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1.
Medicine (Baltimore) ; 100(18): e25799, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950979

RESUMO

ABSTRACT: To investigate the epidemiology and factors associated with the severity of viral acute lower respiratory infection (ALRI) in children hospitalized in Manaus, Amazonas, in 2017 to 2018.Retrospective cohort study of children hospitalized at the Hospital and Emergency Room Delphina Rinaldi Abdel Aziz, in Manaus, from April 01, 2017 to August 31, 2018, with a clinical diagnosis of ALRI and nasopharyngeal aspirates positive for at least 1 respiratory virus.One hundred forty-six children aged 0.2 to 66 months (median 7 months) were included. Patients were divided into 2 groups according to the disease severity classified by an adapted Walsh et al score: moderate disease, score 0-4, n = 66 (45.2%) and severe disease, score 5-7, n = 80 (54.8%). A greater number of viral ALRI cases were observed in the rainiest months. Respiratory syncytial virus was the most prevalent (n = 103, 70.3%), followed by metapneumovirus (n = 24, 16.4%), influenza virus (n = 17, 11.6%), parainfluenza virus (n = 11, 7.5%), and adenovirus (n = 4, 2.7%). Co-detections of 2 to 3 viruses were found in 12 (8.2%) patients. The presence of viral coinfection was an independent risk factor for disease severity (adjusted relative risk [RR] 1.53; 95% CI 1.10-2.14). Twelve patients (8.2%) died, all with severe disease. Risk factors for death were shock (adjusted RR 10.09; 95% CI 2.31-43.90) and need for vasoactive drugs (adjusted RR 10.63; 95% CI 2.44-46.31).There was a higher incidence of viral ALRI in Manaus in the rainy season. Respiratory syncytial virus was the most prevalent virus. The presence of viral coinfection was an independent risk factor for disease severity.


Assuntos
Infecções por Adenovirus Humanos/epidemiologia , Coinfecção/epidemiologia , Influenza Humana/epidemiologia , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Adenoviridae/isolamento & purificação , Infecções por Adenovirus Humanos/diagnóstico , Infecções por Adenovirus Humanos/virologia , Brasil/epidemiologia , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/virologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Influenzavirus A/isolamento & purificação , Influenzavirus B/isolamento & purificação , Masculino , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/diagnóstico , Infecções por Paramyxoviridae/virologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/isolamento & purificação , Respirovirus/isolamento & purificação , Estudos Retrospectivos , Índice de Gravidade de Doença
2.
Viruses ; 13(2)2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33499234

RESUMO

Respiratory viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a constant threat to public health given their ability to cause global pandemics. Infection with either virus may lead to aberrant host responses, such as excessive immune cell recruitment and activation, dysregulated inflammation, and coagulopathy. These may contribute to the development of lung edema and respiratory failure. An increasing amount of evidence suggests that lung endothelial cells play a critical role in the pathogenesis of both viruses. In this review, we discuss how infection with influenza or SARS-CoV-2 may induce endothelial dysfunction. We compare the effects of infection of these two viruses, how they may contribute to pathogenesis, and discuss the implications for potential treatment. Understanding the differences between the effects of these two viruses on lung endothelial cells will provide important insight to guide the development of therapeutics.


Assuntos
Endotélio/virologia , Influenzavirus A/patogenicidade , Lesão Pulmonar/patologia , Lesão Pulmonar/virologia , /patogenicidade , Plaquetas/metabolismo , Citocinas/metabolismo , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Endotélio/metabolismo , Endotélio/patologia , Armadilhas Extracelulares/imunologia , Humanos , Junções Intercelulares/patologia , Lesão Pulmonar/terapia
5.
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
6.
Rev Med Suisse ; 16(705): 1598-1604, 2020 Sep 09.
Artigo em Francês | MEDLINE | ID: mdl-32914590

RESUMO

Influenza A and B infections are marred with variable morbidity and, in some cases, develop into severe or even fatal respiratory, circulatory and neurologic complications. Respiratory complications are most common and involve primary-Influenza pneumonia and pneumonia from bacterial or fungal superinfections. Nonrespiratory complications can affect several organs/systems, namely the heart (myocarditis, type 1 and 2 myocardial infarction) and the nervous system (stroke, encephalitis, Guillain-Barré Syndrome). This article provides an overview of the basic pathophysiological aspects of Influenza virus infection, reviews the main severe respiratory and nonrespiratory complications and discusses the different treatments with their respective indications, contraindications and limitations.


Assuntos
Cardiopatias/virologia , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Influenzavirus A/patogenicidade , Influenzavirus B/patogenicidade , Doenças do Sistema Nervoso/virologia , Cardiopatias/fisiopatologia , Humanos , Doenças do Sistema Nervoso/fisiopatologia
7.
Medicine (Baltimore) ; 99(32): e21469, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769879

RESUMO

Influenza is an acute respiratory infectious disease that poses a threat to public health. We assessed the association between atmospheric visibility and influenza and influenza-like illness (ILI) in Wuxi city, China.Daily meteorological data, ILI activity, and influenza virus infection rates were collected between 31 December 2012 and 31 December 2017. A distributed lag non-linear model (DLNM) was used to analyze the exposure-lag-response of ILI and influenza activity and daily average visibility.A total of 12,800 cases were detected; 1046 cases (8.17%) were of Flu-A and 527 (4.12%) were of Flu-B infection. Our analysis suggested a non-linear relationship between atmospheric visibility and influenza: U-shaped for ILI, and L-shaped for Flu-A and Flu-B. Comparing low visibility (2.5 km) to ILI cases, the risk appeared between day 1 and day 2. For Flu-A, the risk appeared between days 5 and 9, whereas for Flu-B, the risk effect was much stronger and had a longer reaction delay, staying above zero until day 9. The protective effects of high visibility (14 km) on ILI and Flu-B occurred the same day or one day later. However, we found no association between high visibility and Flu-A.In conclusion, our study contributes novel evidence for the effects of atmospheric visibility on influenza. These findings are important for the development of influenza surveillance and early warning systems in Wuxi city.


Assuntos
Influenza Humana/epidemiologia , Influenzavirus A , Influenzavirus B , Conceitos Meteorológicos , China , Humanos , Influenza Humana/diagnóstico , Dinâmica não Linear , Estações do Ano
8.
Int J Legal Med ; 134(4): 1271-1274, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32458044

RESUMO

In the setting of the coronavirus disease 2019 (COVID-19) pandemic, only few data regarding lung pathology induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is available, especially without medical intervention interfering with the natural evolution of the disease. We present here the first case of forensic autopsy of a COVID-19 fatality occurring in a young woman, in the community. Diagnosis was made at necropsy and lung histology showed diffuse alveolar damage, edema, and interstitial pneumonia with a geographically heterogeneous pattern, mostly affecting the central part of the lungs. This death related to COVID-19 pathology highlights the heterogeneity and severity of central lung lesions after natural evolution of the disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/patologia , Pulmão/patologia , Pneumonia Viral/patologia , Adenoviridae/genética , Adenoviridae/isolamento & purificação , Adulto , Autopsia , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Bocavirus/genética , Bocavirus/isolamento & purificação , Proteína C-Reativa/análise , Coronavirus/genética , Coronavirus/isolamento & purificação , Feminino , Humanos , Influenzavirus A/genética , Influenzavirus A/isolamento & purificação , Influenzavirus B/genética , Influenzavirus B/isolamento & purificação , Macrófagos/patologia , Megacariócitos/patologia , Metapneumovirus/genética , Metapneumovirus/isolamento & purificação , Neutrófilos/patologia , Obesidade Mórbida , Pandemias , Pró-Calcitonina/sangue , Reação em Cadeia da Polimerase em Tempo Real , Vírus Sincicial Respiratório Humano/genética , Vírus Sincicial Respiratório Humano/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Rhinovirus/genética , Rhinovirus/isolamento & purificação , Suíça , Linfócitos T/patologia
9.
Pesqui. vet. bras ; 40(4): 254-260, Apr. 2020. graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1135617

RESUMO

This study aimed to determine the frequency and distribution of infectious diseases diagnosed through necropsy examination and histopathological analysis in growing/finishing pigs along 12 years (2005-2016) in Southern Brazil. We evaluated 1906 anatomopathological exams of pigs at growing/finishing phases, of which the infectious diseases corresponded to 75.6% of the cases (1,441/1,906). Porcine circovirus type 2 (PCV2) infections were the most frequent, accounting for 51.3% of the cases (739/1,441) with a higher frequency from 2005 to 2007, characterizing an epidemic distribution, with a gradual decline after 2008. Infectious diseases affecting the respiratory system were the second major cause with 30.1% of the cases. Among these, necrotizing bronchiolitis caused by swine Influenza (15.1%, 218/1,441) and bacterial pneumonia (15%, 216/1,441) were the main conditions. Influenza was mostly diagnosed from 2010 to 2013, accounting for 43.1% (167/387) of the cases. After this period, both respiratory infectious diseases were endemic. Digestive system infectious diseases accounted for 10.5% of the diagnoses (151/1,441), with the following main conditions: Salmonella spp. enterocolitis (43.7%, 66/151), Lawsonia spp. proliferative enteropathy (41.7%, 63/151), and Brachyspira spp. colitis (14.6%, 22/151). The latter had a higher incidence from 2012 to 2014 with all cases detected in this period. Polyserositis and bacterial meningitis represented, respectively, 5.8% (84/1,441) and 2.3% (33/1,441) of the cases diagnosed, with a constant endemic character.(AU)


O objetivo deste estudo consistiu em determinar a frequência e a distribuição das doenças infecciosas diagnosticadas através de exame de necropsia e análise histopatológica em suínos nas fases de crescimento/terminação ao longo de 12 anos (2005-2016) no sul do Brasil. Foram avaliados 1906 laudos anatomopatológicos de suínos nas fases de crescimento/terminação, dos quais as doenças infecciosas corresponderam a 75,6% (1441/1906) do total. As infecções por circovírus suíno tipo 2 (PCV2) foram as mais frequentes, contabilizando 51,3% (739/1441) dos casos, com uma alta frequência de 2005 a 2007 caracterizando uma distribuição epidêmica neste período, e um declínio gradual após o ano de 2008. A segunda principal causa incluiu as doenças infecciosas que afetam o sistema respiratório (30,1% dos casos). Dentre essas, destacaram-se a influenza suína (15,1%; 218/1441) e pneumonias bacterianas (15%; 216/1441). O diagnóstico de influenza apresentou uma frequência elevada de 2010 a 2013, totalizando 43,1% (167/387) dos casos. Após este período, ambas doenças infecciosas respiratórias exibiram caráter endêmico. As doenças infecciosas do sistema digestório totalizaram 10,5% (151/1441) dos diagnósticos, com as seguintes principais condições: enterocolite por Salmonella spp. (43,7%; 66/151), enteropatia proliferativa por Lawsonia spp. (41,7%; 63/151) e colite por Brachyspira spp. (14,6%; 22/151). A colite por Brachyspira spp. apresentou uma alta incidência de 2012 a 2014 com todos os casos detectados no período. As polisserosites e meningites bacterianas representaram 5,8% (84/1441) e 2,3% (33/1441) dos casos diagnosticados, respectivamente, com um caráter endêmico constante.(AU)


Assuntos
Animais , Doenças dos Suínos/epidemiologia , Doenças Transmissíveis/patologia , Doenças Transmissíveis/epidemiologia , Circovirus , Infecções por Circoviridae/patologia , Infecções por Circoviridae/epidemiologia , Infecções por Orthomyxoviridae/patologia , Infecções por Orthomyxoviridae/epidemiologia , Influenzavirus A , Sus scrofa , Enterocolite/epidemiologia , Pneumonia Suína Micoplasmática
10.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 38(3): 123-126, mar. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-200606

RESUMO

BACKGROUND: Organizing pneumonia (OP) is a rare complication of influenza virus infection but scarce data are available. The recognition of this entity is important because require appropriate treatment. METHODS: We report two cases and perform a systematic review on PubMed database. Only cases with histological confirmation of OP and influenza virus positive laboratory test were included. RESULTS: We collected 16 patients. Median age was 52 year, 20% of patients were smokers and 43.8% had not any comorbidity. Influenza A virus infection was diagnosed in 75%. Clinical manifestation consisted on a respiratory deterioration with a median time of appearance of 14 days. Radiological pattern observed was ground-glass opacities with consolidations. Survival was observed in 12 patients (75%). All three patients who did not receive steroid treatment died. CONCLUSION: Physicians must be aware that patients with influenza infection with a torpid course could be developing OP and prompt corticoid therapy should be instaured


ANTECEDENTES: La neumonía organizada (OP, por sus siglas en inglés) es una complicación poco frecuente de la gripe. El reconocimiento de esta entidad es importante porque requiere un tratamiento adecuado. MÉTODOS: Comunicamos 2 casos y realizamos una revisión sistemática en PubMed, incluyendo casos con confirmación histológica de OP y prueba de laboratorio positiva para gripe. RESULTADOS: Se recogieron 16 pacientes. La edad media fue de 52 años, el 20% eran fumadores y el 43,8% no tenían comorbilidades. El virus de la gripe A se identificó en el 75% de los casos. La presentación clínica consistió en un deterioro respiratorio, con una mediana de aparición de 14 días. El patrón radiológico más común fue opacidades en vidrio esmerilado con consolidaciones. Sobrevivieron 12 pacientes (75%). Los 3 pacientes que no recibieron tratamiento esteroideo murieron. CONCLUSIÓN: Los clínicos deben tener en cuenta que los pacientes con gripe con un curso tórpido puedan estar desarrollando una OP


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pneumonia em Organização Criptogênica/virologia , Pneumonia em Organização Criptogênica/diagnóstico , Influenzavirus A , Influenza Humana/complicações
11.
Respir Med ; 161: 105854, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32056728

RESUMO

BACKGROUND: Viral respiratory infections (VRI) in people living with Cystic fibrosis (CF) is less well understood than respiratory bacterial infections, particularly adults with CF and few studies have compared children with adults. This study evaluated the frequency of respiratory viruses in patients with cystic fibrosis (CF) in Western Australia (WA). We determined the VRI in CF and compared them with non-CF patients. Further, we compared CF patients that were hospitalised with those that were not. PATIENTS/METHODS: Nucleic acid from sputum of 157 CF and 348 non-CF patients was analysed for influenzavirus A (Flu A) and B, (Flu B), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), human rhinovirus (RV), and parainfluenza viruses (PIV 1-3) by RT-PCR, during the 2016 winter respiratory season. RESULTS: No significant difference in the frequency of respiratory virus detection between CF and non-CF patients was found. RV was the most frequently detected virus in CF patients, and in hospitalised CF. RSV and hMPV were found less frequently in CF patients and RSV was not found in any hospitalised CF patient. A trend for fewer influenzavirus detections in adult CF patients was observed, however the trend was opposite for paediatric patients. RV and Flu A were the most common viruses detected in hospitalised CF patients. CONCLUSION: There was no significant difference in VRI between CF and non-CF patients. RV and influenza A were most commonly found in hospitalised CF patients, suggesting that infection with these viruses may contribute to hospitalisation for CF respiratory exacerbations.


Assuntos
Fibrose Cística/complicações , Infecções Respiratórias/etiologia , Viroses/etiologia , Adulto , Austrália/epidemiologia , Criança , Fibrose Cística/epidemiologia , Fibrose Cística/virologia , Feminino , Hospitalização , Humanos , Influenzavirus A/isolamento & purificação , Masculino , Estudos Prospectivos , Vírus Sinciciais Respiratórios/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Estações do Ano , Viroses/epidemiologia , Viroses/virologia
13.
Eur J Med Chem ; 186: 111861, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31734025

RESUMO

Respiratory syncytial virus (RSV) and influenza A virus (IAV) are two of the most common viruses that cause substantial morbidity and mortality in infants, young children, elderly persons, and immunocompromised individuals worldwide. Currently, there are no licensed vaccines or selective antiviral drugs against RSV infections and most IAV strains become resistant to clinical anti-influenza drug. Here, we described the discovery of a series of 2-((1H-indol-3-yl)thio)-N-phenyl-acetamide as novel and potent RSV and IAV dual inhibitors. Thirty-five derivatives were designed, prepared, and evaluated for their anti-RSV and anti-IAV activities. Among the tested compounds, 14'c, 14'e, 14'f, 14'h, and 14'i exhibited excellent activity against both RSV and IAV, which showed low micromolar to sub-micromolar EC50 values. Further, compounds 14'c and 14'e were identified as the most promising dual inhibitors with lesser cytotoxicity than the clinical drug, ribavirin. These findings may contribute to the development of a lead compound for the treatment of RSV and/or IAV infections.


Assuntos
Acetamidas/farmacologia , Antivirais/farmacologia , Desenho de Fármacos , Influenzavirus A/efeitos dos fármacos , Vírus Sincicial Respiratório Humano/efeitos dos fármacos , Acetamidas/síntese química , Acetamidas/química , Antivirais/síntese química , Antivirais/química , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Células HEK293 , Humanos , Testes de Sensibilidade Microbiana , Estrutura Molecular , Relação Estrutura-Atividade , Replicação Viral/efeitos dos fármacos
14.
Arch Virol ; 165(1): 201-206, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31745716

RESUMO

Neuraminidase (NA) thermostability of influenza A and B viruses isolated from birds, swine and humans was measured to evaluate its variability associated with host body temperature. The highest 50% inactivation temperature (IT50) was observed with H3N8 avian influenza virus (74 °C), and the lowest IT50 was observed with the seasonal human H3N2 virus (45.5 °C). The IT50 values of A(H1N1)pdm09 viruses 56.4-58.5 °C were statistically higher than that of the prepandemic strain A/Solomon Islands/03/06 (52.5 °C). An analysis of Ca2+ binding sites revealed the correspondence of amino acid changes to NA thermostability. This study demonstrates that changes in NA thermostability correspond to differences in host body temperature.


Assuntos
Influenzavirus A/enzimologia , Influenzavirus B/enzimologia , Neuraminidase/química , Animais , Aves/virologia , Temperatura Corporal , Estabilidade Enzimática , Humanos , Suínos , Termodinâmica , Proteínas Virais/química , Zoonoses/virologia
15.
Minerva Pediatr ; 72(1): 45-54, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27854115

RESUMO

BACKGROUND: This study aimed to determine the frequencies of respiratory tract viruses in patient (acute lower respiratory tract infection [LRTI] or wheezing) and control (history of asthma without symptoms) groups. METHODS: Using multiplex-polymerase chain reaction (PCR), respiratory tract viruses were investigated in the respiratory tract specimens from patient and control groups followed in the Pediatric Clinic. RESULTS: The viruses detected in the patient and control groups (P=0.013) were as follows, respectively: rhinoviruses A, B, C (25.6% and 36.7%), influenza virus A (21.1% and 0.0%), parainfluenza virus type 1 (7.8% and 1.7%), parainfluenza virus type 4 (5.6% and 0.0%), adenoviruses A, B, C, D, E (4.4% and 1.7%), parainfluenza virus type 3 (4.4% and 1.7%), coronaviruses 229E and NL63 (4.4% and 1.7%), coronavirus OC43 (3.3% and 0.0%), respiratory syncytial virus A (3.3% and 0.0%), parainfluenza virus type 2 (2.2% and 0.0%), influenza virus B (2.2% and 0.0%), and respiratory syncytial virus B (1.1% and 1.7%). No bocavirus, metapneumovirus or enterovirus was found in any specimen. Statistically significant differences in the detection of influenza virus A (P=0.000), the total detection of parainfluenza viruses (P=0.008) and coinfection (P=0.004) were observed between the patient and control groups. CONCLUSIONS: The advantage of our study compared with other studies is the inclusion of not only wheezing patients but also children with asthma without symptom. The higher detection of rhinoviruses both in patient and control groups give rise to thought that these viruses may be responsible for asthma exacerbations and may be related with long duration of virus shedding.


Assuntos
Sons Respiratórios , Sistema Respiratório/virologia , Infecções Respiratórias/virologia , Doença Aguda , Adolescente , Asma , Estudos de Casos e Controles , Criança , Pré-Escolar , Coronavirus/isolamento & purificação , Feminino , Humanos , Lactente , Recém-Nascido , Influenzavirus A/isolamento & purificação , Masculino , Reação em Cadeia da Polimerase Multiplex , Vírus Sincicial Respiratório Humano/isolamento & purificação , Respirovirus/isolamento & purificação , Rhinovirus/isolamento & purificação , Manejo de Espécimes/métodos , Avaliação de Sintomas
17.
Bioconjug Chem ; 30(12): 3028-3037, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31738536

RESUMO

Mucosal vaccination, which secretion of immunoglobulin A (IgA) on the mucosa is accompanied by induction of immunoglobulin G (IgG) in the blood, is one of the most effective ways to circumvent influenza epidemics caused by incorrect prediction of epidemic viral strains or viral mutation. Secreted IgA is expected to prevent hosts from being infected with heterologous viruses because this antibody cross-reacts to strains other than those used for immunization. Our previous mouse experiments revealed that intranasal IgA with cross-reactivity was induced through nasal inoculation with inactivated whole viral particles of the H1N1 A/New Caledonia/20/99 IVR116 (NCL) strain in the presence of hyaluronic acid modified with tetraglycine-l-octaarginine. In the present study, heterologous influenza virus challenge was performed to validate a potential of the hyaluronic acid derivative as a mucosal adjuvant with cross-protective abilities. Serious weight loss was observed when mice were nasally inoculated with inactivated NCL viruses alone and subsequently exposed to mouse-adapted infectious viruses of the H1N1 A/Puerto Rico/8/34 (PR8) strain. The symptom associated with virus infection was hardly ever observed for mice inoculated with a mixture of the viral antigens and tetraglycine-l-octaarginine-linked hyaluronic acid, presumably due to high induction of IgG and IgA capable of cross-reacting to PR8 viruses. Less proliferation of PR8 viruses in those mice was also supported by an insignificant elevation of antibody levels through virus exposure. Our polysaccharide derivative enabled hosts to acquire adaptive immunity with cross-protective abilities against heterologous virus infection.


Assuntos
Adjuvantes Imunológicos/química , Reações Cruzadas/imunologia , Ácido Hialurônico/farmacologia , Vacinas contra Influenza/química , Influenza Humana/prevenção & controle , Influenzavirus A/imunologia , Adjuvantes Imunológicos/farmacologia , Administração Intranasal , Animais , Humanos , Ácido Hialurônico/química , Imunoglobulina A/metabolismo , Imunoglobulina G/metabolismo , Vírus da Influenza A Subtipo H1N1/imunologia , Camundongos , Oligopeptídeos/química
19.
BMC Infect Dis ; 19(1): 967, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718578

RESUMO

BACKGROUND: Seasonal influenza causes a considerable burden to healthcare services every year. To better measure the impact of severe influenza cases in Romania, we analyzed active surveillance data collected during the 2017-2018 season from patients admitted for influenza-like illness (ILI) at a tertiary care hospital in Bucharest. METHODS: Patients admitted for acute ILI were included if they were resident in the Bucharest-Ilfov region, had been hospitalized for at least 24 h, and had onset of symptoms within 7 days before admission. Patient demographics, healthcare use, vaccination status, and outcome data were collected by questionnaire or by searching clinical records. Respiratory swabs were also obtained from each patient to confirm influenza A (A/H1 and A/H3 subtypes) or influenza B (Yamagata and Victoria lineages) infection by real-time reverse-transcription polymerase chain reaction assay. RESULTS: The study included 502 patients, many (45.2%) of whom were aged < 5 years. Overall, 108 patients (21.5%) had one or more comorbidities. Seventeen adults aged 18-64 years (3.4%) had been vaccinated against influenza. Patients were hospitalized for a median of 5 days and most (90.4%) were prescribed antiviral treatment. More than one-half of the patients (n = 259, 51.6%) were positive for influenza. Most influenza cases were caused by B viruses (172/259, 66.4%), which were mostly of the B/Yamagata lineage (85 of 94 characterized, 90.4%). Most of the subtyped A viruses were A/H1 (59/74, 79.7%). A/H1 viruses were frequently detected in influenza-positive admissions throughout the 2017-2018 season, whereas the predominant B/Yamagata viruses were detected around the middle of the season, with a peak in cases at week 7 of 2018. Eleven patients were admitted to an intensive care unit; of these, one patient with confirmed B/Yamagata infection died. CONCLUSIONS: These results show that seasonal influenza results in considerable hospitalization in Bucharest-Ilfov, Romania and suggest vaccine coverage should be extended, especially to the youngest age groups. The data from this study should help inform and optimize national influenza healthcare policies.


Assuntos
Hospitalização/estatística & dados numéricos , Influenza Humana/diagnóstico , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Vírus da Influenza B/genética , Vírus da Influenza B/isolamento & purificação , Vacinas contra Influenza/imunologia , Influenza Humana/complicações , Influenza Humana/epidemiologia , Influenzavirus A/genética , Influenzavirus A/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Romênia/epidemiologia , Estações do Ano , Adulto Jovem
20.
Lancet Public Health ; 4(9): e473-e481, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31493844

RESUMO

BACKGROUND: The estimation of influenza-associated excess mortality in countries can help to improve estimates of the global mortality burden attributable to influenza virus infections. We did a study to estimate the influenza-associated excess respiratory mortality in mainland China for the 2010-11 through 2014-15 seasons. METHODS: We obtained provincial weekly influenza surveillance data and population mortality data for 161 disease surveillance points in 31 provinces in mainland China from the Chinese Center for Disease Control and Prevention for the years 2005-15. Disease surveillance points with an annual average mortality rate of less than 0·4% between 2005 and 2015 or an annual mortality rate of less than 0·3% in any given years were excluded. We extracted data for respiratory deaths based on codes J00-J99 under the tenth edition of the International Classification of Diseases. Data on respiratory mortality and population were stratified by age group (age <60 years and ≥60 years) and aggregated by province. The overall annual population data of each province and national annual respiratory mortality data were compiled from the China Statistical Yearbook. Influenza surveillance data on weekly proportion of samples testing positive for influenza virus by type or subtype for 31 provinces were extracted from the National Sentinel Hospital-based Influenza Surveillance Network. We estimated influenza-associated excess respiratory mortality rates between the 2010-11 and 2014-15 seasons for 22 provinces with valid data in the country using linear regression models. Extrapolation of excess respiratory mortality rates was done using random-effect meta-regression models for nine provinces without valid data for a direct estimation of the rates. FINDINGS: We fitted the linear regression model with the data from 22 of 31 provinces in mainland China, representing 83·0% of the total population. We estimated that an annual mean of 88 100 (95% CI 84 200-92 000) influenza-associated excess respiratory deaths occurred in China in the 5 years studied, corresponding to 8·2% (95% CI 7·9-8·6) of respiratory deaths. The mean excess respiratory mortality rates per 100 000 person-seasons for influenza A(H1N1)pdm09, A(H3N2), and B viruses were 1·6 (95% CI 1·5-1·7), 2·6 (2·4-2·8), and 2·3 (2·1-2·5), respectively. Estimated excess respiratory mortality rates per 100 000 person-seasons were 1·5 (95% CI 1·1-1·9) for individuals younger than 60 years and 38·5 (36·8-40·2) for individuals aged 60 years or older. Approximately 71 000 (95% CI 67 800-74 100) influenza-associated excess respiratory deaths occurred in individuals aged 60 years or older, corresponding to 80% of such deaths. INTERPRETATION: Influenza was associated with substantial excess respiratory mortality in China between 2010-11 and 2014-15 seasons, especially in older adults aged at least 60 years. Continuous and high-quality surveillance data across China are needed to improve the estimation of the disease burden attributable to influenza and the best public health interventions are needed to curb this burden. FUNDING: National Science Fund for Distinguished Young Scholars, National Science and Technology Major Project of China, National Institute of Health Research, the Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences, and the China-US Collaborative Program on Emerging and Re-emerging Infectious Disease.


Assuntos
Influenza Humana/mortalidade , Influenzavirus A , Vigilância da População , Transtornos Respiratórios/mortalidade , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Feminino , Carga Global da Doença/estatística & dados numéricos , Humanos , Lactente , Influenza Humana/complicações , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Transtornos Respiratórios/virologia , Adulto Jovem
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