza A virus was found more frequently in neonatal than in maternal sera. By contrast, low titres against influenza B virus were more frequently observed in neonatal than in maternal sera. Maternal age, duration of pregnancy, and birth-weight did not affect the results of the tests.It is suggested that the titre of the newborn against an epidemic influenza virus can be predicted from that of the mother. Furthermore, the maternal titre may be an indication of the susceptibility of the newborn infant to influenza infections.

scholarly journals Influenza A and B viruses in the population of Vojvodina, Serbia

2014 ◽  
Vol 66 (1) ◽  
pp. 43-50 ◽  
Author(s):  
J. Radovanov ◽  
V. Milosevic ◽  
I. Hrnjakovic ◽  
V. Petrovic ◽  
M. Ristic ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Influenza Viruses ◽  
Influenza B Virus ◽  
Nasopharyngeal Swab ◽  
Influenza B ◽  
Influenza A Viruses ◽  
B Virus ◽  
Life Threatening ◽  
Seasonal Epidemic

At present, two influenza A viruses, H1N1pdm09 and H3N2, along with influenza B virus co-circulate in the human population, causing endemic and seasonal epidemic acute febrile respiratory infections, sometimes with life-threatening complications. Detection of influenza viruses in nasopharyngeal swab samples was done by real-time RT-PCR. There were 60.2% (53/88) positive samples in 2010/11, 63.4% (52/82) in 2011/12, and 49.9% (184/369) in 2012/13. Among the positive patients, influenza A viruses were predominant during the first two seasons, while influenza B type was more active during 2012/13. Subtyping of influenza A positive samples revealed the presence of A (H1N1)pdm09 in 2010/11, A (H3N2) in 2011/12, while in 2012/13, both subtypes were detected. The highest seroprevalence against influenza A was in the age-group 30-64, and against influenza B in adults aged 30-64 and >65.

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