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1.
MMWR Morb Mortal Wkly Rep ; 69(7): 177-182, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32078591

RESUMO

During the 2019-20 influenza season, influenza-like illness (ILI)* activity first exceeded the national baseline during the week ending November 9, 2019, signaling the earliest start to the influenza season since the 2009 influenza A(H1N1) pandemic. Activity remains elevated as of mid-February 2020. In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (1). During each influenza season, CDC estimates seasonal influenza vaccine effectiveness in preventing laboratory-confirmed influenza associated with medically attended acute respiratory illness (ARI). This interim report used data from 4,112 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during October 23, 2019-January 25, 2020. Overall, vaccine effectiveness (VE) against any influenza virus associated with medically attended ARI was 45% (95% confidence interval [CI] = 36%-53%). VE was estimated to be 50% (95% CI = 39%-59%) against influenza B/Victoria viruses and 37% (95% CI = 19%-52%) against influenza A(H1N1)pdm09, indicating that vaccine has significantly reduced medical visits associated with influenza so far this season. Notably, vaccination provided substantial protection (VE = 55%; 95% CI = 42%-65%) among children and adolescents aged 6 months-17 years. Interim VE estimates are consistent with those from previous seasons, ranging from 40%-60% when influenza vaccines were antigenically matched to circulating viruses. CDC recommends that health care providers continue to administer influenza vaccine to persons aged ≥6 months because influenza activity is ongoing, and the vaccine can still prevent illness, hospitalization, and death associated with currently circulating influenza viruses as well as other influenza viruses that might circulate later in the season.


Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vigilância da População , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Estações do Ano , Estados Unidos/epidemiologia , Adulto Jovem
2.
Medicine (Baltimore) ; 99(1): e18540, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895791

RESUMO

Infection with influenza virus increases morbidity and mortality in patients with risk factors, including cardiovascular disease (CVD). This study aimed to evaluate factors associated with influenza vaccination coverage in Korean CVD patients.We included 19,599 adults from the 2010 to 2012 Korea National Health and Nutrition Examination Survey. Influenza vaccination rates were compared in subjects with and without CVD. Logistic regression analysis was performed to identify factors associated with influenza vaccination in Korean adults with CVD before and after stratification for age (<65 and ≥65 years).Significantly higher vaccination rates were observed in individuals with CVD than in those without CVD (61.4% vs 31.0%, P < .001). However, young individuals (19-49 years) had decreased influenza vaccination rates, with no difference based on CVD status (20.3% vs 21.6%, P = .859). A lack of private insurance (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.23-0.98) and recent health screening (OR, 4.56; 95% CI, 1.90-10.92) were independent factors for influenza vaccination in CVD patients aged <65 years, whereas female sex (OR, 3.71; 95% CI, 1.24-11.07) and less education (OR, 4.59; 95% CI, 1.27-16.61) were independent factors in CVD patients aged ≥65 years.Improving influenza vaccination coverage for Korean adults with CVD is important, especially in young patients. For young patients with CVD, influenza vaccination status is independently associated with the presence of private insurance and recent health screening. This finding could help establish public health policies to promote influenza vaccination in this population.


Assuntos
Doenças Cardiovasculares/virologia , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia , Fatores de Risco
3.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 21-36, 2020 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-31914565

RESUMO

Influenza virus infection is a respiratory infectious disease. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290 000 to 650 000 deaths globally. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4). In 2018, the Chinese Center for Disease Control and Prevention issued the "Technical Guidelines for Seasonal Influenza Vaccination in China (2018-2019)" ( "Guide 2018" for short). To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2018 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2019-2020)" . The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season which included trivalent and quadrivalent influenza vaccine. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Vacinação/normas , Adolescente , Adulto , Criança , Pré-Escolar , China , Feminino , Humanos , Esquemas de Imunização , Lactente , Pessoa de Meia-Idade , Gravidez , Estações do Ano , Adulto Jovem
4.
MMWR Morb Mortal Wkly Rep ; 69(3): 72-76, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971934

RESUMO

Infants are at increased risk for pertussis-associated morbidity and mortality, and pregnant women and their infants are more likely than other patient populations to experience severe influenza-related illness (1,2). The Advisory Committee on Immunization Practices (ACIP) recommends that all women receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy, preferably during the early part of gestational weeks 27-36 (3). ACIP also recommends that women who are or might be pregnant during the influenza season receive the inactivated influenza vaccine at any time during pregnancy (4). Despite these recommendations, coverage with Tdap and influenza vaccines during pregnancy has been low, with approximately one half of women receiving each vaccine and only one third receiving both, based on a survey during March-April 2019 (5). Data obtained through a retrospective chart review of randomly selected pregnant women who delivered at the University of Florida Health Shands Hospital in Gainesville, Florida, from January 1, 2016, to December 31, 2018, were analyzed to assess vaccination coverage by insurance type. Because the Florida Medicaid policy at that time did not cover these vaccines during pregnancy, the hospital system offered Tdap and influenza vaccines at no additional cost to mothers during the immediate postpartum hospital stay. Among 341 women, 68.6% of privately insured and 13.4% with Medicaid received Tdap during pregnancy, and among 316 women, 70.4% of privately insured and 35.6% with Medicaid received influenza vaccine during pregnancy. Many women, especially those with Medicaid, were vaccinated in the immediate postpartum period, when vaccination was available at no cost, increasing Tdap vaccination rates to 79.3% for privately insured and 51.7% for women with Medicaid; influenza vaccination rates rose to 72.0% for privately insured and 43.5% for women with Medicaid. These data suggest that the state Medicaid policy to not cover these vaccines during pregnancy might have significantly reduced coverage among its enrollees.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas contra Influenza/administração & dosagem , Seguro Saúde/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Feminino , Florida , Humanos , Medicaid/estatística & dados numéricos , Gravidez , Setor Privado/estatística & dados numéricos , Estados Unidos , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 69(2): 40-43, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945035

RESUMO

Multiple genetically distinct influenza B/Victoria lineage viruses have cocirculated in the United States recently, circulating sporadically during the 2018-19 season and more frequently early during the 2019-20 season (1). The beginning of the 2019-20 influenza season in Louisiana was unusually early and intense, with infections primarily caused by influenza B/Victoria lineage viruses. One large pediatric health care facility in New Orleans (facility A) reported 1,268 laboratory-confirmed influenza B virus infections, including 23 hospitalizations from July 31 to November 21, 2019, a time when influenza activity is typically low. During this period, Louisiana also reported one pediatric death associated with influenza B virus infection. An investigation of the influenza B virus infections in Louisiana, including medical and vaccine record abstraction on 198 patients, primarily from facility A, with sporadic cases from other facilities in the state, found that none of the patients had received 2019-20 seasonal influenza vaccine, in part because influenza activity began before influenza vaccination typically occurs. Among 83 influenza B viruses sequenced from 198 patients in Louisiana, 81 (98%) belonged to the recently emerged B/Victoria V1A.3 genetic subclade. Nationally, to date, B/Victoria viruses are the most commonly reported influenza viruses among persons aged <25 years (2). Of the 198 patients in the investigation, 95% were aged <18 years. Although most illnesses were uncomplicated, the number of hospitalizations, clinical complications, and the reported pediatric death in Louisiana serve as a reminder that, even though influenza B viruses are less common than influenza A viruses in most seasons, influenza B virus infection can be severe in children. All persons aged ≥6 months should receive an annual influenza vaccination if they have not already received it (3). Antiviral treatment of influenza is recommended as soon as possible for all hospitalized patients and for outpatients at high risk for influenza complications (including children aged <2 years and persons with underlying medical conditions) (4).


Assuntos
Vírus da Influenza B/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Louisiana/epidemiologia , Estações do Ano , Adulto Jovem
6.
Br J Nurs ; 29(2): 120-121, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972120

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses government concerns about the low uptake of flu vaccination among frontline healthcare staff.


Assuntos
Pessoal de Saúde , Vacinas contra Influenza/administração & dosagem , Programas Obrigatórios , Humanos , Medicina Estatal , Reino Unido
7.
Acta Virol ; 63(4): 347-365, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802678

RESUMO

Influenza A viruses (IAVs) cause yearly repeating infections in humans. The current vaccination approach is based on the production of virus-neutralizing antibodies. Virus-neutralizing antibodies, however, are closely strain-specific due to the IAV variability. Therefore, antibodies produced during the previous influenza season do not provide sufficient protection against new infection, and, hence, annual revaccination is needed. The utilization of the influenza conserved stem domain of hemagglutinin (HA), the HA2 gp, led to a new vaccine design based on cross-reactive cellular and especially humoral immune responses represented by HA2-specific antibodies. The HA2-specific antibodies exhibit cross-reactivity with HA2 gp within one subtype or even among subtypes and play a role in protective immunity against influenza infection. There are several elimination mechanisms of viral replication mediated by HA2-specific antibodies. After recognition of the epitope, they prevent the conformational rearrangement of HA or the insertion of the fusion protein into the endosomal membrane and, consequently, the fusion pore formation. In this case, no release of viral genetic information into the target cell is enabled and virus cannot replicate. The HA2-specific antibodies are involved in the elimination of pathogen via the Fc fragment by activation of the cytotoxic mechanisms of innate immunity as are the antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-dependent phagocytosis (ADP), or complement-dependent cytotoxicity (CDC), resulting in virus elimination and earlier recovery of the host from the infection. Though the protective effect of HA2-specific antibodies on the course of IAV infection was shown, few cases of worsening of IAV infection mediated by HA2-specific antibodies have been described. The identification of antigenic epitopes on HA2 gp that induce antibodies with such deteriorating effect on influenza infection can help to eliminate the unsuitable epitopes of HA2 gp as immunogens during the design of heteroprotective vaccine against influenza and can remove the side effects linked with the observations mentioned above. Keywords: influenza A virus; HA2 stem domain of hemagglutinin; immunization strategies; HA2-specific antibodies.


Assuntos
Anticorpos Antivirais , Vírus da Influenza A , Influenza Humana , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/imunologia , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Humanos , Vírus da Influenza A/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/imunologia
8.
Soins Gerontol ; 24(140): 32-35, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31806176

RESUMO

Improving immunisation coverage for older adults is a public health issue. Since 2008, nurses have been authorised to vaccinate this population against influenza without a medical prescription. One study examined the opinions of a sample of 78 private duty nurses in Martinique on influenza and anti-tetanus vaccination of elderly populations. The majority of nurses said they were not in favour of vaccination.


Assuntos
Vacinas contra Influenza , Influenza Humana , Idoso , Atitude do Pessoal de Saúde , Humanos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Martinica , Enfermeiras e Enfermeiros , Vacinação
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1333-1349, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838802

RESUMO

Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have antigenic variation and changes frequently, which results in rapid and widespread transmission resulting in annual epidemics and outbreaks in population gathering places such as schools, kindergartens and nursing homes. WHO estimated that seasonal influenza epidemics could cause 3 to 5 million severe cases annually, and 290 000 to 650 000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) which includes split-virus influenza vaccine and subunit vaccine, and quadrivalent inactivated influenza vaccine (IIV4) which is split. Except a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients should pay for it. In 2018, China CDC issued the "Technical Guidelines for Seasonal Influenza Vaccination in China (2018-2019)" (Guide 2018). In the past year, new research evidences have been published both in China and abroad, and new seasonal influenza vaccine has been licensed in China. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the Influenza Vaccination Technical Working Group (TWG) of National Immunization Advisory Committee (NIAC) updated the Guide 2018 and compiled the "Technical Guidelines for Seasonal Influenza Vaccination in China (2019-2020)" . Major updates include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season was updated for both IIV3 and IIV4. The recommendations include: Points of vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons whom can accept more than one licensed, recommended and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6 to 59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or prior, 1 dose is recommended. People ≥9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the CDCs at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.


Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Guias de Prática Clínica como Assunto , Vacinação , Adulto , Idoso , Criança , Pré-Escolar , China , Cidades , Feminino , Humanos , Lactente , Gravidez , Estações do Ano
13.
Medicine (Baltimore) ; 98(47): e18035, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764822

RESUMO

Chronic obstructive pulmonary disease (COPD) patients are at a higher risk of development of lung cancer. Frequent exacerbations of COPD trigger the disease course to chronic inflammation which likely plays a role in the pathogenesis of lung cancer. Previous studies showed influenza virus infection is one of important causes for exacerbations of COPD. Therefore, the aim of this study was to know whether influenza vaccination could reduce the incidence of lung cancer in patients with COPD.This cohort study enrolled patients (≥55 years old) with a recorded diagnosis of COPD between January 1, 2000 and December 31, 2012 by using the Taiwan Health Insurance Database. A propensity score was calculated to reduce vaccine therapy selection bias. Cox proportional hazard regressions were used to investigate the association between the influenza vaccination and lung cancer incidence after adjusting for known confounding factors. Besides, we categorized the patients into 4 groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2-3, ≥4) to evaluate the dose-dependent effect on reducing lung cancer occurrence of lung cancer in COPD patients.Our study comprised of 28,752 eligible individuals from the COPD cohort database. Among them, 51% (14,630) received influenza vaccination; the rest (49%) of the COPD patients did not receive influenza vaccination. We observed that COPD patients receiving influenza vaccination had a lower risk of lung cancer (adjusted HR = 0.40, 95% CI (0.35-0.45), P < .001). We also founded comparable protective effect in both sexes and all age groups (55-64, 65-74, ≥75) regardless of influenza seasonality. Furthermore, dose-dependent protective effect could be seen after stratifying patients according to the total number vaccinations, the adjusted HRs for lung cancer risk were 0.48 (0.40-0.54) and 0.24 (0.20-0.29) for patients who received 2 to 3 and ≥4 vaccinations during the follow-up period.This population-based cohort study demonstrated that annual influenza vaccination administration could reduce incidence of lung cancer in COPD patients.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/complicações , Influenza Humana/prevenção & controle , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Esquemas de Imunização , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade
14.
BMC Infect Dis ; 19(1): 990, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752738

RESUMO

BACKGROUND: Since 1985, two antigenically distinct lineages of influenza B viruses (Victoria-like and Yamagata-like) have circulated globally. Trivalent seasonal influenza vaccines contain two circulating influenza A strains but a single B strain and thus provide limited immunity against circulating B strains of the lineage not included in the vaccine. In this study, we describe the characteristics of influenza B viruses that caused respiratory illness in the population in Italy over 13 consecutive seasons of virological surveillance, and the match between the predominant influenza B lineage and the vaccine B lineage, in each season. METHODS: From 2004 to 2017, 26,886 laboratory-confirmed influenza cases were registered in Italy, of which 18.7% were type B. Among them, the lineage of 2465 strains (49%) was retrieved or characterized in this study by a real-time RT-PCR assay and/or sequencing of the hemagglutinin (HA) gene. RESULTS: Co-circulation of both B lineages was observed each season, although in different proportions every year. Overall, viruses of B/Victoria and B/Yamagata lineages caused 53.3 and 46.7% of influenza B infections, respectively. A higher proportion of infections with both lineages was detected in children, and there was a declining frequency of B/Victoria detections with age. A mismatch between the vaccine and the predominant influenza B lineage occurred in eight out of thirteen influenza seasons under study. Considering the seasons when B accounted for > 20% of all laboratory-confirmed influenza cases, a mismatch was observed in four out of six seasons. Phylogenetic analysis of the HA1 domain confirmed the co-circulation of both lineages and revealed a mixed circulation of distinct evolutionary viral variants, with different levels of match to the vaccine strains. CONCLUSIONS: This study contributes to the understanding of the circulation of influenza B viruses in Italy. We found a continuous co-circulation of both B lineages in the period 2004-2017, and determined that children were particularly vulnerable to Victoria-lineage influenza B virus infections. An influenza B lineage mismatch with the trivalent vaccine occurred in about two-thirds of cases.


Assuntos
Vírus da Influenza B/isolamento & purificação , Influenza Humana/virologia , Monitoramento Epidemiológico , Humanos , Vírus da Influenza B/classificação , Vírus da Influenza B/genética , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Itália/epidemiologia , Filogenia , Estudos Retrospectivos , Estações do Ano
15.
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
16.
Artigo em Inglês | MEDLINE | ID: mdl-31738866

RESUMO

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2018 influenza season. In this observational surveillance system, cases were defined as patients admitted to any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency-matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 3 April to 31 October 2018 (the 2018 influenza season), 769 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 30% were elderly (≥65 years), 28% were children (<16 years), 6.4% were Aboriginal and Torres Strait Islander peoples, 2.2% were pregnant and 66% had chronic comorbidities. A small proportion of FluCAN admissions were due to influenza B (13%). Estimated vaccine coverage was 77% in the elderly (≥65 years), 45% in non-elderly adults with medical comorbidities and 26% in children (<16 years) with medical comorbidities. The estimated vaccine effectiveness (VE) in the target population was 52% (95% CI: 37%, 63%). There were a smaller number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2018 than in 2017, with the demographic profile reflecting the change in circulating subtype from A/H3N2 to A/H1N1.


Assuntos
Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H3N2/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Cobertura Vacinal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Relatórios Anuais como Assunto , Austrália/epidemiologia , Estudos de Casos e Controles , Feminino , Hospitalização , Hospitais , Humanos , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Gravidez , Vigilância de Evento Sentinela , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-31738867

RESUMO

Introduction: Maternal influenza vaccination was introduced in 2010 due to the high morbidity and mortality associated with influenza in pregnancy. The aim of this study was to assess the maternal influenza vaccination uptake in Northern Territory public hospitals and identify gaps to improve uptake. Methods: Birth data from Northern Territory (NT) public hospitals obtained from the Perinatal Register for deliveries in 2016 were merged with vaccination records from the NT immunisation register. Results: There were 3,392 viable pregnancies in NT public hospitals in 2016 with 45.6% vaccination coverage against influenza. There was a statistically significant difference in coverage with 68.5% in Indigenous vs 31.7% in non-Indigenous deliveries (p < 0.001), yielding an odds ratio of 4.67 (95% CI 4.02, 5.42) for maternal influenza vaccination across Indigenous status. Influenza vaccination coverage for preterm births (< 37 weeks) was low especially in non-Indigenous mothers at 27.2% vs 65.05% in Indigenous mothers (p < 0.001). A distinct immunisation administration pattern was noted for 2016 with 58.9% of vaccinations occurring between April and June regardless of Indigenous status and maternal gestational age. This correlated with the annual influenza immunisation campaign by the NT and Commonwealth. Conclusion: A year-round maternal influenza vaccination campaign is crucial to avoid missed opportunities and increase vaccination protection for mother and baby. Antenatal influenza vaccination campaign with health care workers education and increasing patient awareness should continue throughout the year.


Assuntos
Programas de Imunização , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cobertura Vacinal , Vacinação , Adolescente , Adulto , Feminino , Humanos , Influenza Humana/virologia , Pessoa de Meia-Idade , Mães , Northern Territory , Grupo com Ancestrais Oceânicos , Gravidez , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
19.
Aust N Z J Public Health ; 43(6): 558-562, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31617660

RESUMO

OBJECTIVES: To describe and compare vaccination coverage for Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) adults in 2004-05 and 2012-13, including the impact of national vaccination funding initiatives. METHODS: National Aboriginal and Torres Strait Islander Health cross-sectional surveys - 2004-05 (n=5,757) and 2012-13 (n=5,482) - were compared. Self-reported influenza and pneumococcal vaccination coverage among Indigenous adults was analysed by age, remoteness, gender and risk factor status. RESULTS: Influenza vaccination coverage among Indigenous adults in 2004-05 and 2012-13 remained low. While coverage increased for those aged 18-49 years from 23% to 29%, it declined for those aged ≥65 years from 84% to 74%. For remote areas, influenza coverage among those aged 50-64 years declined from 76% to 66%. Pneumococcal vaccination coverage remained very low and declined across all age groups in 2004-05 and 2012-13 (50-64 years: 30% to 23%). For remote areas, pneumococcal coverage declined among those aged 50-64 years from 52% to 32%. CONCLUSIONS: Indigenous adult vaccination coverage for influenza and pneumococcal disease remains unacceptably low. Between 2004-05 and 2012-13, declines occurred in pneumococcal vaccination coverage across all age groups ≥18 years. Despite national funding of influenza vaccine in 2010, there was no increase in influenza coverage, except for the 18-49-year age group. Implications for public health: Current approaches to promote, deliver and monitor vaccination of Indigenous adults are inadequate.


Assuntos
Serviços de Saúde do Indígena/estatística & dados numéricos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , Programas de Imunização/normas , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Grupo com Ancestrais Oceânicos , Cobertura Vacinal/tendências , Adulto Jovem
20.
Adv Exp Med Biol ; 1222: 69-73, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637606

RESUMO

This study seeks to define the level of antihemagglutinin antibodies, using the hemagglutination inhibition assay (HAI), in the serum of patients, stratified into seven age groups, in Poland during the influenza epidemic season of 2017/18. A quadrivalent influenza vaccine has been introduced in Poland as of this epidemic season, making it possible for the first time to conduct the analysis for four antigens: A/Michigan/45/2015 (H1N1) pdm09, A/Hong Kong/4801/2014 (H3N2), B/Brisbane/60/2008 - Victoria lineage, and B/Phuket/3073/2013 - Yamagata lineage. We found that the level of individual antihemagglutinin antibodies was different among the seven age groups studied; with the highest in patients of 5-9 years and 10-14 years of age. Interestingly, the protection factor, defined as the percentage of people with the level of antihemagglutinin antibodies of at least 1:40 after vaccination or due to a previous infection, was the highest for the antigen A/Hong Kong/4801/2014 (H3N2) in the same age groups (74% and 75%, respectively). Taking into account the dismal 3.6% of the vaccinated population in Poland, these findings point toward the sustained presence of an immune system response in patients after a prior influenza virus infection.


Assuntos
Anticorpos Antivirais/imunologia , Glicoproteínas de Hemaglutininação de Vírus da Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Feminino , Hemaglutininas , Humanos , Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A Subtipo H3N2 , Vírus da Influenza B , Influenza Humana/sangue , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Estações do Ano , Vacinação/estatística & dados numéricos , Adulto Jovem
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