RESUMEN
Viral respiratory diseases place a heavy burden on the healthcare system, with children making up a significant portion of related hospitalizations. While comorbidities increase the risk of complications and poor outcomes, many hospitalized children lack clear risk factors. As new vaccines for respiratory viral diseases emerge, this study examined pediatric respiratory hospitalizations, focusing on viral etiology, complication rates, and the impact of comorbidities to guide future policy. Data were analyzed from eight pre-COVID influenza seasons (2011/2012-2018/2019) involving patients under 18 years hospitalized with respiratory complaints across 4-10 hospitals in Valencia, Spain. Respiratory specimens were tested for eight viral targets using multiplex real-time reverse-transcription polymerase chain reaction. Demographics, clinical outcomes, discharge diagnoses, and laboratory results were examined. Among the hospitalized children, 26% had at least one comorbidity. These children had higher rates of pneumonia, asthma exacerbation, and pneumothorax, and were twice as likely to require ICU admission, though mechanical ventilation and length of stay were similar to those without comorbidities. Respiratory syncytial virus (RSV) was the most common virus detected (23.1%), followed by rhinovirus/enterovirus (9.5%) and influenza (7.2%). Viral codetection decreased with age, occurring in 4.6% of cases. Comorbidities increase the risk of complications in pediatric respiratory illnesses, however, healthcare utilization is driven largely by otherwise healthy children. Pediatric viral vaccines could reduce this burden and should be further evaluated.
Asunto(s)
Comorbilidad , Hospitalización , Infecciones del Sistema Respiratorio , Humanos , España/epidemiología , Preescolar , Hospitalización/estadística & datos numéricos , Niño , Lactante , Femenino , Masculino , Adolescente , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Recién Nacido , Gripe Humana/epidemiología , Gripe Humana/virología , COVID-19/epidemiología , COVID-19/virología , COVID-19/prevención & control , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/virología , Rhinovirus , SARS-CoV-2RESUMEN
Influenza vaccination is annually recommended for specific populations at risk, such as older adults. We estimated the 2018/2019 influenza vaccine effectiveness (IVE) overall, by influenza subtype, type of vaccine, and by time elapsed since vaccination among subjects 65 years old or over in a multicenter prospective study in the Valencia Hospital Surveillance Network for the Study of Influenza and other Respiratory Viruses (VAHNSI, Spain). Information about potential confounders was obtained from clinical registries and/or by interviewing patients and vaccination details were only ascertained by registries. A test-negative design was performed in order to estimate IVE. As a result, IVE was estimated at 46% (95% confidence interval (CI): (16%, 66%)), 41% (95% CI: (-34%, 74%)), and 45% (95% CI: (7%, 67%)) against overall influenza, A(H1N1)pdm09 and A(H3N2), respectively. An intra-seasonal not relevant waning effect was detected. The IVE for the adjuvanted vaccine in ≥75 years old was 45% (2%, 69%) and for the non-adjuvanted vaccine in 65-74 years old was 59% (-16%, 86%). Thus, our data revealed moderate vaccine effectiveness against influenza A(H3N2) and not significant against A(H1N1)pdm09. Significant protection was conferred by the adjuvanted vaccine to patients ≥75 years old. Moreover, an intra-seasonal not relevant waning effect was detected, and a not significant IVE decreasing trend was observed over time.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Vacunas contra la Influenza , Gripe Humana , Anciano , Estudios de Casos y Controles , Hospitalización , Humanos , Subtipo H3N2 del Virus de la Influenza A , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Estudios Prospectivos , Estaciones del Año , España/epidemiología , VacunaciónRESUMEN
Incidence of pneumococcal disease has increased worldwide in recent years. Response to pneumococcal vaccine is usually measured using the multiserotype enzyme-linked immunosorbent assay (ELISA) pneumococcal test. However, this approach presents several limitations. Therefore, the introduction of new and more robust analytical approaches able to provide information on the efficacy of the pneumococcal vaccine would be very beneficial for the clinical management of patients. Surface plasmon resonance (SPR) has been shown to offer a valuable understanding of vaccines' properties over the last years. The aim of this study is to evaluate the reliability of SPR for the anti-pneumococcal capsular polysaccharides (anti-PnPs) IgGs quantification in vaccinated. Fast protein liquid chromatography (FPLC) was used for the isolation of total IgGs from serum samples of vaccinated patients. Binding-SPR assays were performed to study the interaction between anti-PnPs IgGs and PCV13. A robust correlation was found between serum levels of anti-PnPs IgGs, measured by ELISA, and the SPR signal. Moreover, it was possible to correctly classify patients into "non-responder", "responder" and "high-responder" groups according to their specific SPR PCV13 response profiles. SPR technology provides a valuable tool for reliably characterize the interaction between anti-PnPs IgGs and PCV13 in a very short experimental time.
Asunto(s)
Inmunogenicidad Vacunal , Vacunas Neumococicas/inmunología , Resonancia por Plasmón de Superficie/métodos , Adulto , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Persona de Mediana EdadRESUMEN
OBJECTIVE: In Europe, urogenital schistosomiasis was not endemic, however in 2014 the first cases of a European autochthonous infection outbreak appeared in Corsica (France). In this work a search and description of cases, both import and native urogenital schistosomiasis, published in the European Union (EU) during the last 20 years was made. In addition, a qualitative risk assessment in Spain was carried out. METHODS: A bibliographic search of European Union published cases over the last 20 years (1997-2017) was performed using PubMed. Works that evidenced the presence of intermediate hosts Bulinus truncatus and Planorbarius metidjensis in our country were searched in PubMed, ResearchGate and Google Scholar. Finally, a risk assessment of urogenital schistosomiasis in Spain using the 2011 ECDC guide was made. RESULTS: 481 cases in the EU were found. 328 were imported and 152 autochthonous. All from the autochthonous cases were focused in Corsica, where people from different nationalities got sicked. The presence of two potential host species was documented in different locations of our geography. The result of the risk assessment in Spain was low risk. CONCLUSIONS: Although the risk assessment in Spain was low risk, several factors as the presence of intermediate hosts in Spain, the increase on migratory flows, and the role that the S. haematobium-bovis hybrid had in the outbreak of Corsica, must alert community and health authorities about the possibility that autochthonous cases in our country appear.
OBJETIVO: En Europa no era endémica la esquistosomiasis urogenital, sin embargo en 2014 aparecieron en Francia los primeros casos de un brote de infección autóctona europea. En este trabajo se hace una búsqueda y descripción de casos de esquistosomiasis urogenital, tanto importados como autóctonos, publicados en la Unión Europea (UE) durante los últimos 20 años. Además se realiza una evaluación cualitativa del riesgo en España. METODOS: Se realizó una búsqueda bibliográfica en PubMed de casos publicados en la UE durante los últimos 20 años (1997-2017). Se buscaron trabajos en PubMed, ResearchGate y Google Académico que evidenciasen la presencia hospedadores intermediarios Bulinus truncatus y Planorbarius metidjensis en nuestro país. Finalmente se evaluó el riesgo de esquistosomiasis urogenital en España aplicando la guía del ECDC de 2011. RESULTADOS: Se hallaron 481 casos en la UE, 328 eran importados y 152 autóctonos. En todos los casos autóctonos el foco se localizó en Córcega, donde enfermaron personas de diversas nacionalidades. Se documentó la presencia de dos especies hospedadores potenciales en diversas localizaciones de nuestra geografía. El resultado de la evaluación de riesgo en España fue bajo riesgo. CONCLUSIONES: Si bien el resultado de la evaluación de riesgo en España fue bajo riesgo, factores como la presencia de hospedadores intermediarios, el aumento de los flujos migratorios, y el papel que tuvo el híbrido S. haematobium-bovis en el brote de Córcega, deben poner en sobre aviso a la comunidad médica y las autoridades sanitarias ante la posibilidad de que aparezcan casos autóctonos en nuestro país.
Asunto(s)
Esquistosomiasis Urinaria/epidemiología , Brotes de Enfermedades , Unión Europea , Humanos , Medición de Riesgo , Esquistosomiasis Urinaria/transmisión , España/epidemiologíaRESUMEN
BACKGROUND: The 2015/2016 influenza season was characterized in Europe by the circulation of A(H1N1)pdm09 clade 6B.1 and B/Victoria-lineage influenza viruses. The components of the vaccines used in the current and past two seasons in the Valencia region were similar but not well matched to the 2015/2016 dominant influenza-circulating strains. We estimate influenza vaccine effectiveness (IVE) and interference of previous vaccination in preventing admission with A(H1N1)pdm09 or B/Victoria-lineage in this particular season. METHODS: The Valencia Hospital Network for the Study of Influenza runs an active surveillance hospital-based study to collect clinical and virological data from consecutive admissions possibly related to influenza. Combined nasopharyngeal and pharyngeal swabs are analyzed by reverse transcription polymerase chain reaction, and the hemagglutinin is sequenced in a sample of positive influenza specimens. Vaccination is ascertained consulting a population vaccine information system. We estimate IVE using a test-negative approach. RESULTS: During the 2015-2016 season, we recruited 1049 eligible admissions of patients 60â¯years or older, and 187 tested positive for influenza. The adjusted IVE in preventing admission with A(H1N1)pdm09 was 20.2%; 95% confidence interval (CI) -21.3-47.5% and -33.2%; 95% CI, -140.1-26.1% in preventing admission with B/Victoria-lineage. The majority of A(H1N1)pdm09 sequenced viruses belonged to the emerging 6B.1 subclade, defined by S162N and I216T mutations in the hemagglutinin protein. When we restricted our analysis to those not vaccinated in the previous year, unadjusted IVE was 84.9% (95% CI 9.9-100.0) overall, 77.9% (-32.7-100.0%) in preventing A(H1N1)pdm09 and 48.8% (-219.5-100.0%) in preventing B/Yamagata-lineage admission. CONCLUSIONS: Our findings indicate that IVE was low in preventing A(H1N1)pdm09 and strongly correlated with vaccination in the previous season. No effect in preventing admission with B/Victoria-lineage was observed. For the 2015/2016 season, IVE was low due to a mismatch and lack of concordance between the circulating and vaccine viruses.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A/inmunología , Virus de la Influenza B/inmunología , Vacunas contra la Influenza/inmunología , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Potencia de la Vacuna , Anciano , Antígenos Virales/genética , Monitoreo Epidemiológico , Europa (Continente)/epidemiología , Femenino , Pruebas de Inhibición de Hemaglutinación , Hospitalización , Humanos , Subtipo H3N2 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/inmunología , Masculino , Persona de Mediana Edad , ARN Viral/genética , Vigilancia de Guardia , Análisis de Secuencia de ADN , VacunaciónRESUMEN
BACKGROUND: Most evidence of the effectiveness of influenza vaccines comes from studies conducted in primary care, but less is known about their effectiveness in preventing serious complications. Here, we examined the influenza vaccine effectiveness (IVE) against hospitalization with PCR-confirmed influenza in the predominant A(H3N2) 2011-2012 influenza season. METHODS: A hospital-based, test-negative study was conducted in nine hospitals in Valencia, Spain. All emergency admissions with a predefined subset of symptoms were eligible. We enrolled consenting adults age 18 and over, targeted for influenza vaccination because of comorbidity, with symptoms of influenza-like-illness within seven days of admission. We estimated IVE as (1-adjusted vaccination odds ratio)*100 after accounting for major confounders, calendar time and recruitment hospital. RESULTS: The subjects included 544 positive for influenza A(H3N2) and 1,370 negative for influenza admissions. Age was an IVE modifying factor. Regardless of vaccine administration, IVE was 72% (38 to 88%) in subjects aged under 65 and 21% (-5% to 40%) in subjects aged 65 and over. By type of vaccine, the IVE of classical intramuscular split-influenza vaccine, used in subjects 18 to 64, was 68% (12% to 88%). The IVE for intradermal and virosomal influenza vaccines, used in subjects aged 65 and over, was 39% (11% to 58%) and 16% (-39% to 49%), respectively. CONCLUSIONS: The split-influenza vaccine was effective in preventing influenza-associated hospitalizations in adults aged under 65. The intradermal vaccine was moderately effective in those aged 65 and over.
Asunto(s)
Subtipo H3N2 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza , Gripe Humana/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Investigación sobre la Eficacia Comparativa , Femenino , Hospitalización , Humanos , Vacunas contra la Influenza/administración & dosificación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , España , Adulto JovenRESUMEN
Fundamentos. En Europa no era endémica la esquistosomiasis urogenital, sin embargo, en 2014 aparecieron en Francia los primeros casos de un brote de infección autóctona europea. En este trabajo se hace una búsqueda y descripción de casos de esquistosomiasis urogenital, tanto importados como autóctonos, publicados en la Unión Europea (UE) durante los últimos 20 años. Además, se realiza una evaluación cualitativa del riesgo en España. Métodos. Se realizó una búsqueda bibliográfica en PubMed de casos publicados en la UE durante los últimos 20 años (1997-2017). Se buscaron trabajos en PubMed, ResearchGate y Google Académico que evidenciasen la presencia hospedadores intermediarios Bulinus truncatusy Planorbarius metidjensis en nuestro país. Finalmente se evaluó el riesgo de esquistosomiasis urogenital en España aplicando la guía del ECDC de 2011. Resultados. Se hallaron 481 casos en la UE, 328 eran importados y 152 autóctonos. En todos los casos autóctonos el foco se localizó en Córcega, donde enfermaron personas de diversas nacionalidades. Se documentó la presencia de dos especies hospedadores potenciales en diversas localizaciones de nuestra geografía. El resultado de la evaluación de riesgo en España fue bajo riesgo. Conclusiones. Si bien el resultado de la evaluación de riesgo en España fue bajo riesgo, factores como la presencia de hospedadores intermediarios, el aumento de los flujos migratorios, y el papel que tuvo el híbrido S. haematobium-bovis en el brote de Córcega, deben poner en sobre aviso a la comunidad médica y las autoridades sanitarias ante la posibilidad de que aparezcan casos autóctonos en nuestro país
Background. In Europe, urogenital schistosomiasis was not endemic, however in 2014 the first cases of a European auto-chthonous infection outbreak appeared in Corsica (France). In this work a search and description of cases, both import and native urogenital schistosomiasis, published in the European Union (EU) during the last 20 years was made. In addition, a qualitative risk assessment in Spain was carried out. Methods. A bibliographic search of European Union published cases over the last 20 years (1997-2017) was performed using PubMed. Works that evidenced the presence of intermediate hosts Bulinus truncates and Planorbarius metidjensis in our country were searched in PubMed, ResearchGate and Google Scholar. Finally, a risk assessment of urogenital schistosomiasis in Spain using the 2011 ECDC guide was made. Results. 481 cases in the EU were found. 328 were imported and 152 autochthonous. All from the autochthonous cases were focused in Corsica, where people from different nationalities got sicked. The presence of two potential host species was documented in different locations of our geography. The result of the risk assessment in Spain was low risk. Conclusions. Although the risk assessment in Spain was low risk, several factors as the presence of intermediate hosts in Spain, the increase on migratory flows, and the role that the S. haematobium-bovis hybrid had in the outbreak of Corsica, must alert community and health authorities about the possibility that autochthonous cases in our country appear