Progress in research of influenza vaccination in pregnant women / 中华流行病学杂志

Influenza is an acute respiratory infectious disease caused by influenza virus. Pregnancy is associated with physiologic and immunological changes that may increase the risk for influenza virus infection and influenza-related complications. Influenza vaccination is the most effective way to prevent influenza virus infection. WHO and many countries have classified pregnant women as a priority population for influenza vaccination, however, there are still many challenges for promoting influenza vaccination in pregnant women in China, influenza vaccination coverage in pregnant women remains low and some influenza vaccine package inserts list pregnancy as an absolute contraindication. In this paper, we summarize the research progress in the effects of influenza infection and influenza vaccination during pregnancy both at home and abroad, then discuss the strategies to promote influenza vaccination in pregnancy for the purpose of providing reference for the related research and policy development in China.

Research progress on active components and mechanism of Isatidis Radix for influenza virus / 中国中药杂志

Isatidis Radix is the dried root of the Isatis indigotica, with pharmacological effects such as heat-clearing and detoxification, cooling blood and pharyngeal relief, antibacterial and anti-inflammatory effects. It is often used clinically to prevent and treat influenza and other diseases. In this paper, relevant domestic and foreign literatures in recent years were summarized, and it was found that Isatidis Radix lignans, indole alkaloids, polysaccharides, etc. were the main active components against influenza virus. Then its pharmacological effects and the mechanism of action were reviewed, providing a basis for in-depth research on the antiviral effect of Isatidis Radix.

Network pharmacological analysis and experimental study of Pulsatilla chinensis against inflammatory injury caused by pneumonia in mice infected with influenza virus FM_1 / 中国中药杂志

Network pharmacology and the mouse model of viral pneumonia caused by influenza virus FM_1 were employed to explore the main active components and the mechanism of Pulsatilla chinensis against the inflammatory injury of influenza virus-induced pneumonia. The components and targets of P. chinensis were searched from TCMSP, and the targets associated with influenza virus-induced pneumonia were searched from GeneCards. The common targets between P. chinensis and influenza virus-induced pneumonia were identified with Venn diagram established in Venny 2.1. The herb-component-disease-target(H-C-D-T) network was constructed by Cytoscape 3.7.2. The above data were imported into STRING for PPI network analysis. Gene Ontology(GO) enrichment and KEGG pathway enrichment were performed with DAVID. BALB/cAnN mice were infected with the influenza virus FM_1 by nasal drip to gene-rate the mouse model of pneumonia. Immunohistochemistry was adopted to the expression profiling of inflammatory cytokines in the lung tissues of mice in the blank group, model group, and P. chinensis group 1, 3, 5, and 7 days after infection. The pathological changes of lung and trachea of mice in blank group, model group, and P. chinensis group were observed with light microscope and scanning electron microscope at all the time points. The network pharmacological analysis indicated that 9 compounds of P. chinensis were screened out, with a total of 57 targets, 22 of which were overlapped with those of influenza virus-induced pneumonia. A total of 112 GO terms(P<0.05) were enriched, including 81 terms of biological processes, 11 terms of cell components, and 20 terms of molecular functions. A total of 53 KEGG signaling pathways(P<0.05) were enriched, including TNF signaling pathway, influenza A signaling pathway, NF-κB signaling pathway, MAPK signaling pathway and other signaling pathways related to influenza/inflammation. In the P. chinensis group, the expression of TNF-α and IL-1 in the lung tissue was down-regulated on the 3 rd day after infection, and that of IL-6 in the lung tissue was down-regulated on the 5 th day after infection. Light microscopy and scanning electron microscopy showed that P. chinensis significantly alleviated the pathological damage of lung and trachea compared with the model group. This study reflects the multi-components, multi-targets, and multi-pathways of P. chinensis against influenza virus-induced pneumonia. P. chinensis may reduce the production of proinflammatory cytokines and mediators and block the pro-inflammatory signaling pathways to alleviate viral pneumonia, which provides reference for future research.

Factores ambientales relacionados con la presentación de virus influenza A en aves silvestres / Environmental factors related to Influenza A virus occurrence in wild birds

RESUMEN La investigación y el interés por el virus influenza aviar han aumentado considerablemente en las últimas décadas en respuesta a los brotes de influenza aviar de alta patogenicidad en aves de corral y a su potencial zoonótico. Las aves silvestres acuáticas son el principal reservorio del virus en la naturaleza, por lo tanto, la comprensión de la dinámica de infección del virus influenza A (VIA) en estas poblaciones es fundamental para entender su potencial de persistencia en el ambiente y sus posibilidades de transmisión hacia aves domésticas y humanos. Se ha identificado que factores ambientales (como temperatura, precipitaciones, vegetación y características del paisaje, entre otros) pueden tener un importante rol en el mantenimiento y diseminación del virus en las zonas de concentración de aves silvestres. Sin embargo, los estudios que incluyen aspectos ecológicos del virus y que exploran la interacción entre la prevalencia del VIA en aves silvestres y el ambiente, continúan siendo escasos. En esta revisión se resumen los esfuerzos de investigación que se han realizado para identificar a los factores ambientales involucrados en la persistencia y transmisión del VIA en lugares de concentración de aves silvestres y cómo estos factores pueden incidir en la prevalencia del virus en estas poblaciones, generando diferencias en la presentación de la infección entre distintas zonas geográficas.

ABSTRACT Research and interest in avian influenza virus have increased considerably in recent decades in response to highly pathogenic avian influenza outbreaks in poultry and its zoonotic potential. Wild waterfowl are the main reservoir of the virus, therefore studying the dynamics of influenza A virus (IAV) infection in these populations is essential in order to understand its potential persistence in the environment and transmission to poultry and humans. It has been identified that environmental factors (such as temperature, rainfall, vegetation and landscape characteristics, among others) can play an important role in the maintenance and dissemination of the virus in the areas of concentration of wild birds. However, studies that include ecological aspects of the virus and explore the interaction between the prevalence of IAV in wild birds and environmental factors remain scarce. This review summarizes research efforts that have been made to identify the environmental factors involved in the persistence and transmission of IAV in areas of wild bird concentration and how these factors may influence the prevalence of the virus in these populations, generating differences in the presentation of the infection among different geographical areas.

Comparison of antigenic mutation during egg and cell passage cultivation of H3N2 influenza virus

Plano brasileiro de preparação para enfrentamento de uma pandemia de Influenza / Brazilian plan to prepare for confrontation of an Influenza pandemic

As mais diversas pandemias passadas deixaram um legado na história com um número significativo de óbitos e de pessoas enfermas. Essa experiência é capaz de mostrar a necessidade de elaboração de Planos de Preparação para Enfrentamento de Pandemias, flexíveis e capazes de dar resposta que o problema requer. Assim, o propósito desta revisão é proporcionar informações relativas a preparação e respostas antes, durante e depois de uma pandemia de influenza, cumprir seu papel na organização do Sistema Único de Saúde, além de servir como guia aos gestores das unidades federadas, subsidiando-os na estratégia para enfrentamento de situações de emergência. O plano contém diretrizes gerais que são essenciais à ação dos serviços de saúde. O processo e as respostas a uma possível pandemia de influenza devem ser mais importantes que os detalhes específicos que podem ser inaplicáveis a uma nova situação. De acordo com essa afirmativa é que procuramos apresentar um plano conciso com a certeza de que uma ameaça ou uma pandemia de influenza aumenta o nível de exigência de necessidade de uma ação integrada. Pelo caráter genérico, o Plano Nacional apresenta orientações gerais necessárias à intervenção não só do setor saúde e específicas, face a uma situação de emergência. A conseqüência, a conveniência e as respostas específicas devem ser continuamente revisadas e atualizadas. De modo geral, o Plano reúne as diretrizes de acordo com os períodos e fases e os planos específicos por área, contendo as medidas e os procedimentos que devem ser adotados, encontram-se anexos sob forma de links.

Factores sociodemográficos y fisiopatológicos asociados a la tuberculosis del sistema nervioso central en un Hospital Público de Lima-Perú, 2014-2017 / Sociodemographic and physiopathological factors associated with tuberculosis of the central nervous system in a Public Hospital of Lima-Peru, 2014-2017

Objetivo: Determinar los factores sociodemográficos y fisiopatológicos de la neurotuberculosis (NTB) en los pacientes registrados en el Programa de Control de la Tuberculosis (PCT) del Hospital Nacional Dos de Mayo. Materiales y Métodos: Se realizó un estudio transversal analítico, desarrollado entre Julio del 2014 y Julio del 2017. Se diseñó una ficha que incluyó datos sociodemográficos, fisiopatológicos y las características al diagnóstico. Se obtuvieron las razones de prevalencia (RP) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 1038 pacientes. El 16% de toda la población y de 34% de las tuberculosis extra pulmonares tenia NTB. La forma clínica más frecuente fue la meningoencefalitis tuberculosa (MEC TB) (96%). Dentro de las manifestaciones clínicas destacaron las convulsiones (22%), cefalea (20%), signos meníngeos (18%) y trastorno del sensorio (16%). La presencia de NTB estuvo asociada al diagnóstico de VIH (RPa: 2,06; IC95%: 1,53-2,76; Valor p<0,001), condición de alcoholismo (RPa: 1,53; IC95%: 1,04-2,25; Valor p=0,030) y género femenino (RPa: 1,40; IC95%: 1,06-1,84; Valor p=0,019). Conclusiones: El diagnóstico de VIH, condición de alcoholismo y el género femenino son factores asociados a mayor frecuencia de NTB en el Hospital Dos de Mayo.

Objective: To determine the sociodemographic and physiopathological factors of neurotuberculosis (NTB) in the patients registered in the Tuberculosis Control Program (TCP) of the Hospital Nacional Dos de Mayo. Materials and Methods: Analytical cross- sectional study, developed between July 2014 and 2017 July. We designed a card that included data sociodemographic, pathophysiological and the diagnostic characteristics. Were obtained prevalence ratio (RP) raw and adjusted, with 95% confidence intervals. Results: 1038 patients participated. 16% of the entire population and 34% of the extrapulmonary tuberculosis had NTB. The most common clinical form was tuberculous meningoencephalitis (MEC TB) (96%). Within the clinical manifestations emphasized the seizures (22%), headache (20%), meningeal signs (18%) and sensory disorder (16%). The presence of NTB was associated with the diagnosis of HIV (aPR: 2.06, 95%CI: 1.53-2.76, P value <0.001), alcoholism (aPR: 1.53, 95%CI: 1.04-2.25, p value = 0.030) and female gender (aPR: 1.40, 95%CI: 1.06-1.84, p value = 0.019). Conclusions: The diagnosis of HIV, condition of alcoholism and the female gender are factors associated with increased frequency of NTB in the Hospital Dos de Mayo.

Conocimientos sobre enfermedades tipo influenza en estudiantes de Medicina de la Universidad de Guayaquil, Ecuador / Knowledge about influenza-like illnesses in medical students at Guayaquil University, Ecuador

RESUMEN Fundamento: las enfermedades tipo influenza son de fácil contagio y sus vías de transmisión difíciles de controlar si no son tratadas adecuadamente. Objetivo: determinar los conocimientos que poseen los estudiantes de pregrado y posgrado de la Facultad de Ciencias Médicas de la Universidad de Guayaquil sobre las enfermedades tipo influenza. Métodos: se realizó un estudio descriptivo transversal durante el mes de febrero de 2018. Se utilizaron métodos teóricos: análisis-síntesis e inducción-deducción, y empíricos: la encuesta en forma de cuestionario para indagar sobre el conocimiento de los estudiantes sobre la influenza. Resultados: la totalidad de ellos refirió poseer conocimientos sobre el tema. El 96,32 % de los de pregrado identificaron como más frecuentes la transmisión de tipo viral y el contagio por contacto con persona enferma; mientras en posgrado el 100 % expresó conocimientos al respecto; la complicación habitual más señalada fue la automedicación referida por el 72 % en pregrado y en el posgrado por el 57 %. En relación con las medidas preventivas, manifestaron conocerlas el 87 % y 89 % en el pregrado y posgrado respectivamente. Conclusiones: se comprobó que el grado de conocimientos sobre las enfermedades tipo influenza en cuanto a transmisión, etiología, acciones de protección y medidas preventivas en estos estudiantes de la Facultad de Ciencias Médicas de la Universidad de Guayaquil es aceptable, pero aún persisten algunas carencias identificadas en el estudio realizado.

ABSTRACT Background: influenza is an easily transmitted disease and its way of transmission is difficult to control if it is not properly treated. Objective: to determine the knowledge undergraduate and graduate students have on influenza-like disease at Guayaquil University Medical Sciences Faculty. Methods: a cross-sectional descriptive study was carried out at Guayaquil University Medical Sciences Faculty, during the month of February 2018. Theoretical methods were used: analysis-synthesis and induction-deduction, and empirical methods: the survey in the form of a questionnaire to inquire about students' knowledge on influenza. Results: all the students reported having knowledge on influenza. 96,32 % of the undergraduates identified the transmission of viral type by contact with the sick person as more frequent; in postgraduate studies 100 % expressed knowledge in this regard; the most common complication was self-medication referred by 72 % of undergraduate students in 72 % and in postgraduate students by 57 %. In relation to preventive measures, 87 % and 89 % expressed knowledge in undergraduate and postgraduate respectively. Conclusions: it was found that the degree of knowledge on the influenza-like disease in terms of transmission, etiology, protective actions and preventive measures in these students at Guayaquil University Medical Sciences Faculty is acceptable. There are still some shortcomings identified in the study carried out.

Viral etiology of acute respiratory infections in children in Southern Iran

Abstract INTRODUCTION: Prevalence of influenza A virus (Flu-A), respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) was assessed in children with acute respiratory infections (ARIs). METHODS: Nasopharyngeal aspirates and throat swabs were subjected to real-time polymerase chain reaction (PCR) to detect RSV and Flu-A and to conventional PCR to detect hMPV. RESULTS: Of the 156 children assessed, 93 (59.6%) carried at least one virus, with 35.9% positive for RSV, 14.1% for hMPV, and 9.6% for Flu-A. The prevalence of co-infections was 2.6%. CONCLUSIONS: The high detection rate may reflect increased sensitivity of real-time PCR compared to traditional PCR and viral culture.

Influence of Fine Particulate Dust Particulate Matter 10 on Respiratory Virus Infection in the Republic of Korea

BACKGROUND: This study investigated the effect of fine dust concentrations in the air on the incidence of viral respiratory infections in the Republic of Korea.METHODS: A time series analysis using R statistics was performed to determine the relationship between weekly concentrations of fine dust in the air and the incidences of acute respiratory tract infections caused by the respiratory syncytial virus (RSV), adenovirus (HAdV), rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human parainfluenza virus (HPIV), and influenza virus (IFV), from the beginning of 2016 to the end of 2017. Correlations between various meteorological factors and the amount of fine dust were analyzed using the Spearman's rank correlation coefficient. To analyze the relationship between viral infections and fine dust, a quasi-poisson analysis was performed.RESULTS: The incidence of the HAdV was proportional to fine dust and air temperature. The IFV was proportional to fine dust and relative humidity and was inversely proportional to temperature. The HMPV was proportional to fine dust, wind speed, and inversely proportional to relative humidity. The HCoV was proportional to micro dust, relative humidity, and inversely proportional to temperature. Both the HBoV and HPIV were directly proportional to fine dust, temperature, wind speed, and inversely proportional to relative humidity. The RSV was inversely proportional to fine dust, temperature, wind speed. A lag effect was observed for the influenza virus, in that its incidence increased 2–3 weeks later on the cumulative lag model.CONCLUSION: As the weekly average concentration of fine dust increases, the incidence of HAdV, HMPV, HCoV, HBoV, HPIV, and influenza increase.

A Study on Factors Associated with Duration of Influenza Virus Shedding in Children / 계명의대학술지

To prevent the spread of influenza among infants and adolescents attending kindergartens and schools, proper quarantining of those who are ill is necessary. In this study, the rapid antigen test (RAT) was performed in patients to investigate the factors affecting the duration of virus shedding. The study included pediatric patients who were diagnosed with influenza by RAT at Daedong Hospital between November 2016 and April 2019. We identified the influenza subtype, age, gender, fever duration, oseltamivir medications, and time gap between fever subsided and RAT examination through chart review. A total of 330 patients were examined at discharge. The average age for RAT positive and negative patients was 6.32 ± 4.26 years and 8.47 ± 4.54 years, respectively. The average duration of fever for the RAT positive patients was 3.84 ± 1.09 days, and for those who were RAT negative was 4.191 ± 1.39. The average number of doses oseltamivir for RAT positive and negative patients was 7.68 ± 1.57 and 8.72 ± 1.37, respectively. The RAT was performed 24 to 48 hours after fever subsided (TG 24–48H group). At this time, 60 patients were positive and the rate of positive expression was 55.56%. Of the TG 48–72H group, 36 patients (26.09%) were positive. Of the TG 72–96H group, 18 patients (21.43%) were positive. Age, fever duration, number of doses oseltamivir and time gap after fever subsided were the factors that influenced the duration of influenza virus shedding. These factors should be considered during the quarantining influenza patients.

Effect of Scutellariae Radix on expression of inflammatory cytokine protein and gene in lung of mice with viral pneumonia caused by influenza virus FM1 infection / 中国中药杂志

Mice models of viral pneumonia were induced by pulmonary adaptive strain FM1 of influenza A virus in Asian mice.RT-PCR and immunohistochemistry were used to dynamically observe the effect of Scutellariae Radix on the protein and gene expression of inflammatory cytokine in the lungs of the model mice infected by influenza virus FM1 at different phases. The partial mechanism of Scutellariae Radix in repairing the immune inflammatory damage of target organs of pneumonia caused by influenza virus was further explored. The results showed that Scutellariae Radix reduced protein and gene expression of proinflammatory cytokines tumor necrosis factor( TNF-α),interleukin IL-1,IL-6 in lung tissues from 3 rd to 5 th day after infection,and increased protein and gene expression of IL-10 and IFN-γ in lung tissues on the 5 th day after infection. Scutellariae Radix may inhibit excessive release of pro-inflammatory cytokines and promote the expression of anti-inflammatory cytokines,thereby inhibiting the systemic inflammatory response syndrome,reducing the immunoinflammatory pathological damage of lung caused by influenza virus FM1 infection,and promoting lung repair of tissue inflammatory lesions.

Comparison of clinical severity between single- and coinfections of respiratory syncytial virus and influenza virus with common respiratory viruses

PURPOSE: Multiple virus infections may affect clinical severity. We investigated the effect of coinfection of respiratory syncytial virus (RSV) and influenza virus with other respiratory viruses on clinical severity. METHODS: Data from 634 samples of a single tertiary hospital between September 2014 and April 2015 were analyzed for clinical characteristics (fever duration and O2 need, steroid use, and ICU care) between single infection and coinfection of RSV (n=290) and influenza virus (n=74) with 16 common respiratory viruses from hospitalized children. RESULTS: The RSV coinfection group (n=109) (3.1±2.7 days) showed significantly longer fever duration than the RSV single infection group (n=181) (2.6±2.6 days) (P=0.04), while there was no difference in O2 need, steroid use or ICU care in the 2 groups. The influenza coinfection group (n=38) showed significantly higher O2 need than the influenza single infection group (n=36) (21.1% vs. 5.6%, P=0.05), while there was no difference in fever duration between the 2 groups. CONCLUSION: The results indicate that RSV and Influenza coinfections can increase clinical severity and that the severity may be influenced by the nature of coinfecting viruses.

Modification of the Conventional Influenza Epidemic Models Using Environmental Parameters in Iran / 대한의료정보학회지

OBJECTIVES: The association between the spread of infectious diseases and climate parameters has been widely studied in recent decades. In this paper, we formulate, exploit, and compare three variations of the susceptible-infected-recovered (SIR) model incorporating climate data. The SIR model is a well-studied model to investigate the dynamics of influenza viruses; however, the improved versions of the classic model have been developed by introducing external factors into the model. METHODS: The modification models are derived by multiplying a linear combination of three complementary factors, namely, temperature (T), precipitation (P), and humidity (H) by the transmission rate. The performance of these proposed models is evaluated against the standard model for two outbreak seasons. RESULTS: The values of the root-mean-square error (RMSE) and the Akaike information criterion (AIC) improved as they declined from 8.76 to 7.05 and from 98.12 to 93.01 for season 2013/14, respectively. Similarly, for season 2014/15, the RMSE and AIC decreased from 8.10 to 6.45 and from 117.73 to 107.91, respectively. The estimated values of R(t) in the framework of the standard and modified SIR models are also compared. CONCLUSIONS: Through simulations, we determined that among the studied environmental factors, precipitation showed the strongest correlation with the transmission dynamics of influenza. Moreover, the SIR+P+T model is the most efficient for simulating the behavioral dynamics of influenza in the area of interest.

Transient expression of hemagglutinin antigen from canine influenza virus H3N2 in Nicotiana benthamiana and Lactuca sativa

PURPOSE: Canine influenza virus (CIV), H3N2, carries potentiality for zoonotic transmission and genetic assortment which raises a concern on possible epidemics, and human threats in future. To manage possible threats, the development of rapid and effective methods of CIV vaccine production is required. The plant provides economical, safe, and robust production platform. We investigated whether hemagglutinin (HA) antigen from Korea-originated CIV could be produced in Nicotiana benthamiana and lettuce, Lactuca sativa by a DNA viral vector system. MATERIALS AND METHODS: We used DNA sequences of the HA gene from Korean CIV strain influenza A/canine/Korea/S3001/2015 (H3N2) for cloning into a geminiviral expression vectors to express recombinant HA (rHA) antigen in the plant. Agrobacterium-mediated infiltration was performed to introduce HA-carrying vector into host plants cells. Laboratory-grown N. benthamiana, and grocery-purchased or hydroponically-grown lettuce plant leaves were used as host plants. RESULTS: CIV rHA antigen was successfully expressed in host plant species both N. benthamiana and L. sativa by geminiviral vector. Both complex-glycosylated and basal-glycosylated form of rHA were produced in lettuce, depending on presence of endoplasmic reticulum (ER) retention signal. In terms of rHA expression level, canine HA (H3N2) showed preference to the native signal peptide than ER retention signal peptide in the tested geminiviral vector system. CONCLUSION: Grocery-purchased lettuce leaves could serve as an instant host system for the transient expression of influenza antigen at the time of emergency. The geminiviral vector was able to induce expression of complex-glycosylated and basal-glycosylated rHA in lettuce and tobacco.

Viperin Differentially Induces Interferon-Stimulated Genes in Distinct Cell Types

Viperin is an IFN-stimulated gene (ISG)-encoded protein that was identified in human primary macrophages treated with IFN-γ and in human primary fibroblasts infected with cytomegalovirus (CMV). This protein plays multiple roles in various cell types. It inhibits viral replication, mediates signaling pathways, and regulates cellular metabolism. Recent studies have shown that viperin inhibits IFN expression in macrophages, while it enhances TLR7 and TLR9-mediated IFN production in plasmacytoid dendritic cells, suggesting that viperin can play different roles in activation of the same pathway in different cell types. Viperin also controls induction of ISGs in macrophages. However, the effect of viperin on induction of ISGs in cell types other than macrophages is unknown. Here, we show that viperin differentially induces ISGs in 2 distinct cell types, macrophages and fibroblasts isolated from wild type and viperin knockout mice. Unlike in bone marrow-derived macrophages (BMDMs), viperin downregulates the expression levels of ISGs such as bone marrow stromal cell antigen-2, Isg15, Isg54, myxovirus resistance dynamin like GTPase 2, and guanylate binding protein 2 in murine embryonic fibroblasts (MEFs) treated with type I or II IFN. However, viperin upregulates expression of these ISGs in both BMDMs and MEFs stimulated with polyinosinic-polycytidylic acid or CpG DNA and infected with murine CMV. The efficiency of viral entry is inversely proportional to the expression levels of ISGs in both cell types. The data indicate that viperin differentially regulates induction of ISGs in a cell type-dependent manner, which might provide different innate immune responses in distinct cell types against infections.

Evaluation of Waning Immunity at 6 Months after Both Trivalent and Quadrivalent Influenza Vaccination in Korean Children Aged 6–35 Months

BACKGROUND: The titer of influenza vaccine-induced antibodies declines over time, and younger children have lower immunogenicity and shorter duration of immunity. This study aimed to compare persistence of antibody at 6 months after influenza vaccination according to influenza virus strains, vaccine type, antigen dose, and primed status in children aged 6 to 35 months. METHODS: A total 124 healthy children aged 6 to 35 months were enrolled from September to December 2016 at 10 hospitals in Korea and randomly assigned to either a full dose of quadrivalent influenza vaccine or a half dose of trivalent influenza vaccine with Victoria B strain group. Hemagglutination inhibition antibody titers (that measure the seroprotection rates) were assessed for the recommended influenza strains at 6 months post vaccination. RESULTS: The seroprotection rates at 6 months for strains A (H1N1), A (H3N2), B/Yamagata, and B/Victoria were 88.7%, 97.4%, 36.6%, and 27.6%, respectively. The seroprotection rates for A (H1N1), A (H3N2) and B (Victoria) were 91.4%, 98.7% and 27.5% in a full dose of quadrivalent vaccine vs. 83.7%, 94.6% and 27.9% in a half dose trivalent vaccine, respectively. The seroprotection rate for the B (Yamagata) strain was 23.8% in the quadrivalent group and 14.0% in the trivalent group. CONCLUSION: Persistence of antibodies at 6 months was more favorable against the influenza A strains than against the B strains. Persistence of antibodies to additional B strain at 6 months was superior in the quadrivalent vaccine group. The immunity of primed children with different B strains was not superior to that of the unprimed group with another B strain.

Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses / 결핵

BACKGROUND: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. METHODS: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014–June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription–polymerase chain reaction (RT-PCR). RESULTS: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022–1.312; p=0.022). CONCLUSION: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.