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1.
Ned Tijdschr Geneeskd ; 1642020 08 13.
Artigo em Holandês | MEDLINE | ID: mdl-33030318

RESUMO

The Dutch example shows that there are not only differences but also several similarities between COVID-19 and the Spanish flu, although risk of infection and death toll were much higher than they are now, especially at the end of 1918. These similarities include emphasis on the importance of hand washing, prohibition of gatherings (and disregard of these rules), disruption of public life, uncertainty about the nature of the cause, praise of and warnings against ineffective medication as well as debate on use and necessity of certain measures. There is also the social context in which the disease and the measures taken to combat it are happening, with the poor paying the highest price, now as well as then.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Vírus da Influenza A Subtipo H1N1 , Influenza Pandêmica, 1918-1919/história , Influenza Humana/história , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/prevenção & controle , História do Século XX , Humanos , Influenza Pandêmica, 1918-1919/mortalidade , Influenza Pandêmica, 1918-1919/prevenção & controle , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Países Baixos/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
2.
Oncol Nurs Forum ; 47(6): 621-622, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-33063776

RESUMO

The COVID-19 pandemic continues to affect most aspects of daily life, and looking for ways to cope and adapt in this altered state is a priority. Days of unsettling changes have turned into weeks, months, and, most likely, at least a year or more until an effective vaccine is distributed worldwide. COVID-19 has disrupted societies across the world, with a global scope that is unprecedented, ongoing, and without a demarcated end. Combined with the political turmoil related to the presidential election in the United States, environmental turmoil including widespread fires, and ongoing structural barriers (most notably systemic racism), 2020 has been, for most, a year that will live on in our minds long after the pandemic ends. .


Assuntos
Infecções por Coronavirus , Influenza Humana , Pandemias , Pneumonia Viral , Betacoronavirus , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Incerteza
3.
J Infect Dev Ctries ; 14(9): 953-956, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-33031079

RESUMO

INTRODUCTION: Physical distancing preventive measures were implemented in Mexico as a response to the coronavirus disease 2019 (CoViD-19) pandemic. School closures occurred on March 16, 2020, in 10 out of 32 Mexican states, and one week later in the remaining states. Because the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the influenza virus have similar transmission mechanisms, we aimed to evaluate the impact of physical distancing on the incidence of influenza as a proxy of the impact on SARS-CoV-2 contagion. METHODOLOGY: A national flu surveillance system was cross-sectionally analyzed and daily average percent changes (APCs) of incidence rates were calculated throught Poisson regression models. RESULTS: Greater decreasing trends (APCs -8.8, 95% CI: -12.5, -4.5; vs. -6.0, 95% CI: -9.9, -2.0; p = 0.026) were documented in the states with earlier school closures and across age groups, suggesting that earlier implementation of physical distance results in reduced SARS-CoV-2 spread. CONCLUSIONS: Physical distancing policies decrease the incidence of influenza infections in Mexico; its favorable impact on the spread of SARS-CoV-2 is commendable.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Política de Saúde , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/métodos , Distância Social , Isolamento Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Vigilância em Saúde Pública , Adulto Jovem
5.
J Am Coll Cardiol ; 76(15): 1777-1794, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33032740

RESUMO

Viral respiratory infections are risk factors for cardiovascular disease (CVD). Underlying CVD is also associated with an increased risk of complications following viral respiratory infections, including increased morbidity, mortality, and health care utilization. Globally, these phenomena are observed with seasonal influenza and with the current coronavirus disease 2019 (COVID-19) pandemic. Persons with CVD represent an important target population for respiratory virus vaccines, with capacity developed within 3 large ongoing influenza vaccine cardiovascular outcomes trials to determine the potential cardioprotective effects of influenza vaccines. In the context of COVID-19, these international trial networks may be uniquely positioned to redeploy infrastructure to study therapies for primary and secondary prevention of COVID-19. Here, we describe mechanistic links between influenza and COVID-19 infection and the risk of acute cardiovascular events, summarize the data to date on the potential cardioprotective effects of influenza vaccines, and describe the ongoing influenza vaccine cardiovascular outcomes trials, highlighting important lessons learned that are applicable to COVID-19.


Assuntos
Doenças Cardiovasculares , Infecções por Coronavirus , Vacinas contra Influenza/farmacologia , Influenza Humana , Pandemias , Pneumonia Viral , Betacoronavirus , Cardiotônicos/farmacologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Ensaios Clínicos como Assunto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública , Fatores de Risco , Vacinação/métodos
6.
Curr Opin Ophthalmol ; 31(6): 538-548, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33009087

RESUMO

PURPOSE OF REVIEW: This review provides a historic perspective of the impact that major pandemics have had on human and their relationship with ophthalmology. The novel coronavirus epidemic is also analyzed, highlighting the relevance of the eye as a possible source of transmission, infection, and prognosis for the disease. RESULTS: Smallpox is suspected to be present for more than 12 000 years. However, trachoma seems to be the first recorded ophthalmological infectious disease. The deadliest pandemics include the bubonic plague, smallpox, and Spanish flu. The CoVID-19 epidemic is still developing and measures need to be implemented to prevent further escalation of the crisis. SUMMARY: Understanding the current facts in light of earlier historical evidence may help us prepare better to minimize the spread of infections in the future.


Assuntos
Oftalmopatias/epidemiologia , Pandemias , Animais , Betacoronavirus , Infecções por Coronavirus , Humanos , Influenza Pandêmica, 1918-1919 , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Pneumonia Viral
8.
Rev Soc Bras Med Trop ; 53: e20190605, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32935776

RESUMO

INTRODUCTION: The trivalent inactivated influenza vaccine was approved for use in Turkey during the 2018-2019 influenza season. We evaluated beliefs regarding the vaccine and vaccination outcomes in a Turkish population. METHODS: Individuals who were vaccinated with the trivalent inactivated influenza vaccine between November 1 and December 31, 2018, at the Sisli Hamidiye Training and Research Hospital in Istanbul, Turkey, were included in this study. A 15-item questionnaire was completed by a physician during a face-to-face interview with the participants. All participants were followed during the 2018-2019 influenza season through May 2019. The participants were instructed to consult the same physician in case of sudden illness. Participants' beliefs and outcomes were assessed by their vaccination status for the 2017-2018 influenza season. RESULTS: A total of 150 participants were recruited. Their median age was 66 (range, 22-88) years. During the 2017-2018 influenza season, 4.1% had been hospitalized, 53.5% had developed an upper respiratory disease (URD), and 16.2% had been diagnosed with pneumonia. There were no cases of influenza, pneumonia, or hospitalization in the 2019 season; 49.3% of the participants developed a URD (n = 74). Among participants who had been vaccinated during both influenza seasons, 47.5% had had and/or developed a URD, with a higher number of cases during the 2018-2019 season. CONCLUSIONS: After vaccination, no cases of influenza, hospitalization, and pneumonia were observed and the incidence of URD decreased compared with that of the previous season.


Assuntos
Vacinas contra Influenza , Influenza Humana , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Gravidez , Estações do Ano , Turquia , Vacinação , Adulto Jovem
9.
Acta Biomed ; 91(3): e2020031, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921733

RESUMO

The COVID-19 pandemic and response caused a worrying decline in vaccine uptake around the world. In Italy, the immunization coverage targets set in the 2017-19 National Immunization Prevention Plan (PNPV) have been met only partially. The current public health emergency is likely to have negatively impacted on immunization , with the risk of re-occurrence of Vaccine-Preventable Diseases (VPDs) outbreaks. As flu season approaches, both National Health Institutions  and the scientific community in Italy have taken action. Well in advance as compared to previous years, the Ministry of Health released  the Circular to launch the 2020-2021 influenza immunization campaign which this year is longer (starting on October 2020) and extends flu vaccine recommendations to more  "at risk" subgroups, offered the vaccine free of charge. In addition, some Italian Regions have recently tried to make  flu vaccination compulsory for all Healthcare Workers (HCWs). Since 2017, when the law on childhood vaccination in Italy was passed, compulsory vaccination has proved to be a successful strategy towards coverage increase.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Vacinas contra Influenza/farmacologia , Influenza Humana/prevenção & controle , Influenzavirus A/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Vacinação/métodos , Comorbidade , Saúde Global , Pessoal de Saúde , Humanos , Influenza Humana/epidemiologia
10.
F1000Res ; 9: 352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32864104

RESUMO

Background: School closures have been a recommended non-pharmaceutical intervention in pandemic response owing to the potential to reduce transmission of infection between children, school staff and those that they contact. However, given the many roles that schools play in society, closure for any extended period is likely to have additional impacts. Literature reviews of research exploring school closure to date have focused upon epidemiological effects; there is an unmet need for research that considers the multiplicity of potential impacts of school closures. Methods: We used systematic searching, coding and synthesis techniques to develop a systems-based logic model. We included literature related to school closure planned in response to epidemics large and small, spanning the 1918-19 'flu pandemic through to the emerging literature on the 2019 novel coronavirus. We used over 170 research studies and a number of policy documents to inform our model. Results: The model organises the concepts used by authors into seven higher level domains: children's health and wellbeing, children's education, impacts on teachers and other school staff, the school organisation, considerations for parents and families, public health considerations, and broader economic impacts. The model also collates ideas about potential moderating factors and ethical considerations. While dependent upon the nature of epidemics experienced to date, we aim for the model to provide a starting point for theorising about school closures in general, and as part of a wider system that is influenced by contextual and population factors. Conclusions: The model highlights that the impacts of school closures are much broader than those related solely to health, and demonstrates that there is a need for further concerted work in this area. The publication of this logic model should help to frame future research in this area and aid decision-makers when considering future school closure policy and possible mitigation strategies.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Instituições Acadêmicas , Betacoronavirus , Surtos de Doenças/prevenção & controle , Humanos , Modelos Teóricos
11.
Vaccine ; 38(45): 7049-7056, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-32980199

RESUMO

BACKGROUND: Maintaining health of healthcare workers with vaccination is a major component of pandemic preparedness and acceptance of vaccinations is essential to its success. This study aimed to examine impact of the coronavirus disease 2019 (COVID-19) pandemic on change of influenza vaccination acceptance and identify factors associated with acceptance of potential COVID-19 vaccination. METHOD: A cross-sectional self-administered anonymous questionnaire survey was conducted among nurses in Hong Kong, China during 26 February and 31 March 2020. Their previous acceptance of influenza vaccination and intentions to accept influenza and COVID-19 vaccination were collected. Their relationship with work-related and other factors were examined using multiple multinomial logistic regressions. RESULTS: Responses from 806 participants were retrieved. More nurses changed from vaccination refusal to hesitancy or acceptance than those changed from acceptance to vaccination hesitancy or refusal (15.5% vs 6.8% among all participants, P < 0.001). 40.0% participants intended to accept COVID-19 vaccination, and those in private sector (OR: 1.67, 95%CI: 1.11-2.51), with chronic conditions (OR: 1.83, 95%CI: 1.22-2.77), encountering with suspected or confirmed COVID-19 patients (OR: 1.63, 95%CI: 1.14-2.33), accepted influenza vaccination in 2019 (OR: 2.03, 95%CI: 1.47-2.81) had higher intentions to accept it. Reasons for refusal and hesitation for COVID-19 vaccination included "suspicion on efficacy, effectiveness and safety", "believing it unnecessary", and "no time to take it". CONCLUSION: With a low level of COVID-19 acceptance intentions and high proportion of hesitation in both influenza and COVID-19 vaccination, evidence-based planning are needed to improve the uptake of both vaccinations in advance of their implementation. Future studies are needed to explore reasons of change of influenza vaccination acceptance, look for actual behaviour patterns of COVID-19 vaccination acceptance and examine effectiveness of promotion strategies.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Influenza Humana/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Vacinação/psicologia , Adolescente , Adulto , Fatores Etários , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Estudos Transversais , Feminino , Pessoal de Saúde , Hong Kong/epidemiologia , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Intenção , Masculino , Pessoa de Meia-Idade , Orthomyxoviridae/patogenicidade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Segurança do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Fatores Sexuais , Inquéritos e Questionários , Vacinas Virais/administração & dosagem , Vacinas Virais/imunologia
12.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32900875

RESUMO

This statement updates the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2020-2021 season.The American Academy of Pediatrics (AAP) recommends routine influenza immunization of all children without medical contraindications, starting at 6 months of age. Influenza vaccination is an important intervention to protect vulnerable populations and reduce the burden of respiratory illnesses during the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic. Any licensed, recommended, age-appropriate vaccine available can be administered, without preference for one product or formulation over another.Antiviral treatment of influenza with any licensed, recommended, age-appropriate influenza antiviral medication is recommended for children with suspected or confirmed influenza who are hospitalized, have severe or progressive disease, or have underlying conditions that increase their risk of complications of influenza. Antiviral treatment may be considered for any previously healthy, symptomatic outpatient not at high risk for influenza complications in whom an influenza diagnosis is confirmed or suspected, if treatment can be initiated within 48 hours of illness onset, and for children whose siblings or household contacts either are younger than 6 months or have a high-risk condition that predisposes them to complications of influenza.


Assuntos
Vacinas contra Influenza , Influenza Humana/prevenção & controle , Antivirais/uso terapêutico , Criança , Pré-Escolar , Contraindicações de Medicamentos , Hospitalização/estatística & dados numéricos , Humanos , Esquemas de Imunização , Hospedeiro Imunocomprometido , Lactente , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/efeitos adversos , Influenza Humana/tratamento farmacológico , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Vacinação em Massa , Fatores de Risco , Estados Unidos/epidemiologia , Cobertura Vacinal , Vacinas Atenuadas/efeitos adversos , Vacinas de Produtos Inativados/efeitos adversos
14.
PLoS Pathog ; 16(9): e1008583, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32970783

RESUMO

The prospect of universal influenza vaccines is generating much interest and research at the intersection of immunology, epidemiology, and viral evolution. While the current focus is on developing a vaccine that elicits a broadly cross-reactive immune response in clinical trials, there are important downstream questions about global deployment of a universal influenza vaccine that should be explored to minimize unintended consequences and maximize benefits. Here, we review and synthesize the questions most relevant to predicting the population benefits of universal influenza vaccines and discuss how existing information could be mined to begin to address these questions. We review three research topics where computational modeling could bring valuable evidence: immune imprinting, viral evolution, and transmission. We address the positive and negative consequences of imprinting, in which early childhood exposure to influenza shapes and limits immune responses to future infections via memory of conserved influenza antigens. However, the mechanisms at play, their effectiveness, breadth of protection, and the ability to "reprogram" already imprinted individuals, remains heavily debated. We describe instances of rapid influenza evolution that illustrate the plasticity of the influenza virus in the face of drug pressure and discuss how novel vaccines could introduce new selective pressures on the evolution of the virus. We examine the possible unintended consequences of broadly protective (but infection-permissive) vaccines on the dynamics of epidemic and pandemic influenza, compared to conventional vaccines that have been shown to provide herd immunity benefits. In conclusion, computational modeling offers a valuable tool to anticipate the benefits of ambitious universal influenza vaccine programs, while balancing the risks from endemic influenza strains and unpredictable pandemic viruses. Moving forward, it will be important to mine the vast amount of data generated in clinical studies of universal influenza vaccines to ensure that the benefits and consequences of these vaccine programs have been carefully modeled and explored.


Assuntos
Anticorpos Antivirais/imunologia , Pesquisa Biomédica/tendências , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Vírus da Influenza A/imunologia , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Ensaios Clínicos como Assunto , Humanos , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Influenza Humana/virologia
15.
BMC Public Health ; 20(1): 1374, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907562

RESUMO

BACKGROUND: Influenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages. METHODS: We evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty. RESULTS: Our results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406,600 symptomatic cases, 11,300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly for an incremental direct cost of R$169 million per year, down to R$86 million from a societal perspective. Incremental cost-effectiveness ratios for the switch would be R$49,700 per life-year saved and R$26,800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis. CONCLUSIONS: Our analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.


Assuntos
Análise Custo-Benefício , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Saúde Pública , Vacinação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Pré-Escolar , Economia Médica , Feminino , Hospitalização/economia , Humanos , Lactente , Vírus da Influenza B/classificação , Vírus da Influenza B/imunologia , Vacinas contra Influenza/economia , Vacinas contra Influenza/imunologia , Influenza Humana/economia , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pessoa de Meia-Idade , Modelos Econômicos , Anos de Vida Ajustados por Qualidade de Vida , Estações do Ano , Incerteza , Vacinação/economia , Adulto Jovem
16.
ACS Chem Biol ; 15(9): 2331-2337, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32786258

RESUMO

We report on using the synthetic aminoadamantane-CH2-aryl derivatives 1-6 as sensitive probes for blocking M2 S31N and influenza A virus (IAV) M2 wild-type (WT) channels as well as virus replication in cell culture. The binding kinetics measured using electrophysiology (EP) for M2 S31N channel are very dependent on the length between the adamantane moiety and the first ring of the aryl headgroup realized in 2 and 3 and the girth and length of the adamantane adduct realized in 4 and 5. Study of 1-6 shows that, according to molecular dynamics (MD) simulations and molecular mechanics Poisson-Boltzmann surface area (MM/PBSA) calculations, all bind in the M2 S31N channel with the adamantyl group positioned between V27 and G34 and the aryl group projecting out of the channel with the phenyl (or isoxazole in 6) embedded in the V27 cluster. In this outward binding configuration, an elongation of the ligand by only one methylene in rimantadine 2 or using diamantane or triamantane instead of adamantane in 4 and 5, respectively, causes incomplete entry and facilitates exit, abolishing effective block compared to the amantadine derivatives 1 and 6. In the active M2 S31N blockers 1 and 6, the phenyl and isoxazolyl head groups achieve a deeper binding position and high kon/low koff and high kon/high koff rate constants, compared to inactive 2-5, which have much lower kon and higher koff. Compounds 1-5 block the M2 WT channel by binding in the longer area from V27-H37, in the inward orientation, with high kon and low koff rate constants. Infection of cell cultures by influenza virus containing M2 WT or M2 S31N is inhibited by 1-5 or 1-4 and 6, respectively. While 1 and 6 block infection through the M2 block mechanism in the S31N variant, 2-4 may block M2 S31N virus replication in cell culture through the lysosomotropic effect, just as chloroquine is thought to inhibit SARS-CoV-2 infection.


Assuntos
Adamantano/farmacologia , Vírus da Influenza A/efeitos dos fármacos , Influenza Humana/prevenção & controle , Canais Iônicos/antagonistas & inibidores , Sondas Moleculares/química , Proteínas da Matriz Viral/antagonistas & inibidores , Adamantano/análogos & derivados , Adamantano/química , Adamantano/metabolismo , Betacoronavirus/efeitos dos fármacos , Sítios de Ligação , Células Cultivadas , Cloroquina/farmacologia , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Variação Genética , Humanos , Vírus da Influenza A/química , Vírus da Influenza A/genética , Influenza Humana/tratamento farmacológico , Cinética , Sondas Moleculares/metabolismo , Pandemias/prevenção & controle , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Ligação Proteica , Relação Estrutura-Atividade , Replicação Viral/efeitos dos fármacos
17.
Math Biosci ; 329: 108442, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32777227

RESUMO

On February 5 the Japanese government ordered the passengers and crew on the Diamond Princess to start a two week quarantine after a former passenger tested positive for COVID-19. During the quarantine the virus spread rapidly throughout the ship. By February 20, there were 651 cases. We model this quarantine with a SEIR model including asymptomatic infections with differentiated shipboard roles for crew and passengers. The study includes the derivation of the basic reproduction number and simulation studies showing the effect of quarantine with COVID-19 or influenza on the total infection numbers. We show that quarantine on a ship with COVID-19 will lead to significant disease spread if asymptomatic infections are not identified. However, if the majority of the crew and passengers are immune or vaccinated to COVID-19, then quarantine would slow the spread. We also show that a disease similar to influenza, even with a ship with a fully susceptible crew and passengers, could be contained through quarantine measures.


Assuntos
Infecções Assintomáticas , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena , Navios , Viagem , Número Básico de Reprodução/estatística & dados numéricos , Técnicas de Laboratório Clínico , Doenças Transmissíveis Importadas/prevenção & controle , Doenças Transmissíveis Importadas/transmissão , Simulação por Computador , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/transmissão , Japão/epidemiologia , Computação Matemática , Modelos Biológicos , Pneumonia Viral/epidemiologia , Quarentena/métodos , Medicina de Viagem , Doença Relacionada a Viagens
18.
Public Health Rep ; 135(5): 640-649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32783780

RESUMO

OBJECTIVE: The objective was to compare estimates of childhood influenza vaccination across 7 consecutive influenza seasons based on 2 survey systems. METHODS: We analyzed data from the National Health Interview Survey (NHIS) and the National Immunization Survey-Flu (NIS-Flu) using Kaplan-Meier survival analysis to estimate receipt, based on parental report, of at least 1 dose of influenza vaccine among children aged 6 months to 17 years. RESULTS: We found no significant increasing trend in influenza vaccination coverage among children overall from 2012 to 2018 based on the NHIS or from 2012 to 2019 based on the NIS-Flu. We found 4 seasons with a significant increase in influenza vaccination coverage compared with the previous season (2012-2013 [NHIS, NIS-Flu], 2013-2014 [NIS-Flu], 2017-2018 [NHIS], and 2018-2019 [NIS-Flu]). As of the 2018-2019 season, based on NIS-Flu, influenza vaccination coverage was only 62.6%. Children with health conditions that put them at increased risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied except 2014-2015. For all seasons studied, influenza vaccination coverage estimates for children were higher based on NIS-Flu data compared with NHIS data. Trends across seasons and differences in vaccination coverage between age groups were similar between the 2 surveys. CONCLUSIONS: Influenza vaccination coverage among children appears to have plateaued. Only about half of the children in the United States were vaccinated against influenza. Improvements in measurement of influenza vaccination and development and review of strategies to increase childhood influenza vaccination coverage are needed.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vigilância da População/métodos , Análise de Sobrevida , Cobertura Vacinal/estatística & dados numéricos , Cobertura Vacinal/tendências , Adolescente , Criança , Pré-Escolar , Feminino , Previsões , Humanos , Lactente , Influenza Humana/epidemiologia , Masculino , Inquéritos e Questionários , Estados Unidos/epidemiologia
19.
PLoS Med ; 17(8): e1003238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810149

RESUMO

BACKGROUND: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations. METHODS AND FINDINGS: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates. CONCLUSIONS: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community.


Assuntos
Absenteísmo , Vacinas contra Influenza/administração & dosagem , Serviços de Saúde Escolar/normas , População Urbana , Cobertura Vacinal/normas , Vacinação/normas , Adolescente , California/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Masculino , Instituições Acadêmicas/normas , Estudantes , Vacinação/métodos , Cobertura Vacinal/métodos
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