Trends, patterns, and incidence rate of seasonal influenza among Dubai population and some associated factors, 2017-2-19

Background: WHO estimates that seasonal influenza may result in 290 000-650 000 deaths each year due to respiratory diseases alone. In addition, affected more than 10% of total population annually worldwide, Seasonal influenza is highly contagious disease; spreads easily, with rapid transmission in crowded areas including schools and nursing homes. Objectives: To Study incidence rate, trends and patterns of seasonal influenza among Dubai population for the period 2017-2019, to Study some of the associated factors. Materials & Subjects: A retrospective records review study was carried out of convenience sample of 29158 confirmed seasonal influenza case reported in Emirate of Dubai for the period 2017-2019. All age groups, genders, nationalities, occupations, education and seasons were considered. Findings: The study showed that 53.42% of total seasonal influenza cases were among male groups in Dubai, almost 50% % of the cases were among age group less than 15 years old, and almost one quarter of cases were among the age group between 30-40 years old, the present study showed that 54.37% were among Asian groups, 14.59% of the seasonal influenza incidence in Dubai during 2017-2019 were among Emirati population and 18.79% were among Arabs groups .As per occupation, the study showed that 30.74% of total seasonal influenza cases were among students in Dubai, on the other hand the study revealed that 84.53% of the total seasonal influenza cases during 2017-2019 were handled at outpatient level, yet 15.47% were sever enough cases to be admitted and treated at inpatient facilities. Incidence rate per 100000 population were increased respectively from 2017 through out 2019 (168, 297,466). The study revealed as well that the rate as per nationality the seasonal influenza incidence rate in Dubai from 2017=2019 650/100000 among Jordanian living in Dubai,, almost 50% % of the cases were among age group less than 15 years old, and almost one quarter of cases were among the age group between 30-40 years old, the present study showed that 54.37% were among Asian groups, 14.59% of the seasonal influenza incidence in Dubai during 2017-2019 were among Emirati population and 19.71% were among Arabs groups . The study showed that 30.74% of total seasonal influenza were students in Dubai, 84.53% of the total seasonal influenza cases during 2017-2019 were managed at outpatient. yet 15.47% were sever enough cases to be admitted and treated at inpatient level of different health care facilities in Dubai. Incidence among Egyptian was 557/100000, while among Emirates, 325 /100000, Incidence rate of seasonal influenza 2017-2019 according to age distributions showed that 30.7%among students, and 7.8%among children preschool age, and 5.22%among housewives. The present study showed that the incidence rate of seasonal influenza in Dubai in 2017-2019 as per moth distributions was the highest, 21.4%in November followed by 18.2%in December, and the least was 2%in July. Conclusions: incidence rate of seasonal influenza in Dubai keep increasing during the last three years, the highest rates significantly come from children segment of population specially students and elderly group as well, the period from October to end of February of each years.

A Call for a Reform of the Influenza Immunization Program in Mexico: Epidemiologic and Economic Evidence for Decision Making

Limited information is available to determine the effectiveness of Mexico’s national influenza vaccination guidelines and inform policy updates. We aim to propose reforms to current influenza vaccination policies based on our analysis of cost-effectiveness studies. This cross-sectional epidemiological study used influenza case, death, discharge and hospitalization data from several influenza seasons and applied a one-year decision-analytic model to assess cost-effectiveness. The primary health outcome was influenza cases avoided; secondary health outcomes were influenza-related events associated with case reduction. By increasing vaccination coverage to 75% in the population aged 12–49 years with risk factors (diabetes, high blood pressure, morbid obesity, chronic renal failure, asthma, pregnancy), and expanding universal vaccination coverage to school-aged children (5–11 years) and adults aged 50–59 years, 7142–671,461 influenza cases; 1–15 deaths; 7615–262,812 healthcare visits; 2886–154,143 emergency room admissions and 2891–97,637 hospitalizations could be prevented (ranges correspond to separate age and risk factor groups), with a net annual savings of 3.90 to 111.99 million USD. Such changes to the current vaccination policy could potentially result in significant economic and health benefits. These data could be used to inform the revision of a vaccination policy in Mexico with substantial social value.

Visualization of the Evolutionary Path: an Influenza Case Study

Visualization of viral evolution is one of the essential tasks in bioinformatics, through which virologists characterize a virus. The fundamental visualization tool for such a task is constructing a dendrogram, also called the phylogenetic tree. In this paper, we propose the visualization and characterization of the evolutionary path, starting from the root to isolated virus in the leaf of the phylogenetic tree. The suggested approach constructs the sequences of inner nodes (ancestors) within the phylogenetic tree and uses one-hot-encoding to represent the genetic sequence in a binary format. By employing embedding methods, such as multi-dimensional scaling, we project the path into 2D and 3D spaces. The final visualization demonstrates the dynamic of viral evolution locally (for an individual strain) and globally (for all isolated viruses). The results suggest applications of our approach in: detecting earlier changes in the characteristics of strains; exploring emerging novel strains; modeling antigenic evolution; and study of evolution dynamics. All of these potential applications are critical in the fight against viruses.

Discovery of an Association Between Influenza Infection Rates and the Incidences of Craniosynostosis in the United States: A Potentially Modifiable Risk Factor

Objective: Maternal immune activation secondary to influenza infection during critical periods of fetal development is a significant risk factor for neuropsychiatric and neurodevelopmental disorders. The association between influenza and craniosynostosis is not well documented. We investigate the association between the incidence of influenza infection and incidence of craniosynostosis in the United States. Materials and Methods: Retrospective population-based observational study spanning using the National Inpatient Sample Database, the United States Center for Disease Control and Prevention FluView databases, including infants born with craniosynostosis in the United States from 2004 to 2013 and monthly influenza incidence in the United States from 2003 to 2013. Mixed-effects logistic regression tested the association between 2 variables: national influenza incidences and rate of craniosynostosis. Odds ratios were calculated for the occurrence of craniosynostosis in relation to previous months’ flu incidence. E-values were calculated to evaluate unmeasured confounders. Results: Retrospective analysis performed on 45 356 newborns with craniosynostosis. Mixed-effects logistic regression revealed for each additional influenza case per 1000 people, the odds of craniosynostosis event occurring 6 months later increased by 3.4 (adjusted P = .009, OR = 3.444, CI = 1.756-6.754). For each additional influenza case per 1000 people, the odds of craniosynostosis event occurring 7 and 2 months later decreased by 3.8 and 6.1, respectively (OR = 0.262 and 0.165; adjusted P value = .007 and <.001). E-value for the association between influenza and craniosynostosis incidence 6 months later was 6.35. The E-values for the association between influenza and craniosynostosis incidences 7 months and 2 months later were 7.1 and 11.6. Conclusion: There is an increased risk for craniosynostosis with influenza occurring in third month of pregnancy. There are protective effects against craniosynostosis with influenza occurring in second and seventh months of pregnancy. To our knowledge, this is the first study demonstrating an association between the rate of influenza and craniosynostosis, suggesting a potentially important connection, though not necessarily causality, between maternal immune activation and craniosynostosis.

Invasive pulmonary aspergillosisas a complication of severe influenza (case report)

During last years the frequency of invasive pulmonary aspergillosis (IPA) in immunocompetent patients has increased. Clinical case report of successful treatment invasive aspergillosis with influenza A(H1N1) presented in the article. We analyzed the special literature of patients with IPA following influenza infection. The timely identification and treatment of these patients are necessary.

Seasonal influenza: Modelling approaches to capture immunity propagation

Seasonal influenza poses serious problems for global public health, being a significant contributor to morbidity and mortality. In England, there has been a long-standing national vaccination programme, with vaccination of at-risk groups and children offering partial protection against infection. Transmission models have been a fundamental component of analysis, informing the efficient use of limited resources. However, these models generally treat each season and each strain circulating within that season in isolation. Here, we amalgamate multiple data sources to calibrate a susceptible-latent-infected-recovered type transmission model for seasonal influenza, incorporating the four main strains and mechanisms linking prior season epidemiological out-comes to immunity at the beginning of the following season. Data pertaining to nine influenza seasons, starting with the 2009/10 season, informed our estimates for epidemiological processes, virological sample positivity, vaccine uptake and efficacy attributes, and general practitioner influenza-like-illness consultations as reported by the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC). We performed parameter inference via approximate Bayesian computation to assess strain transmissibility, dependence of present season influenza immunity on prior protection, and variability in the influenza case ascertainment across seasons. This produced reasonable agreement between model and data on the annual strain composition. Parameter fits indicated that the propagation of immunity from one season to the next is weaker if vaccine derived, compared to natural immunity from infection. Projecting the dynamics forward in time suggests that while historic immunity plays an important role in determining annual strain composition, the variability in vaccine efficacy hampers our ability to make long-term predictions.