Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza

Background and Objectives: Considering developing resistance against neuraminidase inhibitors (NAIs) and their adverse reactions, restricted use of NAIs and use of alternative drugs should be considered for treating influenza. Although glucocorticoids (GCs) have been used for severe influenza, their effects on non-severe influenza have rarely been evaluated. This study aimed to evaluate the clinical responses to NAI therapy and GC therapy in pediatric patients with non-severe influenza. Materials and Methods: A total of 601 pediatric patients (<19 years of age) diagnosed with non-severe influenza were retrospectively recruited to evaluate the effects of NAI therapy and GC therapy. Post-admission fever duration and hospitalization duration were compared among four patient groups divided by the administered treatment: No therapy (n = 52), NAI therapy (n = 154), GC therapy (n = 123), and Both therapies (n = 272). Results: In a multivariate analysis with adjustment for confounding variables, the post-admission fever duration was not significantly different among the four patient groups. The post-admission fever duration tended to shorten with increasing age, longer pre-admission fever duration, and incidence of influenza A virus infection and lower respiratory tract infection. The type of administered treatment showed no significant effects on the post-admission fever duration in any subgroups according to patient age, pre-admission fever duration, influenza virus subtype, and clinical diagnosis. Conclusions: Symptomatic treatment rather than antiviral or GC therapy seems to be sufficient for patients with non-severe influenza, although the effects of NAI therapy and GC therapy according to their administered time and dose should be further evaluated.

Genetic Analyses of Common Infections in the Avon Longitudinal Study of Parents and Children Cohort

The burden of infections on an individual and public health is profound. Many observational studies have shown a link between infections and the pathogenesis of disease; however a greater understanding of the role of host genetics is essential. Children from the longitudinal birth cohort, the Avon Longitudinal Study of Parents and Children, had 14 antibodies measured in plasma at age 7: Alpha-casein protein, beta-casein protein, cytomegalovirus, Epstein-Barr virus, feline herpes virus, Helicobacter pylori, herpes simplex virus 1, influenza virus subtype H1N1, influenza virus subtype H3N2, measles virus, Saccharomyces cerevisiae, Theiler’s virus, Toxoplasma gondii, and SAG1 protein domain, a surface antigen of Toxoplasma gondii measured for greater precision. We performed genome-wide association analyses of antibody levels against these 14 infections (N = 357 – 5010) and identified three genome-wide signals (P &lt; 5×10-8), two associated with measles virus antibodies and one with Toxoplasma gondii antibodies. In an association analysis focused on the human leukocyte antigen (HLA) region of the genome, we further detected 15 HLA alleles at a two-digit resolution and 23 HLA alleles at a four-digit resolution associated with five antibodies, with eight HLA alleles associated with Epstein-Barr virus antibodies showing strong evidence of replication in UK Biobank. We discuss how our findings from antibody levels complement other studies using self-reported phenotypes in understanding the architecture of host genetics related to infections.

Seroprevalence of Avian Influenza virus subtype H5N1 in chickens of the two main poultry market in Surakarta area, Central Java

Avian influenza (AI) subtype H5N1 virus is very contagious among domestic poultry such as chicken (Gallus gallus) and potentially infecting humans through direct or indirect contact with the infected animal. In the Surakarta area, Central Java, there are two major poultry markets, Silir poultry market and Jumantono farm. Here, we determined the seroprevalence of the AI virus in chickens sold in both poultry markets. The method was conducted using an explorative experiment by collecting 140 samples of chicken blood serum. The presence of antibodies to the AI virus subtype H5N1 was measured through a standard serological test via hemagglutination-inhibition (HI) assay. The HI assay detected a large antibody difference against AI from samples of both locations; 4.28% from Silir poultry market and 48.57% from Jumantono farm. Because the chickens from the Silir poultry market were not vaccinated, the level of antibody detected indicatesd that some chickens were exposed to the virus through infection. Meanwhile, the high positivity rate in Jumantono farm might reflect the presence of neutralizing antibody, since the chickens from this farm received periodic vaccinations. Continuous quality surveillance in the environment of the poultry market is essential to reduce the impact of AI outbreaks against chickens and humans.

Genetic analyses of common infections in the Avon Longitudinal Study of Parents and Children cohort

The burden of infections on an individual and public health is profound. Many observational studies have shown a link between infections and the pathogenesis of disease; however a greater understanding of the role of host genetics is essential. Children from the longitudinal birth cohort, the Avon Longitudinal Study of Parents and Children, had 14 antibodies measured in plasma at age 7: Alpha-casein protein, beta-casein protein, cytomegalovirus, Epstein-Barr virus, feline herpes virus, Helicobacter pylori, herpes simplex virus 1, influenza virus subtype H1N1, influenza virus subtype H3N2, measles virus, Saccharomyces cerevisiae, Theiler's virus, Toxoplasma gondii, and SAG1 protein domain, a surface antigen of Toxoplasma gondii measured for greater precision. We performed genome-wide association analyses of antibody levels against 14 infections (N = 357-5010) and identified three genome-wide signals (P < 5x10-8), two associated with measles virus antibodies and one with Toxoplasma gondii antibodies. In an association analysis focused on the human leukocyte antigen (HLA) region of the genome, we further detected 15 HLA alleles at a two-digit resolution and 23 HLA alleles at a four-digit resolution associated with five antibodies, with eight HLA alleles associated with Epstein-Barr virus antibodies showing strong evidence of replication in UK Biobank. Our findings provide a useful resource for any future studies using the ALSPAC infection data and contributes to the understanding of the architecture of host genetics related to infections.

Genetic Diversity and Epidemiological Significance of Wild Boar HEV-3 Strains Circulating in Poland

The wild boar is the most important reservoir of zoonotic HEV-3 strains among different wildlife species. The aim of the study was subtype identification of wild boar HEV-3 strains circulating in Poland. Wild boar liver was used in the study in the form of homogenates prepared from 57 samples positive for HEV in a real-time RT-PCR. These samples were collected from juvenile and adult wild boars hunted in the jurisdictions of different Regional Directorates of State Forests (RDSF) across Poland. Subtype identification of detected HEV strains was based on a phylogenetic analysis of the most conserved HEV ORF2 genome fragment. Out of 57 tested samples, consensus HEV ORF2 sequences of 348 bp were obtained for 45 strains. Nineteen strains were identified and belonged to the HEV gt 3a and 3i subtypes, whereas 26 were not assigned to any virus subtype. HEV gt 3i strains prevailed in the Polish wild boar population, 16 of such were identified, and they were significantly more often observed in the RDSF Katowice area (χ2 = 28.6, p = 0.027 (<0.05)) compared to other regions of the country. Circulation of 3a strains was limited only to the RDSF Gdańsk territory (χ2 = 48, p = 0.000 (<0.05)). The virus strains detected in the Polish population of wild boars representing previously identified HEV subtypes in wild boars, pigs, or humans in Europe are of epidemiological importance for public health.

ANTI-INFLUENZA ACTIVITY OF PLANT EXTRACTS OF THE LAMIACEAE FAMILY

In this work, it was revealed that water and ethanol extracts of the plants Nepeta cataria, Nepeta sibirica, Scutellaria baicalensis, Hyssopus officinalis, Betonica officinalis, and water extracts of Dracocephalum moldavica, Glechoma hederacea, Mentha arvensis, Prunella vulgaris, Melissa officinalis ethanol extracts of Mentha piperita, Mentha crispa, Origanum vulgare, Hyssopus officinalis, Salvia verticillata showed antiviral activity against the influenza virus subtype H5N1. Aqueous extracts of Nepeta cataria and Glechoma hederacea (NI 3.75) showed the highest antiviral effect against the H5N1 subtype. It was revealed the antiviral activity against influenza virus subtype H3N2 of aqueous and ethanol extracts of Scutellaria baicalensis, Mentha piperita, Mentha arvensis, Mentha crispa, aqueous extract of Dracocephalum moldavica and ethanol extracts of Glechoma hederacea, Origanum vulgare, Prunella vulgaris, Hyssopus officinalis, Betonica officinalis, Salvia verticillata. Ethanolic extract of Betonica officinalis (NI 4.25) showed the highest virus neutralizing activity against the H3N2 subtype. It was carried out chemical analysis of the aerial parts of plants of the Lamiaceae family. It was shown that the highest content of flavonols was observed in Dracocephalum nutans (4.47±0.04%), the highest content of tannins was found in Mentha arvensis (17.62 ± 0.78%), and the highest content catechins were found in Nepeta cataria (0.43 ± 0.007%). Thus, plant extracts of the Lamiaceae family are promising sources for further studies to develop new antiviral drugs.

A quantitative risk assessment to evaluate the efficacy of mitigation strategies to reduce highly pathogenic avian influenza virus, subtype H5N1 (HPAI H5N1) in the Menoufia governorate, Egypt

Background The poultry industry in Egypt has been suffering from endemic highly pathogenic avian influenza (HPAI) virus, subtype H5N1 since 2006. However, the emergence of H9N2, H5N8, and H5N2 in 2011, 2016, and 2019 respectively, has aggravated the situation. Our objective was to evaluate how effective are the mitigation strategies by a Quantitative Risk Assessment (QRA) model which used daily outbreak data of HPAI-H5N1 subtype in Egypt, stratified by different successive epidemic waves from 2006 to 2016. Results By applying the epidemiologic problem-oriented approach methodology, a conceptual scenario tree was drawn based on the knowledgebase. Monte Carlo simulations of QRA parameters based on outbreak data were performed using @Risk software based on a scenario-driven decision tree. In poultry farms, the expected probability of HPAI H5N1 prevalence is 48% due to failure of mitigation strategies in 90% of the time during Monte Carlo simulations. Failure of efficacy of these mitigations will raise prevalence to 70% with missed vaccination, while failure in detection by surveillance activities will raise it to 99%. In backyard poultry farms, the likelihood of still having a high HPAI-H5N1 prevalence in different poultry types due to failure of passive and active surveillance varies between domestic, mixed and reservoir. In mixed poultry, the probability of HPAI-H5N1 not detected by surveillance was the highest with a mean and a SD of 16.8 × 10–3 and 3.26 × 10–01 respectively. The sensitivity analysis ranking for the likelihood of HPAI-H5N1 in poultry farms due to missed vaccination, failure to be detected by passive and active surveillance was examined. Among poultry farms, increasing vaccination by 1 SD will decrease the prevalence by 14%, while active and passive surveillance decreases prevalence by 12, and 6%, respectively. In backyard, the active surveillance had high impact in decreasing the prevalence by 16% in domestic chicken. Whereas the passive surveillance had less impact in decreasing prevalence by 14% in mixed poultry and 3% in domestic chicken. Conclusion It could be concluded that the applied strategies were not effective in controlling the spread of the HPAI-H5N1 virus. Public health officials should take into consideration the evaluation of their control strategies in their response.

Biological characteristics of influenza virus subtype H6N8 isolated from wild birds in the south of Western Siberia

Aim. The aim is to explore the molecular and biological characteristics of influenza virus subtype H6N8.Material and Methods. Regular collecting of biological samples from wild birds was carried out in 2016 in the south of Western Siberia. Isolation of avian influenza virus strains from birds’ cloacal swabs was performed using three passages in embryonated chicken eggs. Hemagglutination assay was used to detect viruses in the allantoic fluid. Type and subtype of influenza viruses were identified using reverse transcription PCR (RT‐PCR). Results. This is the first time the avian influenza virus H6N8 subtype has been isolated in Russia. Phylogenetic analysis revealed that hemagglutinin (HA) and neuraminidase (NA) segments of A/gadwall/Chany/97/2016(H6N8) strain genome belonged to the Eurasian lineages of avian influenza viruses. Phylogenetic analysis showed that the HA sequence of the strain was closely related to the strain isolated from a duck in Bangladesh in 2015 (A/duck/Bangladesh/25767/2015(H6N1).Conclusion. Avian influenza viruses subtype H6N8 have the ability to circulate among wild waterfowl and poultry, increasing the chance of reassortment and transmission of H6 virus strains among birds. For this reason, it is of crucial importance to strengthen surveillance for avian influenza H6 subtype among wild birds in the south of Western Siberia.