febrero 21, 2012

Referencias sobre influenza

Año 12 Vol. 12 No. 1/Febrero 2012

Ana María Román de Carlos
Biblioteca “MV José de la Luz Gómez”
Facultad de Medicina Veterinaria y Zootecnia
Universidad Nacional Autónoma de México
México, D. F. C. P. 04510

 Fuente: Thomson Reuters Web of Knowledge
AU Brahmi, Nozha; M'rad, Aymen; El Ghord, Hatem; Kouraichi, Nadia; Thabet, Hafedh; Amamou, Mouldi
TI Acute respiratory damage in patients with pandemic 2009 AH1N1 influenza: Pulmonary function testing a year after?
SO ANNALS OF THORACIC MEDICINE. VL 6 IS 4 Pp. 241 - U61 DI 10.4103/1817-1737.84782 PD OCT-DEC 2011

 AU Smoljanovic, Mladen; Smoljanovic, Ankica; Mlikotic, Marijana
TI Predicting AH1N1 2009 influenza epidemic in Southeast Europe
SO CROATIAN MEDICAL JOURNAL. VL 52 IS 2 Pp. 115 - 125 DI 10.3325/cmj.2011.52.115 PD APR 2011
AB Aim To use the data on the AH1N1 2009 influenza epidemic in the Southern hemisphere countries to predict the course and size of the upcoming influenza epidemic in South-Eastern Europe (SEE) countries and other regions of the World with temperate climate. Method We used a comparative epidemiological method to evaluate accessible electronic data on laboratory-confirmed deaths from AH1N1 2009 influenza in the seasons 2009/2010 and 2010/2011. The studied SEE countries were Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Hungary, Kosovo, Macedonia, Montenegro, Romania, Serbia, and Slovenia, while Southern hemisphere countries were Argentina, Australia, Chile, New Zealand, Paraguay, Uruguay, and South Africa. Results In influenza season 2009/2010, Southern hemisphere countries with temperate climate reported 1187 laboratory-confirmed influenza AH1N1 2009 deaths (mortality rate 0.84/100 000; 95% confidence interval [CI], 0.50-1.24). SEE countries with similar climatic conditions reported 659 deaths and similar mortality rates (0.86/100 000, 95% CI, 0.83-1.10). In the whole Europe without the Commonwealth of Independent States countries (CIS, former Soviet Union), there were 3213 deaths (0.60/100 000; 95% CI, 0.65-0.93). In 2010/2011, Southern hemisphere countries reported 94 laboratory-confirmed deaths (mortality rate 0.07/100 000; 95% CI, 0.02-0.28) or only 7.9% of the previous season. SEE countries by the end of the 11th epidemiological week of 2010/2011 season reported 489 laboratory-confirmed deaths, with a mortality rate of 0.64/100 000 (95% CI, 0.26-0.96) or 74.2% of the previous season, which was significantly higher than in the Southern hemisphere countries (X(1)(2) = 609.1, P<0.001). In Europe without CIS countries, there were 1836 deaths, with a mortality rate of 0.34/100 000 (X(2)=153.3, P<0.001 vs SEE countries). Conclusion In the 2009/2010 season, SEE countries and Southern hemisphere countries had similar influenza AH1N1 2009 mortality rates. In the 2010/2011 season, the forecast of 10% increase in total mortality in SEE countries and Europe compared with the 2009/2010 season was significantly exceeded, while the expected impact of type-specific vaccines against influenza AH1N1 2009 was not achieved. Consumption of epidemic potential has greater importance for the prognosis of the course and size of influenza epidemic than the degree of vaccine immunity.

 AU Austria-Corrales, Fernando; Cruz-Valdes, Beatriz; Herrera-Kiengelher, Loredmy; Carlos Vazquez-Garcia, Juan; Salas-Hernandez, Jorge
TI Burnout syndrome among medical residents during the Influenza A H1N1 sanitary contigency in Mexico
AB Objective: To measure the degree of stress among medical residents at a Third Level Hospital in Mexico City during the sanitary contingency caused by the AH1N1 influenza virus. Methods: A transversal descriptive study with a non-probabilistic sample of 99 medical residents with different fields of specialization related to respiratory medicine. Researchers applied the Maslach Burnout Inventory questionnaire to evaluate three dimensions: emotional fatigue, depersonalization, and personal fulfillment. The survey was self-administered and anonymous, and the study was conducted during the first AH1N1 influenza virus outbreak (April 23 to May 10, 2009). During that period, the hospital underwent a process of reorganization that included cancelling vacation periods for all medical residents and adjusting duty rosters. Results: The highest proportion of medical residents with burnout syndrome was those in their second year of specialization in the area of pneumology. Results also showed that medical residents under 30 years of age had a higher probability of presenting burnout syndrome. No significant differences were found regarding the residents' place of origin.

 AU Olalla Sierra, Julian; de Ory Manchon, Fernando; Casas Flecha, Inmaculada; Montiel Quezel-Guerraz, Natalia; Salas Bravo, Daniel; CA Grp Trabajo Estudio MARBEGRIP
TI Asymptomatic Infection by Influenza AH1N1 Virus in Healthcare Workers. MARBEGRIP Study, Preliminar Results
AB Background: The proportion of asymptomatic individuals infected by influenza AH1N1v varies depending on the studies. Health personnel were exposed to the AH1N1v virus due to their professional activity, thus an high seroprevalence to the virus could be expected in the absence of symptomatology. The objective of this study was to determine the prevalence of asymptomatic individuals serologically positive for influenza AH1N1v virus. Methods: A cohort based prospective study on hospital staff was proposed according to an hypothetic decreasing gradient of exposure to the virus, from emergency personnel to medical and surgical areas, and auxiliary staff other than emergency personnel. Serum sample from each participant was taken in September-October, 2009, November-December, 2009, and in April-May, 2010; and a health questionnaire was simultaneously filled out. Specific antibodies against influenza AH1N1v were detected by hemagglutination inhibition test. Eighteen hospitals (1,371 individuals) participated in the study. Results: Health questionnaire and serological results from four hospitals are available. A variable proportion of non vaccinated individuals showed positive serology (5.6-83%). Only 19.4% of subjects received vaccine, with a variable rate of positive serology (18.8-64.7%). Positive serology was significantly lower in non medical participants. In addition, vaccine coverage was higher in medical personnel than in the rest of professional categories Conclusions: There was a variable percentage of influenza AH1N1v seropositive individuals who had not suffered clinical symptomatology. This serological study detects differences on vaccine efficacy.

 AU Hincapie, Doracelly; Ospina, Juan; E Arabnia, HR; Tran, QN
TI Algebraic Analysis of Social Networks for Bio-surveillance: The Cases of SARS-Beijing-2003 and AH1N1 Influenza-Mexico-2009
SO SOFTWARE TOOLS AND ALGORITHMS FOR BIOLOGICAL SYSTEMS. SE Advances in Experimental Medicine and Biology. VL 696 Pp. 751 - 761 DI 10.1007/978-1-4419-7046-6_77 PD 2011
AB Algebraic analysis of social networks exhibited by SARS-Beijing-2003 and AH1N1 flu-Mexico-2009 was realized. The main tools were the Tune polynomials and Maple package Graph-Theory. The topological structures like graphs and networks were represented by invariant polynomials. The evolution of a given social network was represented like an evolution of the algebraic complexity of the corresponding Tune polynomial. The reduction of a given social network was described like an involution of the algebraic complexity of the associated Tune polynomial. The outbreaks of SARS and AH1N1 Flu were considered like represented by a reduction of previously existing contact networks via the control measures executed by health authorities. From Tutte polynomials were derived numerical indicators about efficiency of control measures.

 AU Calvo, Cristina; Gonzalez-Carrasco, Ersilia; Quevedo, Sergio; Garcia-Garcia, Maria Luz; Rando, Alvaro; Ledesma, Juan; Calderon, Ana; Pozo, Francisco; Perez-Brena, Pilar; Casas, Inmaculada
TI Variability of Influenza AH1N1 Infections in a Neonatal Unit in Spain
SO NEONATOLOGY. VL 100 IS 3 Pp. 282 - 284 DI 10.1159/000324232 PD 2011
AB We describe three positive influenza AH1N1 cases in a neonatal unit during the influenza pandemic in Spain. One term baby presented with an upper respiratory tract infection, another preterm infant with an apnea episode following nosocomial infection, and thirdly, a term infant of a mother with influenza AH1N1 had severe respiratory distress and pneumothoraces needing high-frequency ventilation.

 AU Riera, Melchor; Payeras, Antoni; Marcos, Maria A.; Viasus, Diego; Farinas, Maria C.; Segura, Ferran; Torre-Cisneros, Julian; Martin-Quiros, Alejandro; Rodriguez-Bano, Jesus; Vila, Juan; Cordero, Elisa; Carratala, Jordi
TI Clinical presentation and prognosis of the 2009 H1N1 influenza A infection in HIV-1-infected patients: a Spanish multicenter study
SO AIDS. VL 24 IS 16 Pp. 2460 - 2466 DI 10.1097/QAD.0b013e32833e508f. PD OCT 23 2010
AB Objective: The aim of the study was to describe the clinical presentation and prognosis in HIV-1-infected patients with hospital admission and pandemic influenza A 2009 (H1N1) confirmed, and compare this data with those of a general population. Design: This is a prospective study in nature. Methods: All adult patients admitted to 13 hospitals in Spain with confirmed influenza A 2009(H1N1) virus infection by real-time reverse transcriptase PCR assay or culture from June 12 to November 10, 2009 were recruited and followed up until 1 month after discharge. In the HIV group risk factors for HIV infection, AIDS criteria, last CD4 cell count and viral load, and antiretroviral therapy and pneumococcal vaccines were collected. Results: Five hundred and eighty-five patients were recruited, 26 with HIV-1 infection and 559 non-HIV. The HIV patients had a long-term well controlled infection with a median CD4 cell count 503 cells/mu l and 84% with undetectable viral load, although more frequently they had chronic liver and chronic obstructive pulmonary disease. No significant differences were observed about reported symptoms and physical findings on hospital admission. About 50% of patients in both groups present radiological infiltrates and 30% present respiratory failures.  Practically all the patients in both groups received influenza antiviral therapy and in each group 80% received antibacterial therapy. No differences were observed in clinical outcomes. Conclusion: In HIV patients, well controlled on HAART, the pandemic influenza virus AH1N1 had a similar clinical outcome and prognosis to that of non-HIV patients. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

 AU Staniceanu, F.; Cercel, A. Streinu; Popp, C.; Zurac, S.; Nichita, L.; Gramada, E.; Bastian, A.; Micu, G.
TI Pulmonary lesions in 97 fatal cases of pandemic influenza AH1N1 viral infections in Romania
SO HISTOPATHOLOGY. VL 57 Pp. 176 - 176 SU 1 PD OCT 2010
CT 28th International Congress of the International-Academy-of-Pathology. OCT 10-15, 2010. Sao Paulo, BRAZIL. Int Acad Pathol
 AU Mayoral Cortes, Jose Maria; Ruiz Fernandez, Josefa Pachon Diaz, Jeronimo; Navarro Mari, Jose Maria; Puell Gomez, Luz; Perez Morilla, Esteban; Gallardo Garcia, Virtudes; Duran Pla, Enric; Fernandez Merino, Juan Carlos; Pajares Bernaldo-Quiros, Ignacio; Murillo Cabeza, Francisco; Perez Ruiz, M.; Guillen Enriquez, Javier; Carlos Carmona, Juan; Anderica Frias, Gloria
TI Infection by the pandemic virus (H1N1) 2009 in Andalusia
AB In April 2009, in response to the WHO's alert due to the existence of human infection cases with a new AH1N1 influenza virus, known as swine flu, Andalusian Health Authorities trigger an specific action plan. The surveillance actions developped provided us with appropriate clinical, epidemiological and virological characteristics of the disease. During the first few days, contingency plans were set up based on epidemiological surveillance and outbreak control measures were adopted through early alert and rapid response systems. After phase 6 was declared, influenza sentinel and severe cases surveillance were used in order to plan healthcare services, to reduce transmission and to identify and protect the most vulnerable population groups. Behaviour of pandemic influenza in Andalusia was similar to that observed in the rest of the world. Atack rate was similar to a seasonal flu and the peak was reached at the 46th/2009 week. Most of them were mild cases and affected particularly to young people. The average age of hospitalised patients was 32. Prior pulmonary disease, smoking and morbid obesity (BMI>40) were the most common pathologies and risk factors in severe cases. An impact scenario of pandemic wave in Andalusia, with unexpected attack rate from 2 to 5%, was prepared considering watt observed in the southern hemisphere. Characteristics of the epidemic concerning its extent, severity and mortality rate were adjusted to this scenario.

 AU Staniceanu, F.; Streinu-Cercel, A.; Zurac, S.; Nichita, L.; Popp, C.; Micu, G.; Gramada, E.; Bastian, A.; Andrei, R.; Socoliuc, C.; Olariu, M.
TI Risk factors for fatal outcome in AH1N1 influenza patients
SO VIRCHOWS ARCHIV. VL 457 IS 2 Pp. 278 - 278 PD AUG 2010

 AU Boonchai, Waranya; Iamtharachai, Pacharee
TI The pH of Commonly Available Soaps, Liquid Cleansers, Detergents and Alcohol Gels
SO DERMATITIS. VL 21 IS 3 Pp. 154 - 156 DI 10.2310/6620.2010.10003 PD MAY-JUN 2010
AB Background: The hydrogen ion concentration (pH) of a cleanser certainly has an impact on skin condition. Dermatologists always need to recommend a cleanser to patients with hand dermatitis or sensitive skin; particularly during the outbreak of swine (AH1N1 virus) influenza, frequent hand washing and alcohol gel cleansing were greatly recommended. Objectives: The purpose of this study was to evaluate the pH of various commonly available cleansers and alcohol gels on the market to assess patient comfort in using such products and to make good recommendations to our patients. Methods: Multiple brands of liquid cleansers, dishwashing liquids, soaps, laundry detergents, and alcohol gels commonly available on the market were assessed for pH by using a pH meter and pH-indicator strips. The pH assessment imitated real-life conditions by diluting each cleanser with tap water and then comparing the changed pH. Results: The pH levels of liquid cleansers, dishwashing liquids, a beauty bar, and alcohol gels were acidic to neutral and compatible with normal skin pH. Most bar soaps, baby soaps, and powdered laundry detergents had a pH in the alkali range. The pH of concentrated cleansers was slightly different from that of their dissolved forms. Conclusion: Regarding the antiseptic property and pH of the cleansers, alcohol gels with moisturizers appeared to be the best hand cleansers to recommend to our patients.

 AU Canals L, Mauricio; Canals C, Andrea
TI Percolation of influenza AH1N1 epidemic in the world: Usefulness of the spatial-connectivity models
SO REVISTA MEDICA DE CHILE VL 138 IS 5 Pp. 573 - 580 PD MAY 2010
AB Background: The 2009 AH1N1 epidemics expanded rapidly around the world by the current connectivity conditions. The spread of can be described by the phenomenon of percolation, that allows the estimation of the threshold conditions that produce connectivity between different regions and that has been used to describe physical and ecological phenomena. Aim: To analyze the spread of AH1N1 epidemic based on information from the WHO. Material and Methods: The world was considered as composed of a set of countries and regular cells. The moment when the percolation occurred was analyzed and logistic regressions were adjusted to the change in the proportion of infected units versus time, comparing predicted and observed rates. Results: Percolation occurred in America on day 15, in Eurasia on day 32 and in the world on day 74. The models showed adequate predictive capacity. The predictions for the percolation of the epidemic in the world varied between days 66 mid 75. The prediction based on countries was better than that based on cells. Conclusions: These results show that percolation theory fits well to the spread of epidemics. Predictions based only on data on-off (infected non infected) and in the progression of the proportion of infected cells are a good way of predicting the spread of an epidemic and when this crosses a region geographically. (Rev Med Chile 2010; 138: 573-580).

 AU Canals L, Mauricio
TI Short-term predictability of influenza AH1N1 cases based on deterministic models
AB Influenza AH1N1 severely affected the population of Chile. It has high transmissibility, which may stress the health system capacity. An adequate prediction of number of cases and frequency of complications is needed. Chilean and OMS dialy reports of cases from April to Jun 2009 were analyzed in this study. We developed a simple methodology for short-term forecast of case number, based on deterministic models. Predicted and observed values were compared with regression analyses and Bland-Altman diagrams. We found that the intrinsic rate of increase of the number of cases in the world and in Chile, after an initial high instability, decreases to stable values, allowing a relatively accurate forecasting the next day and for a serial period. The estimators obtained are over-estimators, which allow an adequate safety factor for the estimations. The method is easy to implement in software for routine use and can be useful in monitoring this epidemic and others in the future.

 AU Vizcaya, C.; Ferres, M.; Perret, C.; Martinez, C.; Godoy, P.; Contreras, A. M.; Ferrer, P.; Azocar, T.
TI Evaluation of direct immunofluorescent assay (DFA) and rapid antigen test (RAT) for diagnosis of new pandemic influenza A H1N1 2009 (FLU AH1N1) during first wave in Santiago, Chile
SO INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES. VL 14 Pp. E100 - E101 DI 10.1016/j.ijid.2010.02.1709 SU 1 PD MAR 2010

 AU Sandoval, C.; Vizcaya, C.; Perret, C.; Ferres, M.; Martinez, C.; Godoy, P.; Ferrer, P.; Monge, M.; Abarca, K.; Castillo, A.; Potin, M.; Lopez, J. C.
TI Clinical and epidemiology characterization of children hospitalized with influenza A H1N1 (FLU AH1N1) during the first wave of 2009 outbreak, Santiago, Chile
SO INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES. VL 14 Pp. E423 - E424 DI 10.1016/j.ijid.2010.02.562 SU 1 PD MAR 2010

 AU Dabanch Pena, J.
TI Clinical Spectrum of Disease. Influenza AH1N1 2009
SO INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES. VL 14 Pp. E8 - E8 DI 10.1016/j.ijid.2010.02.1495 SU 1 PD MAR 2010

 AU Carrillo-Esper, Raul; Ornelas-Arroyo, Sofia; Perez-Bustos, Estela; Sanchez-Zuniga, Jesus; Uribe-Esquivel, Misael
TI Rhabdomyolysis and acute renal failure in human influenza A H1N1 mediated infection
AB Rabdomiolysis and acute renal failure secondary to influenza infection are rare. Up to now, few cases have been reported and most of them are primarily, among children. Myositis associated to influenza infection is caused by the toxic effect of the virus in the muscular fiber, a dysregulation of inflammatory citokines and a cross reaction between the muscle fiber and the Oral particles. We present the case of a 57 Year old male with a diagnosis of H1N1 influenza who developed polyuria, oligoanuria, elevation of lactic deshidrogenase, myoglobin, creatinin phosphokinase and an electromyography with a myopathic pattern. The diagnosis of radbomyolisis and acute renal failure were made, haemodyalisis was started and the patient improved satisfactorily. This is the first report of a patient with radmoyolisis and acute renal failure secondary to AH1N1 influenza treated during the Mexico epidemic.

 AU Ellis, J.; Iturriza, M.; Allen, R.; Bermingham, A.; Brown, K.; Gray, J.; Brown, D.
AB The sensitivity and specificity of four real-time PCR assays (HPA A(H1) v, CDC A (H1) v, HPA A(N1) v and NVRL S-OIV assays) were evaluated for detection of influenza A(H1N1) v viruses. Nose and throat swab samples containing influenza A(H1N1) v viruses, seasonal influenza AH3N2, AH1N1, influenza B viruses, or negative for influenza viruses were tested by the four assays. Specificity was also analysed using influenza A viruses of different subtypes and non-related respiratory viruses. The sensitivities and specificities of the four assays were in a similar range and suitable for diagnostic use. The HPA (H1) v and the S-OIV assays were the most sensitive assays for use as a first line test, but the S-OIV assay was less specific, detecting all avian subtypes of influenza A viruses tested. The results of this study demonstrate that the concurrent use of primary diagnostic and confirmatory assays provides rapid and accurate assessment of confirmed cases, and allows appropriate management of patients.

 AU Franco-Paredes, Carlos; del Rio, Carlos; Carrasco, Peter; Santos Preciado, Jose Ignacio
TI The response in Mexico to the current influenza AH1N1 outbreak

 AU Mochida, Kyo; Ogawa, Tetsuro
TI Anti-influenza virus activity of extract of Japanese wasabi leaves discarded in summer
SO JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE. VL 88 IS 10 Pp. 1704 - 1708 DI 10.1002/jsfa.3268 PD AUG 15 2008
AB BACKGROUND: Japanese wasabi (Wasabia japonica) is now habitually used as a spice in some kinds of Japanese foods, and its pungent taste and flavor are preferred. Generally, rhizomes and winter leaves are used as a spice and for processed foods such as pickled wasabi. Since the leaf area of summer leaves is far greater than that of winter leaves, they are not used for food, and are discarded. Thus, we need to develop an effective use for summer leaves. We investigated anti-influenza virus activity in these summer leaves as a new function. RESULTS: Seventy percent ethanol extracts of leaves harvested in July exhibited a high replication inhibition rate (98% or higher) in the type A strain (AH1N1, A/shimane/48/2002), its subtype (AH3N2, Alshimane/122/2002), and type B strain (B/shimane/2/2002). The extracts of summer leaves exhibited the same anti-influenza virus activity as winter leaves, and showed a stronger activity than stems, roots, and rhizomes. CONCLUSION: A potent anti-influenza virus activity was discovered in summer leaves of Japanese wasabi. The ethanol extracts inhibited influenza virus replication regardless of the hemagglutinin antigen type. Therefore, such extracts are expected to be a promising source of a novel anti-influenza virus agent. (c) 2008 Society of Chemical Industry.

 AU Huang, Q. Sue; Lopez, Liza D.; McCallum, Lisa; Adlam, Bruce
TI Influenza surveillance and immunisation in New Zealand, 1997-2006
SO INFLUENZA AND OTHER RESPIRATORY VIRUSES. VL 2 IS 4 Pp. 139 - 145 DI 10.1111/j.1750-2659.2008.00050.x PD JUL 2008
AB Background The national influenza surveillance in New Zealand is an essential public health component for assessing and implementing strategies to control influenza. Objective The aim of this study is to report the national influenza surveillance data collected during 1997-2006 in terms of the community disease burden, circulating viral strains, hospitalisations, mortality, and immunisation coverage. Methods The national influenza surveillance system includes sentinel general practice surveillance, laboratory-based surveillance, and hospital admission and mortality surveillance and immunisation coverage. The results obtained during 1997-2006 were analysed. Results When the last 10 years were compared to the previous trend of influenza-like illness rates in the community. Sentinel surveillance also showed that children aged 0-4 years were the most affected. Influenza-related hospitalisation surveillance reported an increasing trend of hospital admissions particularly in children aged 0-19 years. Introduction of routine influenza vaccination among the New Zealand elderly was associated with a significant decrease of influenza-related mortality. Conclusions This report demonstrates that an integrated virological and epidemiological surveillance system for influenza is essential for monitoring the disease burden, identifying circulating strains, guiding effective vaccination and planning for a potential pandemic.

 AU Al Faress, Shaker; Ferraris, Olivier; Moules, Vincent; Valette, Martine; Hay, Alan; Lina, Bruno
TI Identification and characterization of a late AH1N2 human reassortant in France during the 2002-2003 influenza season
SO VIRUS RESEARCH. VL 132 IS 1-2 Pp. 33 - 41 DI 10.1016/j.viruses.2007.10.007 PD MAR 2008
AB We have previously shown a clear differential genetic evolution of the hemagglutinin (HA) of human AH1N1 and AH1N2 viruses, isolated in southern France between 2001 and 2004. However, our analysis revealed that one single AH1N2 isolate, detected in 2003 (A/Lyon/0838/2003), had its HA clustering within the HAs of the AH1N1 subtypes. To determine if this virus was a new reassortant, the nucleotide sequences of its eight RNA gene segments were compared with those of five representative strains of the AH1N1, AH1N2 and AH3N2 viruses, isolated during the same time-period. According to the sequences obtained, the neurammidase (NA) gene segment of the A/Lyon/0838/2003 (H1N2) virus was genetically closely related to those of the AH1N2 viruses, whereas the six internal genes appeared to be clustering with those of the AH1N1 viruses. This suggested that the A/Lyon/0838/2003 (H1N2) virus was the result of a second reassortment event that had occurred during the winter of 2002-2003; the N2 gene segment of an AH1N2 virus being introduced into an AH1N1 genetic background. Subsequently, we analysed the extremities of each gene segment of the viruses from the different subtypes, and experimentally reproduced, in vitro, AH1N2 reassortant viruses through co-infection of Madin-Darby canine kidney (MDCK) cells with both AH1N1 and AHIN2 viruses, isolated in the 2002-2003 influenza season. While the comparison of the AH1N1 and the AH1N2 gene segment extremities revealed no major differences, we successfully reproduced an AH1N2 reassortant virus similar to the A/Lyon/0838/2003 (H1N2) virus. This result provided an experimental evidence of the compatibility between their respective surface H1 and N2 glycoproteins, and suggests that similar events may occur silently amongst human subtypes. (c) 2007 Elsevier B.V. All rights reserved.

 AU Oropesa, S; Acosta, B; Pinon, A; Andreus, H; Hernandez, B; Borrego, I; Llanes, J; BE Kawaoka, Y
TI The impact of influenza vaccination in the reduction of morbidity and in the exacerbation in asthmatic patients
AB Background: Vaccine campaigns against flu in Cuba increased for those groups at risk of developing complications, such as persons with chronic heart or lung diseases, including asthmatics. Several statements justify the study of asthmatic persons with the objective of reducing morbidity, mortality, exacerbations of asthma and the use of antibiotics. Humoral response of a group of asthmatic persons, generated by the commercial vaccine Agrippal S-1 (Biocine s.p.a., Siena, Italy), was evaluated for the influenza virus during the 2000-2001 season. The efficacy and effectiveness of the influenza vaccine to prevent clinical flu infection and exacerbations in a population with asthma (one vaccine dose) was studied. Materials and methods: The study was carried out during the 2000-2001 season, with Agrippal S1 (Chiron Vaccines), containing the influenza strains (formula recommended by WHO for this season). In all, 45 patients received one dose. The sera were measured before vaccination and I month after by hemagglutination test (IH). Statistical analysis was made using the Student's test. Results: The IH test demonstrated the capacity of the vaccine to stimulate the production of antihemagglutinin antibody levels. The positive cases for the subtypes H3N2 and H1N1 were 57.8% before vaccination and 95.6% and 84.4% after vaccination; and, for type 13, 4.4% before and 44.4% after vaccination. There was an increment in the GMT subtype, AH3N2, from 11.7 to 39.4; AH1N1 from 14.9 to 76.2 and type B from 5.2 to 9.7. The family doctor did not report any cases of acute flu or asthma crisis during the year after vaccination, reduction of the morbidity, hospitalizations due to pneumonia and reduction of antibiotic use. Conclusions: The vaccination (one dose) achieved satisfactory levels of antibodies for the strains H3N2 and H1N1. These were low for type B. The real results of the vaccination were very effective. There were neither acute cases of flu nor exacerbations of asthma after vaccination during the following year. The study concluded that the inactivated influenza vaccine is safe to administer to adults and children with asthma, including those with severe asthma. In Cuba, influenza vaccination rates increased, demonstrating the convenience of annual vaccination in high-risk groups. (C) 2004 Published by Elsevier B.V.
CT 5th International Conference on Options for the Control of Influenza
CY OCT 07-11, 2003
CL Okinawa, JAPAN
SP Pharmaceut Manufacturers Assoc Tokyo; Pharmaceut Assoc Osaka; Wyeth Vaccine; MedImmune; Fujirebio; Nagoya City Univ; Takara Bio; Rikaken; Japan Bio Sci Lab; Japanese Soc Control Influenza; Japanese Fdn Promot Int Med Res Corp; Japanese Soc Virol; Japanese Soc Clin Virol; NPO Biomed Sci Assoc; WHO; Minist Hlth, Labor & Welfare Japan

 AU Maeda, A; Kohdera, U; Fujieda, M; Kase, T; Hirota, Y; Kawaoka, Y
TI Evaluation of inactivated influenza vaccine in children aged 6-36 months
AB Approximately 40 children aged 6-36 months were enrolled in a study to evaluate the immunogenicity of the trivalent influenza sub-unit vaccine in the 1999/2000 and 2000/2001 influenza seasons. In 1999/2000, the vaccine dose was 0.1 ml for children aged 6-11 months and 0.2 ml for those aged 12+ months, according to the formulary in Japan. In 2000/2001, the vaccine dose was 0.25 ml, irrespective of age, according to the recommendations of the Advisory Committee on Immunization Practices (ACIP). All children were given two doses approximately 4 weeks apart each year. In 1999/2000, the geometric mean titers and frequency of achieved, protective antibody titers (greater than or equal to 1:40) of children under 12 months of age to those aged 12+ months was 26.3 +/- 4.5 vs. 30.9 +/- 2.1 (p=0.582) and 50% vs. 52% (p=0.0954) for AH1N1 and 42.9 +/- 6.4 vs. 192.5 +/- 4.3 (p=0.029) and 60% vs. 87% (p=0.063) for AH3N2 at 4 weeks after the second vaccinations. In 2000/2001, the geometric mean titers of children under 12 months of age to those aged 12+ months was 17.5 +/- 2.9 vs. 126.5 +/- 4.2 (p=0.002) for AH1N1 and 20.1 +/- 2.0 vs. 66.7 +/- 4.5 (p=0.039) for AH3N2, respectively, and the frequency of achieved, protective antibody titers was 29% vs. 78% (p=0.010) and 43% vs. 67% (p=0.239), respectively. Risk factors including age, vaccine dose (1999/2000 season), vaccination of last year and pre-vaccination titer were assessed by univariate and multivariate analysis to evaluate their associations with the frequency of a four-fold or greater titer rise when comparing HI titers for specimens obtained 4 weeks after the second vaccination and before the first vaccination. In 1999/2000, an independent negative effect was observed for age. In 2000/2001, children under 12 months of age had a lower risk than those over 12+ months for a four-fold or greater titer rise, OR 0.4 (CI 0.05-3.04) for AH1N1 and OR 0.6 (CI 0.11-3.88) for AH3N2. The children under 12 months seemed to exhibit a reduced response to the influenza sub-unit vaccine. The observed values were not statistically significant because our study population was small. These results strongly suggest the necessity for influenza vaccine administration for all household contacts and out-of-home caretakers of children under 12 months old. (C) 2004 Elsevier B.V. All rights reserved.
CT 5th International Conference on Options for the Control of Influenza
CY OCT 07-11, 2003
CL Okinawa, JAPAN
SP Pharmaceut Manufacturers Assoc Tokyo; Pharmaceut Assoc Osaka; Wyeth Vaccine; MedImmune; Fujirebio; Nagoya City Univ; Takara Bio; Rikaken; Japan Bio Sci Lab; Japanese Soc Control Influenza; Japanese Fdn Promot Int Med Res Corp; Japanese Soc Virol; Japanese Soc Clin Virol; NPO Biomed Sci Assoc; WHO; Minist Hlth, Labor & Welfare Japan

 AU Bouwman, JJM; Visseren, FLJ; Bosch, MC; Bouter, KP; Diepersloot, RJA
TI Procoagulant and inflammatory response of virus-infected monocytes
SO EUROPEAN JOURNAL OF CLINICAL INVESTIGATION. VL 32 IS 10 Pp. 759 - 766 DI 10.1046/j.1365-2362.2002.01041.x PD OCT 2002
AB Background Monocytes play a prominent role in inflammation, coagulation and atherosclerosis by their ability to produce tissue factor (TF) and cytokines. The aim of the present study was to establish whether virus-infected monocytes initiate coagulation. In addition, the production of cytokines by monocytes may accelerate the chronic process of atherosclerosis and may contribute to coronary syndromes by eliciting plaque instability. Materials and methods Monocytes were isolated by Vacutainer(R), BD Biosciences, Alphen aan den Rijn, Netherlands and subsequent magnetic cell sorting (MACS(R), Milteny Biotec, Bergish Gladbach, Germany). Coagulation times in normal pooled plasma and Factor VII-deficient plasma were measured after infection with cytomegalovirus (CMV), Chlamydia pneumoniae (Cp) and influenza A\H1N1. Anti-TF antibodies were added to neutralize TF expressed on monocytes. Interleukins (IL) 6, 8 and 10 were measured in the supernatants. Results Chlamydia pneumoniae- and CMV-infected monocytes decreased the clotting time by 60%, and influenza-infected monocytes by 19%, as compared to uninfected monocytes. Procoagulant activity was absent when Factor VII-deficient plasma or anti-TF antibodies were used. Monocytes produced both IL-6 and IL-8 after infection with CMV (317 pg mL(-1) and 250 pg mL(-1)) or Cp (733 pg mL(-1) and 268 pg mL(-1)). Similar results were obtained for influenza virus-infected monocytes, but the levels of both cytokines were 3-5-fold higher (1797 pg mL(-1) and 725 pg mL(-1)). Interleukin-10 was not produced by infected monocytes. Conclusion The procoagulant activity of virus-infected monocytes is TF-dependent. Although influenza infection did not generate a significant reduction in clotting time, the pronounced expression of IL-6 and IL-8 may induce local and/or systemic inflammatory reactions, which may be associated with plaque rupture and atherosclerosis. The lack of production of the anti-inflammatory cytokine IL-10 may even accelerate these processes.

 AU Gregory, V; Douglas, AR; Lin, YP
TI The evolution of human influenza viruses
AB The evolution of influenza viruses results in (i) recurrent annual epidemics of disease that are caused by progressive antigenic drift of influenza A and B viruses due to the mutability of the RNA genome and (ii) infrequent but severe pandemics caused by the emergence of novel influenza A subtypes to which the population has little immunity. The latter characteristic is a consequence of the wide antigenic diversity and peculiar host range of influenza A viruses and the ability of their segmented RNA genomes to undergo frequent genetic reassortment (recombination) during mixed infections. Contrasting features of the evolution of recently circulating influenza AH1N1, AH3N2 and B viruses include the rapid drift of AH3N2 viruses as a single lineage, the slow replacement of successive antigenic variants of AH1N1 viruses and the co-circulation over some 25 years of antigenically and genetically distinct lineages of influenza B viruses. Constant monitoring of changes in the circulating viruses is important for maintaining the efficacy of influenza vaccines in combating disease.
CT Discussion Meeting on the Origin and Control of Pandemic Influenza
CY APR 25-26, 2001

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