Barriers Associated with Seasonal Influenza Vaccination among College Students

Influenza can spread rapidly on college campuses because of high-density living conditions and frequent social interactions. However, seasonal influenza vaccination rates on college campuses are low. The purpose of this study is to identify barriers associated with receipt of the seasonal influenza vaccination. Questionnaires were completed by a convenience sample of 383 undergraduate students in January 2014. Data were analyzed to identify barriers associated with receiving the seasonal influenza vaccine. Only 20.6% of students reported receiving the vaccine within the last 6 months. Among students who did not receive the vaccine, 47.8% believed they would get influenza from the vaccine, 41.6% believed the vaccination may have dangerous side effects, and 39.6% believed they were not at risk for contracting influenza. The majority of nonvaccinated students did not believe cost of the vaccine or access to the vaccine were barriers. Many college students are not receiving the seasonal influenza vaccine, representing an important area for improvement. Understanding potential barriers associated with receipt of this vaccine is important for identifying and creating effective public health education programs and campaigns. There is a need for enhanced vaccination education efforts among college students, particularly with respect to the safety and importance of this vaccine.

Serological Survey for Avian Influenza in Turkeys in Three States of Southwest Nigeria

Since the first outbreak of avian influenza (AI) in Nigeria in 2006, there has been continuous monitoring of the disease in chickens with little attention given to turkeys. As part of on-going surveillance for AI in southwest Nigeria, we used a competitive ELISA to detect anti-AI virus antibodies in 520 turkey sera obtained from poultry farms in Oyo, Osun, and Ondo states while haemagglutination inhibiting antibodies against low pathogenic AI viruses (LPAIVs) were detected using H3N8 and H5N2 subtype-specific antigens. The overall seroprevalence obtained by ELISA was 4.4% (23/520). Of the 23 ELISA-positive samples, 18 were positive for anti-AIV H3N8 antibodies only and four were positive for both anti-AIV H3N8 and H5N2 antibodies indicating a mixed infection, while five were negative for antibodies to either of the two AIV subtypes. Considering that turkeys have been implicated as a mixing vessel for generating influenza virus reassortants of human and avian origin, the detection of antibodies to LPAIV H3N8 and H5N2 in these turkeys is of public health concern. We advocate further studies to determine the potential role of turkeys in the zoonotic transmission of AIVs in Nigeria. Additionally, the practice of rearing turkeys with chickens should be discouraged.

Passive Broad-Spectrum Influenza Immunoprophylaxis

Influenza is a perennial problem affecting millions of people annually with the everpresent threat of devastating pandemics. Active prophylaxis by vaccination against influenza virus is currently the main countermeasure supplemented with antivirals. However, disadvantages of this strategy include the impact of antigenic drift, necessitating constant updating of vaccine strain composition, and emerging antiviral drug resistance. The development of other options for influenza prophylaxis, particularly with broad acting agents able to provide protection in the period between the onset of a pandemic and the development of a strain specific vaccine, is of great interest. Exploitation of broad-spectrum mediators could provide barricade protection in the early critical phase of influenza virus outbreaks. Passive immunity has the potential to provide immediate antiviral effects, inhibiting virus replication, reducing virus shedding, and thereby protecting vulnerable populations in the event of an impending influenza pandemic. Here, we review passive broad-spectrum influenza prophylaxis options with a focus on harnessing natural host defenses, including interferons and antibodies.

Avian Influenza Surveillance in the Danube Delta Using Sentinel Geese and Ducks

Highly pathogenic avian influenza (HPAI) H5N1 virus incursions from migrating birds have occurred multiple times in Romania since 2005. Beginning in September 2008 through April 2013, seasonal sentinel surveillance for avian influenza A viruses (AIVs) using domestic geese (Anser cygnoides) and ducks (Anas platyrhynchos) in the Danube Delta was established by placing 15 geese and 5 ducks at seven sites. Tracheal and cloacal swabs, and sera collections (starting in 2009) were taken monthly. We studied a total of 580 domestic birds and collected 5,520 cloacal and tracheal swabs from each and 2,760 sera samples. All swabs were studied with real-time reverse transcription polymerase chain reaction (rRT-PCR) for evidence of AIV. Serological samples were studied with hemagglutination inhibition assays against avian H5, H7, and H9 influenza viruses. From 2009 to 2013, 47 swab specimens from Cot Candura, Enisala, and Saon screened positive for AIV; further subtyping demonstrated that 14 ducks and 20 geese had cloacal evidence of H5N3 carriage. Correspondingly, 4 to 12 weeks after these molecular detections, sentinel bird sera revealed elevated HI titers against H5 virus antigens. We posit that domestic bird surveillance is an effective method to conduct AIV surveillance among migrating birds in delta areas.

Effect of the PB2 and M Genes on the Replication of H6 Influenza Virus in Chickens

H6 subtype influenza viruses are commonly isolated from wild aquatic birds. However, limited information is available regarding H6 influenza virus isolated from chickens. We compared the viral genome segment between A/chicken/Hong Kong/W312/97 (H6N1), which was able to grow in chicken trachea, and A/duck/Shantou/5540/01 (H6N2), which was isolated from wild aquatic duck, to explore the factors for effective replication in chicken. When chickens were inoculated with 7+1 reassortants (W312 background), the replication of viruses with PB2 and M genes derived from the duck strain was significantly reduced. Chimeras of PB2 and M proteins, encoding the C-terminal region of the PB2 protein and the M2 protein from W312, were required for efficient replication in canine-derived (MDCK) cells and in chicken trachea. These results indicate that host range may be determined by some types of internal proteins such as PB2 and M2, as well as by surface glycoprotein like hemagglutinin.

Detection and Isolation of Airborne Influenza A H3N2 Virus Using a Sioutas Personal Cascade Impactor Sampler

The air we breathe contains microorganisms that can cause infectious respiratory diseases. After two occupants of an apartment were diagnosed with influenza in February of 2013, efforts were made to detect and isolate airborne influenza virus using two different types of active air samplers: a Sioutas Personal Cascade Impactor Sampler (PCIS) and an SKC BioSampler. The PCIS collects size-fractionated particles by impaction on polytetrafluoroethylene filters, whereas the SKC BioSampler collects airborne particles in liquid media. Influenza H3N2 virus was collected by both types of air samplers. The PCIS collected a range of particle sizes containing influenza virus near one of the sick individuals but only ultrafine particles when the samplers were positioned farther away. Viable virus was present in the liquid collection media of the SKC BioSampler and some PCIS filters. These findings suggest that influenza patients produce ultrafine aerosol particles that contain viable virus.

3D Molecular Modelling Study of the H7N9 RNA-Dependent RNA Polymerase as an Emerging Pharmacological Target

Currently not much is known about the H7N9 strain, and this is the major drawback for a scientific strategy to tackle this virus. Herein, the 3D complex structure of the H7N9 RNA-dependent RNA polymerase has been established using a repertoire of molecular modelling techniques including homology modelling, molecular docking, and molecular dynamics simulations. Strikingly, it was found that the oligonucleotide cleft and tunnel in the H7N9 RNA-dependent RNA polymerase are structurally very similar to the corresponding region on the hepatitis C virus RNA-dependent RNA polymerase crystal structure. A direct comparison and a 3D postdynamics analysis of the 3D complex of the H7N9 RNA-dependent RNA polymerase provide invaluable clues and insight regarding the role and mode of action of a series of interacting residues on the latter enzyme. Our study provides a novel and efficiently intergraded platform with structural insights for the H7N9 RNA-dependent RNA Polymerase. We propose that future use and exploitation of these insights may prove invaluable in the fight against this lethal, ongoing epidemic.

Comparative Serological Assays for the Study of H5 and H7 Avian Influenza Viruses

The nature of influenza virus to randomly mutate and evolve into new types is an important challenge in the control of influenza infection. It is necessary to monitor virus evolution for a better understanding of the pandemic risk posed by certain variants as evidenced by the highly pathogenic avian influenza (HPAI) viruses. This has been clearly recognized in Egypt following the notification of the first HPAI H5N1 outbreak. The continuous circulation of the virus and the mass vaccination programme undertaken in poultry have resulted in a progressive genetic evolution and a significant antigenic drift near the major antigenic sites. In order to establish if vaccination is sufficient to provide significant intra- and interclade cross-protection, lentiviral pseudotypes derived from H5N1 HPAI viruses (A/Vietnam/1194/04, A/chicken/Egypt-1709-01/2007) and an antigenic drift variant (A/chicken/Egypt-1709-06-2008) were constructed and used in pseudotype-based neutralization assays (pp-NT). pp-NT data obtained was confirmed and correlated with HI and MN assays. A panel of pseudotypes belonging to influenza Groups 1 and 2, with a combination of reporter systems, was also employed for testing avian sera in order to support further application of pp-NT as an alternative valid assay that can improve avian vaccination efficacy testing, vaccine virus selection, and the reliability of reference sera.

A Time Off Incentive Was Not Associated with Influenza Vaccination Acceptance among Healthcare Workers

Objectives. The national influenza vaccination rate among healthcare workers (HCWs) remains low despite clear benefits to patients, coworkers, and families. We sought to evaluate formally the effect of a one-hour time off incentive on attitudes towards influenza vaccination during the 2011-2012 influenza season. Methods. All HCWs at the Philadelphia Veterans Affairs (VA) Medical Center were invited to complete an anonymous web-based survey. We described respondents’ characteristics and attitudes toward influenza vaccination and determined the relationship of specific attitudes with respondents’ acceptance of influenza vaccination, using a 5-point Likert scale. Results. We analyzed survey responses from 154 HCWs employed at the Philadelphia VA Medical Center, with a response rate of 8%. Among 121 respondents who reported receiving influenza vaccination, 34 (28%, 95% CI 20–37%) reported agreement with the statement that the time off incentive made a difference in their decision to accept influenza vaccination. Conclusions. Our study provides evidence that modest incentives such as one-hour paid time off will be unlikely to promote influenza vaccination rates within medical facilities. More potent interventions that include mandatory vaccination combined with penalties for noncompliance will likely provide the only means to achieve near-universal influenza vaccination among HCWs.

Mortality Associated with Influenza in Tropics, State of São Paulo, Brazil, from 2002 to 2011: The Pre-Pandemic, Pandemic, and Post-Pandemic Periods

The impact of the seasonal influenza and 2009 AH1N1 pandemic influenza on mortality is not yet completely understood, particularly in tropical and subtropical countries. The trends of influenza related mortality rate in different age groups and different outcomes on a area in tropical and subtropical climate with more than 41 million people (State of São Paulo, Brazil), were studied from 2002 to 2011 were studied. Serfling-type regression analysis was performed using weekly mortality registries and virological data obtained from sentinel surveillance. The prepandemic years presented a well-defined seasonality during winter and a clear relationship between activity of AH3N2 and increase of mortality in all ages, especially in individuals older than 60 years. The mortality due to pneumonia and influenza and respiratory causes associated with 2009 pandemic influenza in the age groups 0–4 years and older than 60 was lower than the previous years. Among people aged 5–19 and 20–59 years the mortality was 2.6 and 4.4 times higher than that in previous periods, respectively. The mortality in all ages was higher than the average of the previous years but was equal mortality in epidemics of AH3N2. The 2009 pandemic influenza mortality showed significant differences compared to other years, especially considering the age groups most affected.