Influenza Hemagglutinin Antibody Levels in the Elderly: Impact of Sex, Age, and Influenza/COVID-19 Vaccination Status During the 2021/2022 Epidemic Season in Warsaw, Poland.

BACKGROUND The purpose of the study was to determine the level of antihemagglutinin antibodies in the serum of patients in the geriatric population in Doctor's Surgery NZOZ Nucleus Warsaw, Poland, during the epidemic season 2021/2022 using the hemagglutination inhibition assay (HAI), according to anti-influenza and anti-COVID-19 vaccination, age, and sex. MATERIAL AND METHODS Serum samples taken from 256 patients aged 65 to 99 years were examined for anti-hemagglutinin antibodies and protective levels of antibodies against antigens: A/Victoria/2570/2019 (H1N1)pdm09, A/Cambodia/e0826360/2020(H3N2), B/Washington/02/2019 (B/Victoria lineage), and B/Phuket/3073/2013 (B/Yamagata lineage) of the quadrivalent influenza vaccine for epidemic season 2021/2022. RESULTS The highest protective level, ie, the percentage of people with antibody titers ≥40 was 87.5% and was recorded for subtype A/Cambodia/e0826360/2020(H3N2), the dominant type causing infections in the epidemic season 2021/2022 confirmed by molecular biology methods. Geometric mean titer (GMT) values and protective levels for B/Washington/02/2019 (B/Victoria lineage) antigen were higher for men than women (respectively 38.4 vs 67.6; P<0.001 and 58.0% vs 74.6%; P<0.001). The protective levels of antibodies among patients vaccinated vs unvaccinated against COVID-19 were higher for B/Washington/02/2019 (B/Victoria lineage) and B/Phuket/3073/2013 (B/Yamagata lineage) antigens (64.2% vs 44.4%; P=0.023 and 78.6% vs 55.6%; P=0.004). GMT values for vaccinated against COVID-19 were also higher. There were no significant differences between younger (65-79 years) and older (≥80 years) seniors. CONCLUSIONS The analysis shows differences in the level of individual antibodies, GMT and the protective level depending on subtypes of influenza A or B virus, B/Victoria or B/Yamagata lineage, sex, and previous vaccination history against influenza and COVID-19.

Molecular Determinants of Drug Resistance and Mutation Patterns in Influenza Viruses Circulating in Poland Across Multiple Epidemic Seasons: Implications for Vaccination Strategies.

BACKGROUND According to the WHO, up to 650 000 people die each year from seasonal flu-related respiratory illnesses. The most effective method of fighting the virus is seasonal vaccination. However, if an infection does occur, antiviral medications should be used as soon as possible. No studies of drug resistance in influenza viruses circulating in Poland have been systematically conducted. Therefore, the aim of the present study was to investigate the drug resistance and genetic diversity of influenza virus strains circulating in Poland by determining the presence of mutations in the neuraminidase gene. MATERIAL AND METHODS A total of 258 clinical specimens were collected during the 2016-2017, 2017-2018, and 2018-2019 epidemic seasons. The samples containing influenza A and B were analyzed by RT-PCR and Sanger sequencing. RESULTS Differences were found between the influenza virus strains detected in different epidemic seasons, demonstrating the occurrence of mutations. Influenza A virus was found to be more genetically variable than influenza B virus (P<0.001, Kruskal-Wallis test). However, there was no significant difference in the resistance prevalence between the influenza A subtypes A/H1N1/pdm09 (4.8%) and A/H3N2/ (6.1%). In contrast, more mutations of drug-resistance genes were found in the influenza B virus (P<0.001, chi-square test). In addition, resistance mutations appeared en masse in vaccine strains circulating in unvaccinated populations. CONCLUSIONS It seems important to determine whether the influenza virus strains tested for drug resistance as part of global influenza surveillance are equally representative of viruses circulating in populations with high and low vaccination rates, for all countries. Our results suggest that countries with low levels of influenza immunization may constitute reservoirs of drug-resistant influenza viruses.

Influenza vaccination as a prognostic factor of humoral IgA responses to SARS-CoV-2 infection.

There is evidence that influenza vaccination may provide additional benefits by inducing training of innate immunity and increasing humoral responses to heterologous challenges. Immunoglobulin A (IgA) antibodies dominate the early phase of the adaptive response to SARS-CoV-2 infection, but whether their production may be associated with previous influenza vaccination has not been a subject of any study. This study compared serum SARS-CoV-2-specific IgA responses, measured with Microblot-Array assay, in individuals who experienced COVID-19 (N = 1318) and differed in the status of the seasonal influenza vaccine, age, sex, and disease severity. Influenza-vaccinated individuals had a higher seroprevalence of IgA antibodies against nucleocapsid (anti-NP; by 10.1%), receptor-binding domain of spike protein (anti-RBD; by 11.8%) and the S2 subunit of spike protein (anti-S2; by 6.8%). Multivariate analysis, including age, sex, and COVID-19 severity, confirmed that receiving the influenza vaccine was associated with higher odds of being seropositive for anti-NP (OR, 95% CI = 1.57, 1.2-2.0), anti-RBD (OR, 95% CI = 1.6, 1.3-2.0), and anti-S2 (OR, 95% CI = 1.9, 1.4-2.7), as well as being seropositive for at least one anti-SARS-CoV-2 IgA antibody (OR, 95% CI = 1.7, 1.3-2.1) and all three of them (OR, 95% CI = 2.6, 1.7-4.0). Age ≥ 50 years was an additional factor predicting better IgA responses. However, the concentration of particular antibodies in seropositive subjects did not differ in relation to the influenza vaccination status. The study evidenced that influenza vaccination was associated with improved serum IgA levels produced in response to SARS-CoV-2 infection. Further studies are necessary to assess whether trained immunity is involved in the observed phenomenon.

IgG autoantibodies against ACE2 in SARS-CoV-2 infected patients.

How frequently autoantibodies against angiotensin-converting enzyme 2 (ACE2) occur in patients infected by SARS-CoV-2 is understudied and limited to investigations on a small sample size. The presence of these antibodies may contribute to the long-lasting effects of COVID-19 observed in some individuals, particularly if IgG-class antibodies would emerge in patients. This study assessed the prevalence of IgG autoantibodies against ACE2 in 1139 patients infected with SARS-CoV-2 and examined their relationship with severity, demographic characteristics, and status of vaccination against influenza. The overall prevalence of anti-ACE IgG antibodies in our cohort was 1.5%. Most of these individuals were men (76.5%) and underwent mild COVID-19, but some severe and asymptomatic cases were also observed. Patients with severe infection had twofold higher titers than mild and asymptomatic cases. Age, comorbidities, and influenza vaccination status were not related to antibody prevalence. The prevalence of IgG anti-SARS-CoV-2 antibodies (against nucleocapsid protein and S2 subunit, but not against receptor-binding domain) was higher in the subset with ACE2 autoantibodies. Further research is required to understand the potential spectrum and duration of effects of IgG autoantibodies against ACE2 in patients after SARS-CoV-2 infection, particularly concerning long COVID-19.

Influenza and Influenza-Like Virus Infection in Children Under 14 Years of Age: An Investigation of 725 Cases in the 2021/2022 Influenza Epidemic Season in Poland.

BACKGROUND Influenza in children poses a significant health problem worldwide. In this study we investigated 725 cases of influenza and influenza-like virus infection in children under 14 years of age in the 2021/2022 influenza epidemic season in Poland. MATERIAL AND METHODS The material for the study (nose and throat swabs) was collected during the 2021/2022 epidemic season. We analyzed 725 samples from the National Influenza Center, Department of Influenza Research at the National Institute of Public Health NIH-NRI or at 16 Voivodship Sanitary Epidemiological Stations across Poland. Quantitative polymerase chain reaction (qRT-PCR) was applied to determine the influenza virus type and subtype (in RNA isolated from positive samples). RESULTS This study shows the high incidence of influenza among children under the age of 14. Most confirmed infections were caused by influenza A. The genetic material of the A/H1N1/pdm09 subtype was not found among the analyzed samples. The highest number of influenza A infections was among the youngest children (the 0-4 years age group). The most common influenza-like virus was respiratory syncytial virus (RSV). The greatest number of cases caused by this respiratory virus was registered among the youngest children (0-4 years). CONCLUSIONS This study, which shows the high incidence of influenza among children under the age of 14, highlights the importance of regular influenza vaccination. Since children often play a dominant role in spreading influenza virus in the community, regular vaccination can have both health and economic benefits for all age groups.

Importance of Influenza Anti-Hemagglutinin Antibodies During the SARS-CoV-2 Pandemic in the 2019/2020 Epidemic Season in Poland.

BACKGROUND The aim of this study was to determine the level of anti-hemagglutinin antibodies in the serum of recovered patients during the SARS-CoV-2 pandemic in the 2019/2020 epidemic season in Poland, and the course of COVID-19. MATERIAL AND METHODS The material for the study consisted of the sera of COVID-19 convalescents obtained from the following 9 Regional Blood Donation and Blood Supply Centers located in 8 voivodeships. The hemagglutination inhibition reaction assay (HAI) using 8 viral hemagglutination units was used to determine antibody levels, in accordance with WHO recommendations. RESULTS This research confirms that a patient's declared severity of the course of SARS-CoV-2 infection is influenced by the patient's age and concomitant diseases. There was no statistically significant correlation between the level of anti-hemagglutinin antibodies and the severity of the course of a SARS-CoV-2 infection. Based on the serological tests conducted, it can be unequivocally concluded that both vaccinated and influenza-infected patients had a response rate in line with the requirements of the European Commission and the Committee for Medicinal Products for Human Use hemagglutinin antibodies for 4 influenza virus antigens tested. CONCLUSIONS Patients who confirmed their antibody levels with the Commission of the European Communities and the Committee for Propriety Medicinal Products (CPMP) requirements had a mild COVID-19 course. The results of our research emphasize the role of anti-hemagglutinin antibodies in the course of SARS-CoV-2 infection. COVID-19 convalescents have a higher response rate against all 4 types of anti-hemagglutinin antibodies analyzed.

Analysis of Infections Caused by Influenza Viruses and Influenza-Like Viruses in the Population of People over 65 Years of Age in the 2019-2020 Epidemic Season in Poland.

BACKGROUND Influenza can be the most dangerous for people in risk groups, for example for seniors, in whom it can lead to serious and life-threatening complications. The aim of this research was to analyze the activity of influenza viruses and influenza-like viruses in patients over 65 years of age in the 2019-2020 epidemic season in Poland. MATERIAL AND METHODS A total of 1269 samples collected from patients over 65 years of age with suspected influenza or other respiratory viruses in the 2019-2020 epidemic season (from October 1, 2019, to September 30, 2020) were analyzed. The test material was nose and throat swabs collected during the 2019-2020 epidemic season. Quantitative polymerase chain reaction was used to determine the influenza virus type and subtype for positive samples. RESULTS Among the confirmed infections with influenza viruses, cases due to influenza A were dominant, and the dominant subtype was influenza A subtype A/H1N1/pdm09. Infections with influenza-like viruses were also confirmed in the patients participating in the study, with the presence of genetic material of respiratory syncytial viruses confirmed most often. CONCLUSIONS Seasonal vaccinations can significantly reduce the number of cases and thus the risk of post-influenza complications and deaths among seniors. This is very important, especially now, due to the current epidemiological situation related to the ongoing SARS-CoV-2 respiratory virus pandemic.

Subtypes of Influenza Virus Infection and Outcomes in Individuals Older than 65 Years of Age in Poland in the 2016/2017 to 2019/2020 Epidemic Seasons.

BACKGROUND Influenza is a viral disease causing many deaths each season. With aging, the human immune system becomes weaker, so people over the age of 65 years are at higher risk of complications after influenza infections. This population study, conducted in Poland, aimed to identify the subtypes of influenza virus infection and outcomes in individuals more than 65 years of age in the 2016/2017 to 2019/2020 epidemic seasons. MATERIAL AND METHODS The research materials were nose and throat swabs. Research was conducted in 16 Voivodship Sanitary and Epidemiological Stations and in the Department of Influenza Research, National Influenza Centre, NIPH-NIH. Methods of RNA isolation depended on the laboratory where the isolation was performed. In all laboratories, quantitative polymerase chain reaction (qRT-PCR) was used to determine the influenza virus type and subtype. RESULTS The analysis of the incidence of influenza among people over the age of 65 included the 2016/2017, 2017/2018, 2018/2019, and 2019/2020 influenza epidemic seasons. We analyzed the percentage of positive samples, the dynamics of epidemic seasons, and the percentage share of influenza viruses in the 65+ age group, according to the epidemic season and percentage of deaths. CONCLUSIONS This population study showed that, in Poland, between the 2016/2017 and 2019/2020 epidemic seasons, people who were more than 65 years of age were at higher risk of influenza virus infection and its complications. The findings support the importance of seasonal influenza vaccination in the population over age 65 years.

Immunogenicity of Split Inactivated Quadrivalent Influenza Vaccine in Adults with Obesity in the 2017/2018 Season.

BACKGROUND Obesity is associated with susceptibility to severe influenza infection and several disturbances of the immune response to the influenza vaccine. However, the effect of obesity on the immunogenicity of the influenza vaccine is not fully understood. Our objective here was to assess the immunogenicity of the split, inactivated quadrivalent influenza vaccine (QIV) in Polish adults with obesity. MATERIAL AND METHODS Fifty-three subjects with obesity aged 21-69 years were vaccinated with the QIV in 2017/2018 season. Antibody titers against the 4 vaccine strains were measured using the hemagglutination inhibition (HI) assay. The mean fold antibody increase (MFI), seroprotection rate (protection rate, PR), and seroconversion rate (response rate, RR) were calculated to assess vaccine immunogenicity. RESULTS The vaccine elicited a significant increase in the anti-HI titers against the QIV antigens. The MFI, PR, and RR for the QIV antigens also reached the required age-specific values, indicating the QIV meets current immunogenicity criteria. Individuals with class I and class II/III obesity had similar anti-HI titers, MFI, PR, and RR to each of the vaccine strains. Adults aged <60 years had similar anti-HI titers, MFI, PR, and RR to the QIV strains to those aged ≥60 years. CONCLUSIONS Our results indicate that the split virion, inactivated QIV is immunogenic in adults with obesity regardless of their degree of obesity and age (ie, <60 and ≥60 years).

Epidemiology of Influenza Viruses and Viruses Causing Influenza-Like Illness in Children Under 14 Years Old in the 2018-2019 Epidemic Season in Poland.

BACKGROUND This study aimed to investigate the epidemiology of influenza viruses and viruses that caused influenza-like disease in children under 14 years of age in the 2018-2019 epidemic season in Poland, and to identify the public health lessons that can be learned. MATERIAL AND METHODS Nose and throat swabs were used to obtain samples. The samples were analyzed in the National Influenza Center, Department of Influenza Research at the National Institute of Public Health-National Institute of Hygiene as well as in 16 Voivodship Sanitary Epidemiological Stations across the country. Methods of RNA isolation depended on the laboratory where the isolation was performed. In all laboratories, quantitative polymerase chain reactions were used to determine the influenza virus type as well as the subtype. RESULTS The study group was confirmed to be infected with influenza A and B, with influenza A/H1N1/pdm09 as the dominant subtype. Among the age group of children up to 14 years of age, cases of infection with viruses that cause influenza-like disease were also reported. It was noticeable that the largest number of confirmed cases of infection was recorded in the group of the youngest children (0-4 years). In addition, several different variants of co-infection were registered. CONCLUSIONS This population study showed that in the 2018-2019 epidemic season in Poland children aged under 14 years were at risk of influenza virus infection and its complications. The presented data support increasing the percentage of children being vaccinated in Poland.

Influenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Seazon and the COVID-19 Pandemic in Poland: Data from the Department of Influenza Research, the National Influenza Center at the National Institute of Public Health, National Institute of Hygiene-National Research Institute and 16 Voivodeship Sanitary and Epidemiological Stations

BACKGROUND This population study aimed to investigate influenza and influenza-like respiratory virus infections in children during the 2019/20 influenza season and the coronavirus disease 2019 (COVID-19) pandemic in Poland. MATERIAL AND METHODS This study analyzed data from the National Influenza Centre, the Department of Influenza Research at the National Institute of Public Health, and 16 Voivodeship Sanitary and Epidemiological Stations in Poland. Nose and throat swabs were obtained from children during the 2019/20 influenza season and the COVID-19 pandemic. Viral RNA detection was performed using quantitative reverse transcription-polymerase chain reaction (qRT-PCR) to diagnose influenza virus infection and viral subtypes. RESULTS In the analyzed group, both cases of influenza A and B and infections with influenza-like viruses were confirmed. Among all cases caused by influenza viruses, influenza A was more frequent than B, with predominance of the A/H1N1/pdm09 subtype. The flu-like virus which infected most children was the human respiratory syncytial virus (RSV). The greatest number of cases with RSV was registered in the group of the youngest children (0-4 years). CONCLUSIONS This population study from Poland showed that during the COVID-19 pandemic, and during the winter influenza season of 2019/20, influenza and influenza-like viral infections in children showed some differences from previous influenza seasons. The findings highlight the importance of viral infection surveillance and influenza vaccination in the pediatric population.

Serum Vitamin D and Immunogenicity of Influenza Vaccination in the Elderly.

Vaccination is the most effective preventive measure that reduces the risk of influenza and post-influenza complications. It prevents influenza-related hospitalizations and deaths in 50-60% and about 80% of patients aged over 65, respectively. There is the clinical plausibility of the association between serum vitamin D (VIT D) content and viral respiratory infections. In this study, we addressed the issue of a vitamin D modulatory effect on the immune response to seasonal influenza vaccination in elderly persons. The study comprised 96 participants aged 60-75 during the 2016/17 epidemic season. After the determination of the baseline content of VIT D and anti-hemagglutinin antibodies (H1, H3, and HB), participants were vaccinated with a trivalent vaccine. The content of the anti-hemagglutinin antibodies was rechecked 4-5 weeks afterward, showing inappreciable alterations. The negative findings of this study make the influence of serum VIT D content on the immunogenicity of influenza vaccination highly unlikely in elderly persons.

Epidemic Influenza Seasons from 2008 to 2018 in Poland: A Focused Review of Virological Characteristics.

The objective of this review was to elaborate on changes in the virological characteristics of influenza seasons in Poland in the past decade. The elaboration was based on the international influenza surveillance system consisting of Sentinel and non-Sentinel programs, recently adopted by Poland, in which professionals engaged in health care had reported tens of thousands of cases of acute upper airway infections. The reporting was followed by the provision of biological specimens collected from patients with suspected influenza and influenza-like infection, in which the causative contagion was then verified with molecular methods. The peak incidence of influenza infections has regularly been in January-March each epidemic season. The number of tested specimens ranged from 2066 to 8367 per season from 2008/2009 to 2017/2018. Type A virus predominated in nine out of the ten seasons and type B virus of the Yamagata lineage in the 2017/2018 season. Concerning the influenza-like infection, respiratory syncytial virus predominated in all the seasons. There was a sharp increase in the proportion of laboratory confirmations of influenza infection from season to season in relation to the number of specimens examined, from 3.2% to 42.4% over the decade. The number of confirmations, enabling a prompt commencement of antiviral treatment, related to the number of specimens collected from patients and on the virological situation in a given season. Yet influenza remains a health scourge, with a dismally low yearly vaccination rate, which recently reaches just about 3.5% of the general population in Poland.

Antibody Response to Trivalent Influenza Vaccine in the Northern and the Southern Hemisphere in Elite Athletes.

Being frequent travelers, the elite athletes are advised to undergo an influenza vaccination. The aim of the study was to describe the antibody response to repeated trivalent, inactivated, split influenza vaccine, of different antigenic content, recommended for the Northern and the Southern Hemisphere, administered to sportsmen before the Olympic Games in Brasil in 2016. Fourteen athletes were included in the study. For both A/California/7/209/pdm09 A/H1N1/ antigen and A/Switzerland/971593/2013/A/H3N2/ antigen, higher seroconversion rates were obtained after the first than the second vaccination (10.2 vs. 1.5 and 10.6 vs. 3.0, respectively; p < 0.05 both). Conversion rates for B/Phuket/3073/2013, B/Brisbane/60/2008, and A/HongKong/4801/2014/A/H3N2/ antigens were lower. Nonetheless, the protection rate was greater than 70% for all antigens contained in both vaccines. The proportion of individuals demonstrating a high level of both protection rate and response rate was greater after the first than the second vaccination. We conclude that the immunological response after influenza vaccination is good in elite athletes and remains so after a second influenza vaccination required due to a different vaccine composition recommended for different hemispheres.

Vaccine Effectiveness against Influenza in 2015/16 in Hospital and Ambulatory Medical Care Facilities: Polish Results of the European I-MOVE+ Multicenter Study.

Influenza vaccination is the best measure available to prevent seasonal influenza infection. The majority of studies on vaccine effectiveness in the 2015/16 season conducted in the European I-MOVE+ Project, show that a match between the circulating influenza strains in the general public and those included in the vaccine for the Northern Hemisphere was low to moderate. As part of I-MOVE+, Poland has implemented a case control negative study design and molecular biology methods, such as real time RT-PCR, to assess the vaccine match and effectiveness. The research described herein consisted of two major influenza vaccine effectiveness investigations conducted in Poland in the 2015/16 season. The general practice part of the study included 228 cases consisting of 159 type A, 65 type B, and 4 coinfections (types A + B), and 312 negative control cases. The hospital study part included 26 cases consisting of 21 type A, 2 type B, and 3 coinfections, and 13 negative control cases. The data were collected from patients of all ages recruited by 46 volunteering doctors in 15 Poland's provinces and three hospitals, respectively. In both study parts, only were seven patients and 12 control subjects vaccinated. Low vaccine coverage, a major limitation of the Polish study, makes the calculation of vaccine effectiveness for the Polish population hardly applicable statistically. Despite the crudeness of data, they were included into the common European analysis. The overall vaccine effectiveness amounted to 21.0% (95% CI: 74-122). It was somehow better for type B virus: 53.9% (95% CI: 47-87) and type A virus: 23.6% (95% CI: 83-185). A larger sample size is needed to achieve a desired interpretation of results on influenza vaccine effectiveness in Poland.

The Lethal Spanish Influenza Pandemic in Poland.

The Spanish influenza pandemic in the years 1918-1920 was the largest and most tragic pandemic of infectious disease in human history. Deciphering the structure of the virus (including the determination of complete genome sequence) of this pandemic and the phylogenetic analysis and explanation of its virulence became possible thanks to molecular genetic analysis of the virus isolated from the fixed and frozen lung tissue of influenza victims who died in 1918 and were buried frozen in Alaska and Spitsbergen. Epidemiological data from the course of this pandemic in Poland have not been previously published. For analysis, we used source materials such as clinical studies and case reports of doctors fighting against the pandemic and registries of influenza cases in units of the Polish Army and military hospitals. Clinically, the pandemic of 1918 was characterized by the same symptoms and course as influenza in other years. Pathologically, the disease was similar to the other pandemic, in that the destruction was mostly limited to the respiratory tract. The "Spanish" influenza pandemic of 1918-1920 took place in Poland in 3 epidemic waves. The peaks of morbidity and mortality occurred in the capital, Warsaw, in December 1918 and in December 1919 to January 1920. It is estimated that throughout the pandemic period of 1918-1920 in Poland, 200 000 to 300 000 people died.

Observation and Clinical Pattern in Patients with White Dot Syndromes: The Role of Color Photography in Monitoring Ocular Changes in Long-Term Observation.

BACKGROUND The aim of this study was to assess the clinical course and distinctive features of different white dot syndromes (WDS) in patients attending the Ophthalmology Department, Medical University of Warsaw in the years 1995-2015. MATERIAL AND METHODS Sixty-two (62) patients (43 females and 19 males), aged 18 to 77 years, referred with a WDS were included in this prospective study, with observation period ranging from 5 months to 16 years. All patients underwent a complete ophthalmological examination and multimodal imaging studies. RESULTS In this cohort of 62 patients, the following WDS entities were identified: multifocal choroiditis with panuveitis (MFCPU), multifocal choroiditis (MFC), punctate inner choroidopathy (PIC), birdshot, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), subretinal fibrosis and uveitis, multiple evanescent white dot syndrome (MEWDS), serpiginous choroiditis, and single cases of acute annular outer retinopathy (AAOR). CONCLUSIONS The study was performed at a Polish referral center and may to some extent reflect the varied geographical distribution of white dot syndromes, as none of the subjects was found to suffer from acute zonal occult outer retinopathy (AZOOR), acute macular neuroretinopathy (AMN), or diffuse unilateral subacute neuroretinitis (DUSN). Long-term follow-up is warranted by the evolution of lesions in the eye fundus, while management depends on correct diagnosis of WDS. When the posterior pole is involved in some cases of the WDS an immunosuppressive treatment, the use of the PDT or anti-VEGF injections were necessary.

Rapid Influenza Diagnostic Tests Improve Suitability of Antiviral Treatment in Hospitalized Children.

Influenza may have a complicated course in young children. The aim of the study was to analyze the suitability of influenza treatment among children younger than 5 years hospitalized due to an influenza-like illness. We conducted a comparison of the treatment among children hospitalized in two consecutive years: 2015, when no rapid influenza diagnostic tests (RIDT) were in use, and 2016, when RIDT were implemented into a routine practice in the pediatric ward. In both seasons, nasopharyngeal swabs were collected and examined with real time qRT-PCR. In the 2015 season, influenza was diagnosed in 15/52 (28 %) children and none of them received oseltamivir, while 14/15 (93 %) patients received antibiotics. In the 2016 season, influenza was diagnosed in 11/63 (17 %) children, 7/11 (64 %) of them received oseltamivir and another 7/11 (64 %) received antibiotics. In four cases antibiotics overlapped oseltamivir. These differences in the use of oseltamivir and antibiotics were statistically significant (p < 0.05). We conclude that the implementation of RIDT improves the suitability of influenza treatment and decreases the frequency of antibiotic therapy. RIDT should be available in pediatric departments to optimize influenza treatment.

Influenza Vaccination Coverage Among Polish Patients with Chronic Diseases.

Patients at a high-risk of severe influenza, because of their underlying health disorders, are recommended to receive a seasonal influenza vaccination. In Poland, influenza coverage rate in the general population is very low (3.4 %). However, there is little known about the coverage rate among high-risk patients. The aim of this study was to describe a general knowledge, perception, and influenza vaccination coverage rate among Polish patients with enhanced risk for influenza. We conducted a self-reported survey among 500 patients with chronic disorders: 120 pulmonary, 80 hemodialyzed, 100 thyroid cancer, and 200 cardiovascular patients. We found the following influenza vaccination coverage in the respective groups of patients: 58 % in pulmonary, 34 % in hemodialyzed, 32 % in cardiovascular, and 9 % in thyroid cancer patients. The difference between the coverage rate in pulmonary patients compared with the other risk groups was significant (p < 0.05). In pulmonary patients, the most important barrier for influenza vaccination was a lack of recommendations from healthcare workers, while a high awareness of influenza was the most powerful driver for vaccination (p < 0.05). We conclude that although the influenza vaccination coverage in Polish patients with chronic diseases is higher than that reported in the general population, this rate remains much below the recommended level and should be improved.