Acute Viral Respiratory Disease Research Articles

TREATMENT OF PREGNANT WOMEN WITH A POLYHYDRAMON

Introduction. Treatment of polyhydramnios as a consequence of the infectious processis a difficultt ask because it requires urgent results. In the case of in sensitivity to conditionally pathogenic or pathogenic microflora, or the presence of viruses, delay in treatment can lead to intrauterine infection of the fetus.The aim of the study. To evaluate the efficacy of treatment of viral genesis polyhydramnion.Materials and Methods. Clinical and laboratory examination and treatmentof 60 pregnant women with polyhydramnion and the presence of an acute respiratory viral disease or isolated herpes simplex virus. The methods of study used were external obstetric examination, ultrasound, microscopic, bacteriological, immunofluorescence, enzyme immunoassay.Results. Рregnant women are divided in to two subgroups: the first subgroup immediately assigned immunocorrectiveantiviral drugs (n=30), the second – antimicrobial drugs, which proved to be ineffective, leading to changes in treatment (n=30). For the treatment immunocorrective preparations of flavonoidgly cosides are used – drops in a dose of 12 drops twice a day per os for 10-15 minutes before meals. After 7-10 days of application of the drug in 67 % of polyhydramnion decreased, in 14 days in 87 %, no signs of polyhydramnion.Conclusions. The pathogenetic treatment of polyhydramnion the use of antiviral drugs is a safe highly effective method of treating polyhydramnion, leads to recovery in 87% within 10-14 days, in other cases, to positive dynamics, which requires long-term treatment.

Тридцатилетний опыт применения пептидных тимомиметиков в профилактике и лечении острых респираторных вирусных заболеваний и гриппа

Тридцатилетний опыт применения пептидных тимомиметиков в профилактике и лечении острых респираторных вирусных заболеваний и гриппа

Cloud service for the differential clinical diagnostics of acute respiratory viral diseases (including those associated with highly contagious coronaviruses) with an application of methods of artificial intelligence

Increasing population density and mobility contribute to the high incidence of the acute respiratory viral infections and the emergence of dangerous epidemic situations associated with them The XXI century began with an epidemic (November 1, 2002 - July 31, 2003) caused by the coronavirus of Severe Acute Respiratory Syndrome (SARS-CoV) (Coronaviridae, Betacoronavirus);this was later followed by a pandemic was registered in 2009 (June 11, 2009-August 10, 2010) of the so-called Swine Influenza (H1N1) pdm09 (Orthomyxoviridae, influenzavirus A);in 2012, the Middle East Respiratory Syndrome coronavirus (MERS - COV) (Coronaviridae, Betacoronavirus) showed its epidemic potential December 2019 was the month of the beginning of epidemic of the modern COVID-19 (Coronavirus Disease 2019), etiologically related to SARSCoV-2 (temporarily named 2019-nCoV - 2019 novel coronavirus) March 11, 2020 World health organization has announced the beginning of the COVID-19 pandemic The modern paradigm of mass differential diagnosis of acute respiratory diseases is based on the indication of the pathogen using polymerase chain reaction (PCR), but this, firstly, does not exclude the establishment of a preliminary differential diagnosis based on clinical data, and secondly, differential clinical diagnosis comes to the fore during major epidemic outbreaks (especially in developing countries), the scale of which exceeds the practical possibilities of laboratory diagnostics This is the reason why diagnostic decision-making support systems are one of the most promising areas of digitalization in the medical practice This paper presents the results of the development of a medical diagnostic service that is based on a model of medical knowledge and an intelligent decision-maker The model of medical knowledge, in turn, includes models of definitions, medical diagnosis, medical history, and justification of the decisions made An intelligent decision-maker generates a structured report using common medical definitions about diseases that have either been confirmed or rejected by the system, and a detailed justification of the decisions made The developed cloud service allows users to accumulate data on the clinical manifestations of acute respiratory viral infections and to use artificial intelligence methods to generate solutions that can significantly facilitate and speed up the establishment of the preliminary diagnosis

Forcing Seasonality of Influenza-Like Epidemics with Daily Solar Resonance

Seasonality of acute viral respiratory diseases is a well-known and yet not fully understood phenomenon. Several models have been proposed to explain the regularity of yearly recurring outbreaks and the phase-differences observed at different latitudes on Earth. Such models take into account known internal causes, primarily the periodic emergence of new virus variants that evade the host immune response. Yet, this alone, is generally unable to explain the regularity of recurrences and the observed phase-differences. Here we show that seasonality of viral respiratory diseases, as well as its distribution with latitude on Earth, can be fully explained by the virucidal properties of UV-B and A Solar photons through a daily, minute-scale, resonant forcing mechanism. Such an induced periodicity can last, virtually unperturbed, from tens to hundreds of cycles, and even in presence of internal dynamics (host’s loss of immunity) much slower than seasonal will, on a long period, generate seasonal oscillations.

Forcing Seasonality of Influenza-Like Epidemics with Daily Solar Resonance

Seasonality of acute viral respiratory diseases is a well-known and yet not fully understood phenomenon. Several models have been proposed to explain the regularity of yearly recurring outbreaks and the phase-differences observed at different latitudes on Earth. Such models take into account known internal causes, primarily the periodic emergence of new virus variants that evade the host immune response. Yet, this alone, is generally unable to explain the regularity of recurrences and the observed phase-differences. Here we show that seasonality of viral respiratory diseases, as well as its distribution with latitude on Earth, can be fully explained by the virucidal properties of UV-B and A Solar photons through a daily, minute-scale, resonant forcing mechanism. Such an induced periodicity can last, virtually unperturbed, from tens to hundreds of cycles, and even in presence of internal dynamics (host's loss of immunity) much slower than seasonal will, on a long period, generate seasonal oscillations.

Acute respiratory viral diseases: modern approaches to the diagnosis and treatment

Acute respiratory viral infections (ARVI) are one of the most common reasons patients seek ambulatory care. ARVIs can be caused by more than 200 strains of viruses, among which rhinoviruses remain a leading cause. The article discusses the epidemiological characteristics of ARVI and the economic damage caused by high incidence to the community. The clinical presentation of ARVI is nearly always accompanied by a combination of symptoms such as nasal discharge, nasal congestion, sore throat and cough combined with muscle pain, weakness, fatigue, headache and decreased appetite. Diagnosis of acute respiratory viral infections must be differentiated from influenza, allergic rhinitis, streptococcal tonsillitis, sinusitis and otitis media. Practicing hand hygiene is an effective way to prevent infections. The article discusses possibilities and effectiveness of concomitant adjuvant therapy, including the use of decongestants, topical glucocorticosteroids, nasal irrigation solutions, non-steroidal anti-inflammatory drugs, paracetamol and antitussive drugs. Antibacterial therapy does not have a positive effect on the course of ARVI. A clinical case describing the management of a patient with ARVI is provided.

2185. Group A Streptococcus (GAS) Detection by PCR in Children with Viral Acute Respiratory Illness and Healthy Children

BackgroundAcute pharyngitis is mostly of viral etiology; GAS, the leading bacterial cause, comprises 20%–30% of pediatric pharyngitis. Patients with pharyngitis and additional acute respiratory illness (ARI) symptoms more suggestive of viral etiology, including cough, rhinorrhea and conjunctivitis, are not recommended for GAS testing. The use of highly sensitive GAS PCR assays in patients with sore throat and viral ARI symptoms may detect GAS colonization and lead to antibiotic overuse. We evaluated GAS PCR in viral ARI inpatients and asymptomatic healthy controls (HC) to illustrate the potential negative impact of offering GAS PCR test in poorly selected patients.MethodsIn November 2015–June 2016, 458 ARI inpatients (< 18 years) and 205 HC (< 5 years, no ARI symptoms within 72 hours) in Kansas City were enrolled in the New Vaccine Surveillance Network study. Mid-turbinate and throat swabs were tested by multiplex respiratory panel PCR and leftover nucleic acid extracts were further tested by real-time GAS PCR. Presenting symptoms of cough, rhinorrhea and/or conjunctivitis, plus sore throat were assessed by parent interview.ResultsOverall, 6.3% of HC < 5 years old and 8.7% of ARI subjects < 18 years were GAS (+); mostly in the 3–15 year old age group (25/40, 62.5%). Among 3–15 year old GAS (+) ARI subjects, 92.8% had cough, 76.2% rhinorrhea and 37.2% conjunctivitis; 80% had > 2 of 3 symptoms noted above. Among 40 GAS (+) ARI subjects, a virus was co-detected in 34 (85%), among which Rhinovirus/Enterovirus were predominant 22/34 (55%). Of the 130 (28%) ARI subjects with sore throat, more tested positive for viruses (107/130, 82.3%) than for GAS (9/130, 6.9%). All GAS (+) HC (13/205, 6.3% overall) were < 3 year olds.ConclusionPCR detected GAS in 6.3% HC < 5 years old and 8.7% ARI subjects < 18 years old; mostly in 3- to 15-year-old ARI subjects. Most GAS (+) ARI children had cough, rhinorrhea or conjunctivitis and/or virus co-detection suggesting GAS carriage. Our data demonstrate that GAS may be detected in patients with a low clinical suspicion for acute GAS pharyngitis. These findings highlight the need to review patient selection and exercise caution in implementing highly sensitive GAS PCR assays especially in such clinical settings. Disclosures All authors: No reported disclosures.

Polygalasaponin F treats mice with pneumonia induced by influenza virus

BackgroundInfluenza is an acute viral respiratory illness that causes high morbidity and mortality globally. Therapeutic actions are limited to vaccines and a few anti-viral drugs. Polygala (P.) japonica herba is rich in Polygalasaponin F (PSF, C53H86O23), used for acute bronchitis, pharyngitis, pneumonia, amygdalitis, and respiratory tract infections treatment in China. Hypercytokinemia is often correlated with severe pneumonia caused by several influenza viruses. PSF was reported to have anti-inflammatory effects and its mechanism is associated with the nuclear factor (NF)-κB signaling pathway. The action of PSF to alleviate pulmonary inflammation caused by influenza A virus (IAV) infection requires careful assessment. In the present study, we evaluated the effect and mechanism of PSF on mice with pneumonia caused by influenza H1N1 (A/FM/1/47).MethodsMice were infected intranasally with fifteen 50% mouse lethal challenge doses (MLD50) of influenza virus. BALB/c mice were treated with PSF or oseltamivir (oral administration) for 2 h post-infection and received concomitant treatment for 5 days after infection. On day 6 post-infection, 10 mice per group were killed to collect related samples, measure body weight and lung wet weight, and detect the viral load, cytokine, prostaglandins, pathological changes, and cell pathway protein expression in the lungs. In addition, the survival experiments were carried out to investigate the survival of mice. The expression profile of cell pathway proteins was detected and analyzed using a broad pathway antibody array and confirmed the findings from the array by western blotting.ResultsPolygalasaponin F and oseltamivir can protect against influenza viral infection in mice. PSF and oseltamivir significantly relieved the signs and symptoms, reduced body weight loss, and improved the survival rate of H1N1-infected mice. Moreover, PSF efficiently decreased the level of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-4, interferon (IFN)-γ, thromboxane A2 (TXA2), and prostaglandin E2 (PGE2) in lung tissues of mice infected with influenza virus (p < 0.05–0.01). Oseltamivir had a similar effect to lung cytokine of PSF, but did not decrease the levels of TXA2 and PGE2. There was a twofold or greater increase in four cell pathway protein, namely NF-κB p65 (2.68-fold), I-kappa-B-alpha (IκBα) (2.56-fold), and MAPK/ERK kinase 1 (MEK1) (7.15-fold) assessed in the array induced by influenza virus. Western blotting showed that the expression of these proteins was significantly decreased in lung after influenza virus challenge in PSF and oseltamivir-treated mice (p < 0.05–0.01).ConclusionPolygalasaponin F appears to be able to augment protection against IAV infection in mice via attenuation of pulmonary inflammatory responses. Its effect on IAV-induced pulmonary inflammation was associated with suppression of Raf/MEK/ERK and NF-κB expressions.

The Prevalence of Respiratory Viruses Among Patients with Influenza-Like Illness in Zahedan, Southeastern Iran

Background: Acute viral respiratory diseases are among the most prevalent diseases in humans. Viral respiratory infections are the main reasons for hospitalization and death in developing countries. Objectives: The aim of this study is to determine the prevalence and clinical symptoms of the respiratory viruses including influenza viruses A and B, respiratory syncytial virus type A and B (RSV-A and RSV-B), human parainfluenza virus type 1 to 4 (HPIV-1-4) among patients with Influenza-like illness (ILI) in Zahedan City, Southeastern Iran from October 2015 to March 2016. Methods: Clinical and epidemiological data from patients who presented to outpatient clinics with ILI from October 2015 to March 2016 in Zahedan were collected. A total of 240 throat swabs were tested for Influenza virus by RT-PCR, and then those with negative results were tested for RSV-A, RSV-B, and HPIV type 1 - 4 using Multiplex-PCR. Results: Among 240 patients, 115 (47.9%) were male and 125 (52.1%) were female. Influenza A virus was detected in 196 (81.7%) patients, out of them 157 (65.4%) had H1N1 subtype and the remaining patients had H3N2 subtype. Influenza B virus was observed in 9 (3.8%) patients. Respiratory syncytial virus type A and B, and human parainfluenza virus type 1 to 4 were not detected in this study. The highest rate of influenza A infection was in the age range of 16 - 45 years old and for influenza B was in the age group of more than 46 years. The most common clinical manifestations in both influenzas A and B were fever, cough, and myalgia. Over half of the patients with influenza B had dyspnea compared to 30% of ILI patients with influenza A virus infection. Conclusions: The results of the study revealed the highest rate of Influenza A infection with H1N1 subtype among patients presented to the outpatient clinics with the clinical manifestations of influenza-like illness. This study suggests continuing surveillance, infection control, and annual vaccination for Influenza.

20th International Conference on Emerging Infectious Diseases in the Pacific Rim Organized by the United States-Japan Cooperative Medical Sciences Program (USJCMSP).

The 20th International Conference on Emerging Infectious Diseases in the Pacific Rim to3ok place in Shenzhen, China on January 8–9, 2018 followed by meetings of the acquired immunodeficiency syndrome (AIDS)/immunology, acute respiratory infections, cancer, hepatitis, and viral diseases panels on January 10–11. The conference was organized as part of the United States-Japan Cooperative Medical Sciences Program (USJCMSP) by the Japan Agency for Medical Research and Development (AMED) and the U.S. National Institutes of Health (NIH) and was locally hosted by the Shenzhen Third People’s Hospital and the Chinese Academy of Sciences (CAS) Institute of Microbiology. The conference provides the basis for networking and fostering of collaboration opportunities between researchers in Southeast Asia and the United States based on the scientific and interactive platform of the USJCMSP and takes place in the region on an annual basis. This report summarizes the discussions and conclusions from the conference.

Вплив лікарського засобу «Резістол®» на гуморальний та клітинний імунітет дітей з рекурентними та гострими вірусними респіраторними захворюваннями: результати дослідження

Вплив лікарського засобу «Резістол®» на гуморальний та клітинний імунітет дітей з рекурентними та гострими вірусними респіраторними захворюваннями: результати дослідження

Efficacy Profile of the Homeopathic Combination for Influenza and Acute Respiratory Viral Diseases Treatment and Prevention

Background. Acute respiratory viral infection (ARVI) is accompanied by a general intoxication syndrome and respiratory mucosa predominant damage. A significant number of viral nature pathogens from various nosological groups (influenza viruses, parainfluenza, adenoviruses, respiratory syncytial viruses, coronaviruses, picornaviruses, rhinoviruses, enteroviruses, herpesviruses, etc.) could cause development of ARVI at human respiratory tract. Methods of ethnoscience and non-traditional medicine can be used as part of integrated treatment and prevention of influenza and ARVI. With the help of anti-cold homeopathic remedies, people can be treated from the very beginning of the disease when an elevated temperature is observed and there are all signs of intoxication and inflammation. Objective. Scientific justification for the safety and efficacy of a complex homeopathic formulation in tablet form ( Aconitum napellus D6, Ammonium bromatum D4, Atropa belladonna D6, Bryonia D6, Cinchona pubescens D6, Echinacea D3, Hydrargyrum bicyanatum D8, Rhustoxicodendron D6) intended to enhance the natural immunity in influenza and respiratory diseases, to normalize the functional state of the immune system and upper respiratory tract. Results. Most patients have acute febrile respiratory syndrome, and some population groups have an increased risk of complications in the form of severe illness or death. These groups include elderly people, very young people, and people with concomitant illnesses. Annually, every third inhabitant of the planet suffers from acute respiratory infections. We have conducted a scientific substantiation of the safety and efficacy of a complex homeopathic tablet formulation ( Aconitum napellus D6, Ammonium bromatum D4, Atropa belladonna D6, Bryonia D6, Cinchona pubescens D6, Echinacea D3, Hydrargyrum bicyanatum D8, Rhustoxico ­dendron D6), which can be used to treat and prevention of these diseases. Conclusions. Components of developed homeopathic preparation are used in medical practice as anti-cold and immunomodulating mono- and complex homeopathic preparations for more than 100 years. There are no restrictions on the use of the drug in the context of its safety profile, since the active ingredient concentrations used are completely non-toxic. The preparation enhances the body’s protective responses and promotes the relief of symptoms of acute respiratory infections and flu (headache, sneezing, runny nose, sore throat, body aches, fever) and rapid recovery.

Proteomics of Bronchoalveolar Lavage Fluid Reveals a Lung Oxidative Stress Response in Murine Herpesvirus-68 Infection.

Murine herpesvirus-68 (MHV-68) productively infects mouse lungs, exhibiting a complex pathology characteristic of both acute viral infections and chronic respiratory diseases. We sought to discover proteins differentially expressed in bronchoalveolar lavage (BAL) from mice infected with MHV-68. Mice were infected intranasally with MHV-68. After nine days, as the lytic phase of infection resolved, differential BAL proteins were identified by two-dimensional (2D) electrophoresis and mass spectrometry. Of 23 unique proteins, acute phase proteins, vitamin A transport, and oxidative stress response factors Pdx6 and EC-SOD (Sod3) were enriched. Correspondingly, iNOS2 was induced in lung tissue by seven days post-infection. Oxidative stress was partly a direct result of MHV-68 infection, as reactive oxygen species (ROS) were induced in cultured murine NIH3T3 fibroblasts and human lung A549 cells infected with MHV-68. Finally, mice infected with a recombinant MHV-68 co-expressing inflammatory cytokine murine interleukin 6 (IL6) showed exacerbated oxidative stress and soluble type I collagen characteristic of tissue recovery. Thus, oxidative stress appears to be a salient feature of MHV-68 pathogenesis, in part caused by lytic replication of the virus and IL6. Proteins and small molecules in lung oxidative stress networks therefore may provide new therapeutic targets to ameliorate respiratory virus infections.

742. “Troponin Leaks” in Patients with Acute Respiratory Viral Infections Enrolled in SUPERNOVA: A Marker of Worse Clinical Outcomes

BackgroundCardiac troponin I (cTnI) is a specific marker of cardiac muscular injury. Many patients hospitalized with acute respiratory illness (ARI) have elevated cTnI levels but do not meet EKG criteria for an acute ischemic cardiac event. Troponin leaks could be due to demand ischemia or acute inflammation of the myocardium. We hypothesized that patients with viral ARI and elevated cTnI have worse cardiopulmonary outcomes than those with viral ARI and normal cTnI.MethodsFrom November 11, 2016–September 30, 2017 nasopharyngeal swabs from patients enrolled in SUPERNOVA ARI Study, a CDC/2-VA site, active surveillance platform to evaluate the incidence of viral infection in patients hospitalized with symptoms and/or signs of ARI, were tested using a FilmArray Respiratory Panel. Based on detection of any virus, patients were categorized as positive (vPCR+) or negative (vPCR−). Patient enrolled at the Houston site with cTnI obtained <48 hours of admission were included in the analysis. cTnI above upper limit of normal (>0.03 ng/dL) was defined as elevated. Demographic and clinical data were abstracted from chart review. Outcomes were myocardial infarction (MI) on admission, 30- and 90-day re-admissions due to cardio-respiratory illness and 30- and 90-day all-cause mortality. For the univariable analysis of baseline factors and outcomes we used unpaired t-tests for continuous variables and χ2 or Fisher exact test for categorical variables as appropriate.ResultsNinety-four of 332 cases were vPCR positive and cTnI levels on admission were available in 86. Demographics and comorbidities were all similar for the high (N = 42) and normal (N = 44) cTnI groups. Compared with normal cTnI group, those with high cTnI had similar 30- and 90-day readmission rates (14% vs. 9%, P = 0.4 and 26% vs. 16%, respectively, P = 0.2). However, 30- and 90-day mortality rates were higher for high cTnI patients (10% vs. 0% and 19% vs. 5%, P < 0.03).ConclusionTroponin elevation on patients with a documented viral respiratory infection is associated with higher 30- and 90-day mortality rates. Troponin leaks should not be dismissed as a trivial finding in this group of patients. Further work on its pathogenesis is warranted.Disclosures All authors: No reported disclosures.

A Cross-sectional Surveillance Study of the Frequency and Etiology of Acute Respiratory Illness Among Pregnant Women.

Other than influenza, little is known about the consequences of viral acute respiratory illness (ARI) on pregnant women and fetuses. Our objectives were to determine the frequency of ARI due to respiratory viruses and the associated clinical outcomes during pregnancy. Pregnant women in their second or third trimester were enrolled if they reported having symptoms of ARI or were healthy within the preceding 2 weeks. Nasopharyngeal secretions were evaluated for respiratory viruses by molecular diagnostic assays. Clinical outcomes were evaluated at enrollment and via a follow-up telephone-based questionnaire 2 weeks later. There were 155 pregnant participants, with 81 ARI cases and 91 healthy controls. Acute lower respiratory tract illness (ALRTI) was identified in 29 cases (36%). Human rhinovirus (HRV), respiratory syncytial virus (RSV), and influenza virus accounted for 75% of virus-positive cases of ALRTI. Cases with ALRTI often reported a longer duration of illness, history of allergies, symptoms of wheezing, shortness of breath, or chest pain, and use of prescription medication. Two cases with ALRTI reported decreased fetal movement; a third case with ALRTI was hospitalized. In over one third of ARI cases, participants had symptoms consistent with ALRTI. Infection with HRV, RSV, or influenza virus was commonly detected in patients with ALRTI. Viral ALRTI during pregnancy appears to be common and is associated with significant morbidity.

The problem of bacterial complications post respiratory viral infections

ABSTRACT Every person over the course of their lifetime is repeatedly infected by a variety of respiratory viruses that represent risk factors for the development of bacterial complications. The most dangerous among the etiological factors of acute respiratory viral diseases is the influenza A virus. This virus is capable of causing catastrophic pandemics with high mortality mainly due to secondary bacterial pneumonia. As has been shown in numerous recent studies, the main mechanism of provoking bacterial infections irrespective of the type of respiratory virus is the imbalanced response of the antiviral innate immunity – excessive interferon response and uncontrolled inflammation. The probability of severe bacterial complications in the course of acute respiratory viral infections is determined by both the virulence of the virus itself and by the composition of the respiratory microbiota at the time of the viral infection as well as by the genetic characteristics of the organism. The occurrence of severe bacterial complications is also affected by the chronic diseases that have an impact on the regulation of the innate immune response. This review summarizes the current concept of the mechanisms of the development of post viral bacterial complications as well as the potential prevention strategies for these complications.

Проблема бактериальных осложнений при респираторных вирусных инфекциях

Разнообразные респираторные вирусы многократно поражают каждого человека в течение жизни и являются фактором риска развития бактериальных осложнений. Наиболее опасным среди возбудителей острых респираторных вирусных заболеваний является вирус гриппа А, способный вызывать катастрофические пандемии, высокая смертность при которых в значительной степени обусловлена вторичной бактериальной пневмонией. В многочисленных исследованиях последних лет показано, что независимо от типа респираторного вируса основным механизмом провоцирования бактериальных инфекций является несбалансированный ответ системы врожденного противовирусного иммунитета – избыточный интерфероновый ответ и неконтролируемое воспаление. Вероятность тяжелых бактериальных осложнений при острых респираторных вирусных инфекциях определяется как вирулентностью самого вируса, так и составом респираторной микробиоты в момент вирусного заражения, а также генетическими особенностями организма и наличием хронических заболеваний, влияющих на регуляцию системы врожденного иммунного ответа. В данном обзоре суммированы современные представления о механизмах развития бактериальных осложнений, следующих за вирусной инфекцией, и возможностях их предотвращения.

Pathogenicity differences between QX-like and Mass-type infectious bronchitis viruses

Infectious bronchitis is a highly contagious, acute viral respiratory disease of chickens, caused by infectious bronchitis virus (IBV). In recent years, the isolation rate of QX-like IBV has increased in the world. To clarify this phenomenon and better understand the pathogenicity of QX-like IBV, we examined differences in pathogenicity between two IBV strains, SD and M41, which belong to QX-like and Mass-type IBV, respectively. SD strain was more virulent in 3-week-old specific-pathogen-free chickens than M41 strain causing higher mortality with severe renal lesions. The tissue distribution of the two virus strains was tested by real-time RT-PCR. The results showed that the viral genome copy numbers in the tissues of chickens inoculated with SD strain were higher than those in chickens inoculated with M41 strain, with the exception of the trachea and lung. This study indicates that there are tremendous differences in pathogenicity and tissue tropism between the QX-like strain and Mass-type strain. These findings may benefit the prevention of infectious bronchitis in the poultry industry in China.

Perception Regarding Swine Flu Among School Teacher in Inaruwa Municipality of Eastern Nepal

Introduction Swine flu is an acute respiratory viral disease, caused by a strain of the influenza type A virus known as H1N1. Currently swine flu is spreading rapidly in India with a regular threat of it being spread to Nepal owing to the open borders.ObjeciveThe objective of this study was to assess the knowledge, attiude and practice on different aspects of Swine Flu.MethodologyThis is cross-sectional study conducted in Inaruwa municipality of Sunsari district from 1st March to 10th April, 2015. A total of 31 schools (21 private and 10 public) were identified in the municipality out of which 16 were randomly chosen for the study.ResultsTotal sample size was 260 school teachers. Majority of the respondents belong to the age group 30-39 years, about 72 % were male and 86% thought that it is a preventable disease. It was observed that females had a better attitude towards preventive measures of swine flu as compared to the males (p&lt;0.023), but males had beertter practices as compared to the females (p&lt;0.001).ConclusionThe preventation on practice for swine flu was not adequate. Despite having acceptable knowledge and attitude positive practices needs to be encouraged. The teachers should be well informed about the earliest appearing symptoms of swine flu. So that they can closely monitor the students and can recommend the students for medical checkup on appearance of the symptoms. Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 150-155

Estimating influenza vaccine effectiveness: Evolution of methods to better understand effects of confounding in older adults.

Older adults are at high risk for serious complications of influenza illness and loss of vaccine-mediated protection. It is increasingly recognized that in addition to age, multiple chronic conditions and associated frailty contribute to the decline in vaccine effectiveness in this population. However, observational studies have been fraught with issues of confounding related to the degree of frailty and functional decline, measures of which are not included in standard administrative health care databases that are used to calculate vaccine effectiveness. This issue has led to the identification of confounding by indication or from "healthy vaccinee" bias, which respectively lead to underestimates or overestimates of influenza vaccine effectiveness. In addition, the sensitivity and specificity of the criteria used to define influenza-like illness declines with increasing age due to atypical presentations of illness and the inability to distinguish between influenza and other respiratory viruses. The test-negative case:control design has emerged as a method to estimate influenza vaccine effectiveness by comparing vaccination rates in those with laboratory-confirmed influenza to those with other acute viral respiratory illnesses. This review provides a perspective on how test-negative case:control study designs and new insights into mechanisms of protection have considerably strengthened influenza vaccination policy decisions for older adults that have historically been undermined by the conclusions of observational studies.