Flu Cases Research Articles

Assessing the effects of the Spanish partial smoking ban on cardiovascular and respiratory diseases: methodological issues

ObjectiveRecent research has assessed the impact of tobacco laws on cardiovascular and respiratory morbidity. In this study, we also examined whether the association between the implementation of the 2005 Spanish...

Correlation of days of illness on which oseltamivir was started with outcome in swine flu patients, in Government Medical College, Aurangabad (Jan-2015 to May 2015)

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Since 2009, Government Medical College, Aurangabad, a tertiary care hospital in the Marathwada region of Maharashtra, India, has been regularly admitting cases of pneumonia and ARDS, that are labeled as swine flu suspects.</span> Oseltamivir is effective in swine flu cases if given within 48 hours and better, within 24 hours of start of illness. However most of our patients do not get oseltamivir within 48 hours. Hence we decided to compare the outcome in patients who received oseltamivir within 48 hours and after that.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> This is an observational, cross-sectional study comparing the time lag between the start of symptoms and getting the first dose of oseltamivir. 59 H1N1 positive patients were admitted to the swine flu ward between January to May 2015. We compared the two groups, one that received oseltamivir within 48 hours of start of symptoms and one that received after 48 hours and compared it with the outcome, i. e survival or death.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>38 patients (64.40%) in our study belonged to the age group of 31-50. Out of 59 positive patients, only 7 received oseltamivir within 48 hours, of whom 4 died. 52 received oseltamivir after 48 hours of whom 20 died. All the 11 who were given non-invasive ventilation, whereas only 1 of the 25 on invasive ventilation survived. </p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Oseltamavir does not appear to have made a difference for survival whether it was given within 48 hours as compared to after 48 hours of onset of symptoms. However, these two groups were not comparable.</p>

Assessment of the Costs Associated with Outpatient and Inpatient Treatment of ARVI and Influenza and its Complications

In this paper the authors are presenting the analysis of an economic burden caused by influenza and acute respiratory viral infections (ARVI). This is the first study of its kind in the Kyrgyz Republic. The goal of the study was to calculate the economic burden caused by the flu and ARVI morbidity in the Republic. The study was done during 2013 - 2014 on the basis of two hospitals among inpatients and in the basis of a policlinic in the city of Bishkek among outpatients. We found that the cost of one case of flu or ARVI was 4771.41 kyrgyz som (USD 97.79). In the overall structure, the cost of medical expenses was lower than the cost of non-medical expenses (41.3 compared to 58.7%). Results of this study allowed for the first time in Kyrgyzstan to calculate the total cost for treatment of ARVI and influenza in the country. For the year 2013 they amounted to 636 516 889.2 kyrgyz som or USD 13,835,558.85. Results of the study allowed determining the factors that influence the costs that medical institutions and patients face, as well as come up with recommendations on the need for preventive vaccination against influenza.

Health Shocks and Human Capital Accumulation: The Case of Spanish Flu in Italian Regions

Percoco M. Health shocks and human capital accumulation: the case of Spanish flu in Italian regions, Regional Studies. The impact of health on economic development is a hotly debated issue in the economics literature, with most scholars supporting the idea that the diffusion of diseases is detrimental to development. In this context, pandemics are an important case study given their exogenous nature, which makes identification of the impact of diseases on development clearer than in other cases such as malaria or smallpox. This paper focuses on Spanish flu in Italy, one of the countries with the highest mortality rate due to the pandemic. By exploiting the regional variation in mortality and focusing on the hypothesis of the foetal origins of cognitive abilities, the long-run consequences of influenza exposure in terms of human capital accumulation are estimated. An average reduction of 0.3–0.4 years of schooling for the cohort born in 1918–20 is found. This result points to a small but persisting effect of health shocks on regional productivity through a variation in the rate of accumulation of human capital.

Our Experiences of Swine Flu Cases in Office Practice in Jan-Feb: 2015

Our Experiences of Swine Flu Cases in Office Practice in Jan-Feb: 2015

A method for discovery and analysis of temporal patterns in complex event data

Pattern analysis techniques currently common within geography tend to focus either on characterizing patterns of spatial and/or temporal recurrence of a single event type (e.g., incidence of flu cases) or on comparing sequences of a limited number of event types where relationships between events are already represented in the data (e.g., movement patterns). The availability of large amounts of multivariate spatiotemporal data, however, requires new methods for pattern analysis. Here, we present a technique for finding associations among many different event types where the associations among these varying event types are not explicitly represented in the data or known in advance. This pattern discovery method, known as T-pattern analysis, was first developed within the field of psychology for the purpose of finding patterns in personal interactions. We have adapted and extended the T-pattern method to take the unique characteristics of geographic data into account and implemented it within a geovisualization toolkit for an integrated computational-geovisual environment we call STempo. To demonstrate how T-pattern analysis can be employed in geographic research for discovering patterns in complex spatiotemporal data, we describe a case study featuring events from news reports about Yemen during the Arab Spring of 2011–2012. Using supplementary data from the Global Database of Events, Language, and Tone, we briefly summarize and reference a separate validation study, then evaluate the scalability of the T-pattern approach. We conclude with ideas for further extensions of the T-pattern technique to increase its utility for spatiotemporal analysis.

Effectively containing an influenza in an acute psychiatry ward of a medical center based on previous experience

Purpose: The implementation of infection control strategies was relatively difficult in psychiatry ward because these patients were not good for caring themselves and obeying medical orders. Therefore, the infections of influenza virus easily clustered in them. However, the outbreak could be stopped if we paid more attention to early detection and intervention of cluster. Methods: In the acute psychiatry ward, two patients suffered from flu in four days. According to the possibility of flu clustering, four empiric strategies were listed below for the intervention of infection control: 1. Practical facility of droplets isolation and hands hygiene, 2. Restriction of patients’ living range, 3. Environmental cleaning and disinfection, 4. Monitoring the health of members. However, cases of flu were consecutively increased in this ward. The team of infectious disease control was notified for surveillance and discussion of flu clustering with key members of this department. The further resolutions from our consensus were listed below: 1. Suspending group activities, 2. Increased frequency of environmental cleaning and disinfection, 3. Practical facility of surgical mask for work, 4. Keeping distance and silent at meal. Results: After our interventions, there was not a new case found. Only one case was proven as influenza virus type A by the virus isolation. Conclusions: In hospital, each member has the responsibility of infectious disease control. They should have the training to deal with abnormal events or episodes of infections in their department. If they obtain the ability and further internalized them as standard operating procedure, the cluster of flu could be controlled more rapidly.

Prediction, risk and control of anti-influenza drugs in the Yodo River Basin, Japan during seasonal and pandemic influenza using the transmission model for infectious disease

To reduce the risk of producing an anti-influenza drug-resistant virus from wildfowl, it is important to estimate the concentrations of anti-influenza drugs in river water during an influenza pandemic and to evaluate the concentrations that keep river basins safe. We first created a newly designed infectious disease transmission model based on the Susceptible–Infected–Recovered model. This model was then applied to replicate the transitional changes of three representative anti-influenza drugs, oseltamivir (OS), oseltamivir carboxylate (OC), and zanamivir (ZAN), in the urban area of the Yodo River system, which is one of the major basins in Japan with a population of 12 million; this region contains nearly 10% of the country's flu cases during the seasonal influenza outbreaks between 1999 and 2010. The results showed high correlations between the estimated number of influenza cases and the concentrations of the three investigated anti-influenza drugs with the reported values.We then extended the application of the model to estimate the concentration level of these anti-influenza drugs during the several influenza pandemics. The maximum estimated concentrations for OS, OC, and ZAN were known to be 260–450ng/L, 1500–2600ng/L and 40–70ng/L, respectively, at the peak of the influenza pandemic. These results suggest that it is possible that a drug-resistant influenza virus can originate from wild mallard when there is a large-scale influenza pandemic. However, ozonation before discharge at sewage treatment plants is known to significantly reduce the release of such drugs into the aquatic environment to reduce the risk of a drug-resistant virus outbreak. It was also suggested that further environmental risk could be reduced by decreasing these concentrations further in river water.

Influenza Surveillance in Mozambique: Results and Challenges from the First Year of Implementation

An approriate approach is needed for Mozambique reality to maintain the appropriate surveillance of influenza and other respiratory virus. Such approaches include the appropriate hospital staff (commitment and understanding), flow within the system, cost-effectiveness, case definitions and selection of the sentinel sites. The approach used at the start of the influenza surveillance yield to low income of samples, but more flu positive cases detected, with other challenges related to staff commitment, awarness and others. A second approach was adopted and specimens income increased, but the flu positivity was low and some other challenges remains to be find out and overcome.

Estimación del impacto de la vacunación antigripal con adyuvante MF59 en población mayor de 64 años para el Sistema Nacional de Salud: efectos y costes

ObjectiveTo determine the differential effects between influenza vaccination with and without adjuvant MF59 in over 64 years, and, specifically, the impact on the cost of vaccination. MethodsA budget impact analysis was performed considering two scenarios: Scenario 1 with a non-adjuvanted influenza vaccine and scenario 2 in which a MF59-adjuvanted vaccine was used. Flu cases, medical consultations, pharmacological costs and associated complications were comparatively evaluated. The costs of medical consultations were those shown in the Boletín Oficial de Andalucía and costs of complication rates according to the Ministry of Health. ResultsWe found that the use of adjuvanted vaccine in the population over 64 years represented a higher cost of € 3.864 million. This higher cost is compensated by flu cases prevented, estimated 113,189, hospitalizations and associated complications, which would have meant a cost of € 79.998 million. Consequently, the budgetary impact is an overall saving of € 76.134 million. Sensitivity analyzes showed savings between € 43.944 and € 96.686 million, depending on the level of vaccination coverage ConclusionsThe higher cost of adjuvanted vaccines compared to non-adjuvanted vaccines, is offset by the savings obtained with the decreasing number of cases and complications avoided. Extend to the entire population over 64 years the use of adjuvanted influenza vaccine, would be a significant savings for the health system.

Clinical profile and outcome of recent outbreak of influenza A H1N1 (swine flu) at a tertiary care center in Hyderabad, Telangana

Background: Swine influenza, also called swine flu, hog flu, and pig flu, is an infection caused by any one of the several types of swine influenza viruses. The World Health organization ( WHO) raised a worldwide pandemic alert for swine flu on June 11, 2009 that was a first of its kind in the past 70 years. In India, the index cases were reported from Pune, Maharashtra. We witnessed a recent outbreak in India during late 2014 and early 2015. Methodology: A retrospective study was carried out to describe the clinical profile and outcome of the confirmed cases of swine flu who were admitted at our center between December 10, 2014 and May 11, 2015. The cases were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on respiratory specimens. Results: A total of 514 patients with symptoms suggestive of swine flu were tested for hemagglutinin type 1 and neuraminidase type 1 (H1N1) out of whom 88 were positive, which accounted for 17.12% positivity. The mean age was 31.15 years with a range of 11-90 years, with equal distribution among males and females (males: 45, females: 43). The epidemic peaked in the month of January (n = 44.50%). Fever (95.45%) was the most common clinical manifestation followed by cough (85.22%), breathlessness (51.22%), and myalgia (50%). The majority were in category C (59.09%) based on the severity of the illness. All the patients were hospitalized and treated with oseltamivir. Of all the positive patients, 39 (44.31%) were advised home isolation after discharge for 5-7 days in view of the mild disease. Hypertension, diabetes, existing lung diseases, cardiovascular diseases, smoking habit, alcohol consumption, and pregnancy were found to be the major risk factors. Women in the third trimester of their pregnancy were found to be at a higher risk. Our study had an overall mortality of 14.77% (n = 13). Mortality was higher among pregnant women (n = 1/6, 16.66%) compared to nonpregnant women (n = 5/37, 13.51%). Multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were the most common causes of death. Conclusion: Swine flu activity has come down significantly, with a single case being reported in the month of April and none in May in 2015 at our center.

Epidemiological characteristics including seasonal trend of hospital based swine flu cases in Jamnagar region, Gujarat, India

Epidemiological characteristics including seasonal trend of hospital based swine flu cases in Jamnagar region, Gujarat, India

A study of the outcome of confirmed avian flu and swine flu cases admitted to Abbassia Chest Hospital between 2006 and 2010

Type A viruses are the most virulent human pathogens among the three influenza types and cause the most severe disease: H1N1, which caused swine flu in 2009, and H5N1, which caused avian flu in 2004. The aim of this study was to evaluate the clinical and epidemiological features and the treatment outcome of confirmed cases of avian flu and swine flu admitted in Abbassia Chest Hospital between 2006 and 2010. This was a retrospective study that included 213 patients PCR-positive for influenza A H1N1 and 23 patients PCR-positive for influenza A H5N1, who were admitted to Abbassia Chest Hospital during the period from March 2006 to December 2010. The following data were collected by retrospective reviews of hospital records for each patient: epidemiological data through interview with the patient or their relatives, full history data, complete clinical examination data, full laboratory investigations, chest radiograph film at the time of admission and during the hospitalization period, a nasopharyngeal swab, ECG, and arterial blood gases. Statistical analysis of the data was then carried out. Regarding swine flu cases, there was no statistical difference with regard to the age distribution, the sex distribution, the presence of comorbidities, and the time of presentation among the studied patients. The results showed that 170 patients recovered, whereas 43 died, with a mortality rate of 20.2%. Among the avian flu cases, seven patients recovered, whereas 16 died, with a mortality rate of 69.5%. The mortality rate was high in renal patients, patients having bilateral complicating pneumonia, and in the patients who needed mechanical ventilation. Some comorbidities, such as diabetes mellitus, cardiac illness, and chronic chest illness, have no implication on mortality. In contrast, renal conditions and the need of mechanical ventilation were associated with a high mortality rate. Egypt J Broncho 2014 8:70–78

Simultaneous detection of respiratory viruses and influenza A virus subtypes using multiplex PCR

This study was conducted to investigate the respiratory viruses and subtyping of influenza A virus when positive by multiplex PCR in patients with flu-like symptoms, after the pandemic caused by influenza A (H1N1)pdm09. Nasopharyngeal swab samples collected from 700 patients (313 female, 387 male; age range: 24 days-94 yrs, median age: 1 yr) between December 2010 - January 2013 with flu-like symptoms including fever, headache, sore throat, rhinitis, cough, myalgia as defined by the World Health Organization were included in the study. Nucleic acid extractions (Viral DNA/RNA Extraction Kit, iNtRON, South Korea) and cDNA synthesis (RevertAid First Strand cDNA Synthesis Kits, Fermentas, USA) were performed according to the manufacturer's protocol. Multiplex amplification of nucleic acids was performed using DPO (dual priming oligonucleotide) primers and RV5 ACE Screening Kit (Seegene, South Korea) in terms of the presence of influenza A (INF-A) virus, influenza B (INF-B) virus, respiratory syncytial virus (RSV), and the other respiratory viruses. PCR products were detected by automated polyacrylamide gel electrophoresis using Screen Tape multiple detection system. Specimens which were positive for viral nucleic acids have been further studied by using specific DPO primers, FluA ACE Subtyping and RV15 Screening (Seegene, South Korea) kits. Four INF-A virus subtypes [human H1 (hH1), human H3 (hH3), swine H1 (sH1), avian H5 (aH5)] and 11 other respiratory viruses [Adenovirus, parainfluenza virus (PIV) types 1-4, human bocavirus (HBoV), human metapneumovirus (HMPV), rhinovirus types A and B, human coronaviruses (HCoV) OC43, 229E/NL63] were investigated with those tests. In the study, 53.6% (375/700) of the patients were found to be infected with at least one virus and multiple respiratory virus infections were detected in 15.7% (59/375) of the positive cases, which were mostly (49/59, 83%) in pediatric patients. RSV and rhinovirus coinfections were the most prevalent (18/29, 62.7%) dual infections. The distribution of 436 respiratory viruses identified from 375 patients were as follows; 189 (43.3%) RSV, 93 (21.4%) rhinovirus, 86 (19.8%) INF-A, seven (1.6%) INF-B, 22 (5%) PIV types 1-3, 14 (3.2%) HMPV, 11 (2.5%) HCoV, nine (2%) HBoV, and five (1.2%) adenovirus. Fifty-five (64%) out of 86 INF-A viruses were subtyped as hH3, 24 (27.9%) were sH1 and seven (8.1%) were hH1. Avian H5 was not detected in any samples. The overall prevalence rates of INF-A, INF-B, RSV and other respiratory viruses were 12%, 1%, 27%, and 14.6%, respectively. RSV was the most prevalent respiratory agent in pediatric (161/313, 51%) cases, while INF-A virus in adult (24/62, 38.7%) patients. Influenza viruses were detected as responsible pathogens in 13.3% (93/700) of the patients with flu-like symptoms. Among the cases, a 1-month-old baby was infected with three virus strains (INF-A hH1+INF-A sH1+HCoV OC43) and a 82-year-old patient was infected with two INF-A virus subtypes (hH3 + sH1). INF-A viruses were mostly detected (79/86) in winter period, from December to March. INF-A virus sH1, was the most prevalent subtype in flu cases till February 2011 (22/86), after replaced by INF-A virus hH3. Beginning from February 2012, a significant increase observed in the cases infected with INF-A virus subtype hH3 (39/86). In conclusion, the identification and surveillance of influenza virus types and subtypes circulating in populations have importance both for epidemiological data and selection of vaccine strains.

Su1349 Pre-Operative Serological Markers May Predict Postoperative Crohn's Disease Recurrence: Results From a Prospective Mono-Centric Trial

RR 1.39, 95% CI 1.02, 1.89) was significantly higher among IS users than non-users. There was no significant difference in the rate of infections based on the vaccination status but the number of flu and pneumonia cases was very small. Conclusions: Although routine immunization rates among IBD patients have risen in the last few years, these preventative measures are still substantially underutilized. Although IS users are more likely to contract both flu and pneumonia, the incidence of documented infections in this population is very low and therefore the effectiveness of vaccinations is difficult to estimate.

Su1348 The Non Use of IBD-Specific Prescription Medications in Patients With IBD

RR 1.39, 95% CI 1.02, 1.89) was significantly higher among IS users than non-users. There was no significant difference in the rate of infections based on the vaccination status but the number of flu and pneumonia cases was very small. Conclusions: Although routine immunization rates among IBD patients have risen in the last few years, these preventative measures are still substantially underutilized. Although IS users are more likely to contract both flu and pneumonia, the incidence of documented infections in this population is very low and therefore the effectiveness of vaccinations is difficult to estimate.

A case of swine flu superinfected with carbapenem resistant Klebsiella

Swine flu is caused by antigenic shift of influenza A virus with clinical features similar to seasonal influenza virus. Majority of the morbidity and mortality due to swine flu are attributable to pneumonia and the acute respiratory distress syndrome (ARDS). Bacterial superinfection can occur, though it is rare in adults. Here we report a case of swine flu superinfected with carbapenem resistant Klebsiella, which is often coined as Klebsiella ‘superbug’. Asian Journal of Medical Science, Volume-5(3) 2014: 120-122 http://dx.doi.org/10.3126/ajms.v5i3.8589

Inference for reaction networks using the linear noise approximation

We consider inference for the reaction rates in discretely observed networks such as those found in models for systems biology, population ecology, and epidemics. Most such networks are neither slow enough nor small enough for inference via the true state-dependent Markov jump process to be feasible. Typically, inference is conducted by approximating the dynamics through an ordinary differential equation (ODE) or a stochastic differential equation (SDE). The former ignores the stochasticity in the true model and can lead to inaccurate inferences. The latter is more accurate but is harder to implement as the transition density of the SDE model is generally unknown. The linear noise approximation (LNA) arises from a first-order Taylor expansion of the approximating SDE about a deterministic solution and can be viewed as a compromise between the ODE and SDE models. It is a stochastic model, but discrete time transition probabilities for the LNA are available through the solution of a series of ordinary differential equations. We describe how a restarting LNA can be efficiently used to perform inference for a general class of reaction networks; evaluate the accuracy of such an approach; and show how and when this approach is either statistically or computationally more efficient than ODE or SDE methods. We apply the LNA to analyze Google Flu Trends data from the North and South Islands of New Zealand, and are able to obtain more accurate short-term forecasts of new flu cases than another recently proposed method, although at a greater computational cost.

The H1N1 Pandemic Flu. Some Critical Remarks from a Legal Point of View

Aim: This paper analyses the global and European responses to the break out of the H1N1 virus in 2009 and highlights the major deficiencies of the European authorization procedure of vaccines against H1N1 pandemic flu.Study Design: The study analyses the institutional reactions to the spread of the H1N1 pandemic flu (commonly called swine flu). The study reports the fundamental steps undertaken by global and European Institutions since 2009 to face the spreading of the H1N1 flu.Methodology: The study applies a legal methodology proceeding from formal rules towards the substantial effects taking place in the specific health protection field considered.Results: The analysis of the European authorization procedure of vaccines against H1N1 pandemic flu shows the lack of coordination between Member States and the European Union, as well as coordination between the European Medicines Agency (EMA) and the European Office of the World Health Organization (WHO); moreover, a fundamental violation of the precautionary principle emerged. In the European context, in fact, the principle does not coincide with the temporary nature of the measures, but reflects the fundamental distinction between assessment and risk management.Conclusions: The supranational mediation of the European Union has offered in many cases the guarantee of health protection within contexts in which the multiplicity of involved interests increases the level of conflict. That mediation has definitely failed in the case of swine flu because of the lack of supranational constituency representation within the European Medicines Agency that allows the intergovernmental component andthe underlying unilateral protection of economic interests to resurface.In the case of swine flu, the trust relationships between global and European bodies have been affected by the lack of transparency of the responsible organizations (WHO and EMA) and the lack of pluralistic openness to different interests in the decision-making procedures.

Case of bird flu confirmed in UK

Case of bird flu confirmed in UK