Acute Respiratory Infection Cases Research Articles

Epidemiological and pathological characterization of acute respiratory infections.

This research comprehensively investigates the epidemiological features and pathogen profile of acute respiratory infections (ARI) in Shihezi City, Xinjiang. A pivotal aspect of this study is the construction of a Bayes discriminant function for principal pathogen infections. This innovative methodology aims to furnish a robust scientific basis for the prevention and clinical management of ARI, potentially guiding more effective strategies in both public health and clinical settings. We compiled and examined data from January 2020 to June 2023, pertaining to patients admitted with acute respiratory infections at the First Affiliated Hospital of Shihezi University. This investigation focused on discerning patterns in epidemiology and pathogen etiology. Among 2110 cases of acute respiratory infections (ARI), 1736 underwent pathogenetic testing. Of these, 595 cases tested positive for at least one pathogen, marking a positivity rate of 34.27%. Viral detections, at a rate of 27.47%, were notably higher than bacterial detections, which stood at 6.51%. The most prevalent viruses identified were Human respiratory syncytial virus (hRSV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and Human adenovirus (HAdV), while the dominant bacterial pathogens included Klebsiella pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Co-infections were observed in 76 cases, accounting for 12.77% of positive diagnoses, predominantly involving hRSV in conjunction with other pathogens. In cases of acute bronchiolitis, hRSV was the most frequent pathogen, contributing to 23.10% of such cases. Similarly, in severe pneumonia cases, SARS-CoV-2 was predominant, accounting for 25.4% of these infections. The group with bacterial positivity exhibited elevated levels of C-reactive protein (CRP, 19.17 mg/L) and neutrophilic granulocyte percentage (NE%, 54.7%). The Bayes discriminant function demonstrated an initial validation accuracy of 74.9% and a cross-validation accuracy of 63.7%. The study underscores that hRSV, SARS-CoV-2, and HAdV are the primary pathogens in acute respiratory infections in the Shihezi region. Pathogen susceptibility exhibits variation across different age groups, with a higher pathogen detection rate in children compared to adults. The Bayes discriminant function shows significant promise in the classification and diagnosis of major pathogenic infections.

Forecasting severe respiratory disease hospitalizations using machine learning algorithms

BackgroundForecasting models predicting trends in hospitalization rates have the potential to inform hospital management during seasonal epidemics of respiratory diseases and the associated surges caused by acute hospital admissions. Hospital bed requirements for elective surgery could be better planned if it were possible to foresee upcoming peaks in severe respiratory illness admissions. Forecasting models can also guide the use of intervention strategies to decrease the spread of respiratory pathogens and thus prevent local health system overload. In this study, we explore the capability of forecasting models to predict the number of hospital admissions in Auckland, New Zealand, within a three-week time horizon. Furthermore, we evaluate probabilistic forecasts and the impact on model performance when integrating laboratory data describing the circulation of respiratory viruses.MethodsThe dataset used for this exploration results from active hospital surveillance, in which the World Health Organization Severe Acute Respiratory Infection (SARI) case definition was consistently used. This research nurse-led surveillance has been implemented in two public hospitals in Auckland and provides a systematic laboratory testing of SARI patients for nine respiratory viruses, including influenza, respiratory syncytial virus, and rhinovirus. The forecasting strategies used comprise automatic machine learning, one of the most recent generative pre-trained transformers, and established artificial neural network algorithms capable of univariate and multivariate forecasting.ResultsWe found that machine learning models compute more accurate forecasts in comparison to naïve seasonal models. Furthermore, we analyzed the impact of reducing the temporal resolution of forecasts, which decreased the model error of point forecasts and made probabilistic forecasting more reliable. An additional analysis that used the laboratory data revealed strong season-to-season variations in the incidence of respiratory viruses and how this correlates with total hospitalization cases. These variations could explain why it was not possible to improve forecasts by integrating this data.ConclusionsActive SARI surveillance and consistent data collection over time enable these data to be used to predict hospital bed utilization. These findings show the potential of machine learning as support for informing systems for proactive hospital management.

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia.

This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia. This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs. The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001). An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

The relationship between nutritional status and the incidence of ARI In toddlers aged 1-5 years

Background: Acute Respiratory Infection (ARI) is a disease that causes the highest number of deaths (mortality) and morbidity (morbidity) in children under five in both developed and developing countries, including Indonesia. The prevalence of ARI cases in Indonesia increases every year, according to the Indonesian Ministry of Health, ARI pneumonia cases reached 386,724 (38.78%) in 2022 with 69.2% (267,733 cases) of them occurring in the 1-5 year age group. Objective: This study aims to analyze the relationship between nutritional status and the incidence of ARI in toddlers aged 1-5 years in the working area of ​​the Mulyorejo Community Health Center, Surabaya, Indonesia. Method: This research uses an analytical observational study with a cross sectional approach. The samples in this research were toddlers who visited the Mulyorejo Community Health Center, Surabaya for the period November 2023-April 2024. The sampling technique used non-probability sampling, namely the purposive sampling method. The sample size was 100 toddlers. The research instrument is medical records. Research data was analyzed using the Mann-Whitney U Test. Result: Most (76%) respondents had normal nutritional status. The results of the Mann-Whitney U test to analyze the relationship between the nutritional status of toddlers and the incidence of ARI in toddlers obtained P Value = 0.492. Conclusion: These data show that there is no relationship between nutritional status and the incidence of ARI in toddlers aged 1-5 years in the working area of ​​the Mulyorejo Community Health Center, Surabaya, Indonesia.

Validation of an acute respiratory infection phenotyping algorithm to support robust computerised medical record-based respiratory sentinel surveillance, England, 2023.

IntroductionRespiratory sentinel surveillance systems leveraging computerised medical records (CMR) use phenotyping algorithms to identify cases of interest, such as acute respiratory infection (ARI). The Oxford-Royal College of General Practitioners Research and Surveillance Centre (RSC) is the English primary care-based sentinel surveillance network.AimThis study describes and validates the RSC's new ARI phenotyping algorithm.MethodsWe developed the phenotyping algorithm using a framework aligned with international interoperability standards. We validated our algorithm by comparing ARI events identified during the 2022/23 influenza season in England through use of both old and new algorithms. We compared clinical codes commonly used for recording ARI.ResultsThe new algorithm identified an additional 860,039 cases and excluded 52,258, resulting in a net increase of 807,781 cases (33.84%) of ARI compared to the old algorithm, with totals of 3,194,224 cases versus 2,386,443 cases. Of the 860,039 newly identified cases, the majority (63.7%) were due to identification of symptom codes suggestive of an ARI diagnosis not detected by the old algorithm. The 52,258 cases incorrectly identified by the old algorithm were due to inadvertent identification of chronic, recurrent, non-infectious and other non-ARI disease.ConclusionWe developed a new ARI phenotyping algorithm that more accurately identifies cases of ARI from the CMR. This will benefit public health by providing more accurate surveillance reports to public health authorities. This new algorithm can serve as a blueprint for other CMR-based surveillance systems wishing to develop similar phenotyping algorithms.

Clean and Healthy Living Behavior to Prevent Acute Respiratory Infection among Farmer's Families

Acute Respiratory Infection (ARI) cases in Indonesia and abroad are still a significant health problem. In Indonesia, ARI ranks first as a cause of death in infants and toddlers, with a mortality rate of around 20-30%. ARI can cause severe breathing difficulties, such as pneumonia, and ARI is also one of the leading causes of death in children under the age of five in developing countries. This study aims to analyze how to improve clean and healthy living behavior to prevent ARI in farmer families. The research method used was a literature review conducted through Google Scholar, PubMed, and Science Direct in the 2019-2024 range. The keywords used in the search for articles were "ARI, Respiratory Disorders," "Unhealthy Living Behavior, Reduced Working Period, Well Ventilated House," and "Farmer, Family". Researchers found ten studies that met the inclusion criteria in the review. Prevention of respiratory tract infections (URI) in farming families involves practicing healthy behaviors, such as washing hands with soap, maintaining environmental hygiene, and avoiding exposure to cigarette smoke. The articles highlight the importance of understanding knowledge and adherence to clean and healthy living behaviors (PHBS) in reducing the risk of ARI. However, therapeutic communication is also essential, through providing clear information and emotional support to change unhealthy behaviors. The article still has obstacles, such as the underutilization of sanitation clinics, which calls for a more intensive and focused therapeutic communication approach to overcome these obstacles. Factors that increase the risk of Acute Respiratory Infection (ARI) include cooking with biogas inside the house, high housing density leading to a lack of sanitation around the house, poor ventilation, heavy workload for farmers, which increases exposure to dust, smoke and toxic gases, intense smoking, lack of access or awareness of the benefits of local sanitation clinics, and lack of awareness of the importance of maintaining environmental sanitation. Nurses are expected to conduct community counseling to improve understanding of clean and healthy behavior in ARI prevention practices among farmers.

Clinical and economic assessment of using topical bacterial lysate Imudon® for the treatment and prevention of acute upper respiratory tract infections in children

Objective: pharmacoeconomic analysis of the feasibility of using topical bacterial lysate Imudon® for the treatment and prevention of acute upper respiratory tract infections in the pediatric population in comparison with other medicines belonging to the class of topical antiseptics.Material and methods. For the population calculated on the basis of Rosstat data, taking into account the Russian clinical recommendations "Acute respiratory viral infection (ARVI)" and "Acute tonsillitis and pharyngitis (acute tonsillopharyngitis)", the direct medical costs of medical care were determined. The cost of basic therapy of 1 case of acute respiratory infection (ARI) with symptoms of pharyngitis was calculated for two variants of clinical course: favorable (when ARI proceeds without complications and the patient does not need to be prescribed antibacterial drugs), and unfavorable (when confirmed bacterial infection joins and antibiotics are required). The indirect costs of child care are associated with lost gross domestic product (GDP). In estimating the GDP shortfall, it was assumed that the parent does not contribute to the country’s GDP during the entire childcare period.Results. GDP per capita for 2022 amounted to 2853.13 rubles per day. Thus, with a favorable course of the disease, indirect costs will be 19,972 rubles, and with an unfavorable course – 39,944 rubles. The total costs of the healthcare system and the state for 1 ARI patient are 32,192 rubles in case of favorable course and 71,644 rubles in case of unfavorable course. Imudon® administration allows reducing direct costs of parents for purchase of medicines for treatment of 1 ARI case by 23.6% compared to the therapeutic strategy associated with the use of local antiseptics.Conclusion. For the first time in Russian economic conditions, the use of Imudon® for the treatment and prevention of acute upper respiratory tract infections in children was evaluated. Its use from the first ARI symptoms allows refusing the use of local antiseptics, shortens the duration of the disease symptoms, and reduces the need for antibiotics, i.e. is feasibleable compared to local antiseptics.

Viral Etiology Associated With Acute Respiratory Tract Infection Patients in Bangkok, Thailand.

Background Acute respiratory infections (ARIs) are a significant public health concern globally. After the relaxation of COVID-19 containment measures, there has been an increase in respiratory tract infections. However, the epidemiological data on circulating respiratory pathogens after the COVID-19 pandemic in Bangkok, Thailand are interesting. We conducted a study on the respiratory pathogens detected in patients with ARIs in 2023. Methodology This retrospective study utilizes archived nasopharyngeal swab samples from patients with ARIs of all ages at Bangpakok 9 Hospital between January and December 2023. These samples were collected when physicians ordered multiplex polymerase chain reaction testing as part of the diagnostic investigation. All samples were tested for 23 types of respiratory viruses and bacteria using multiplex reverse transcription-polymerase chain reaction (QIAstat-Dx, Qiagen) testing. Results Of 321 patients, viral pathogens were found in 78.5% of cases, with 21.5% remaining unidentified. Most patients (47%) were aged between two months to five years.The most common pathogen identified was rhino/enterovirus (28.0%), followed by human parainfluenza virus (15.1%), influenza virus (12.0%), respiratory syncytial virus (9.9%), human metapneumovirus (9.5%), adenovirus (9.2%), bocavirus (8.0%), and coronavirus (5.5%). Interestingly, the prevalence of SARS-CoV-2 infection was relatively low at 2.8%. Moreover, viral co-infection was observed in 25% of cases. Monthly distribution revealed the fluctuating prevalence of detected respiratory pathogens co-circulation throughout the year. In addition, the proportion of identified pathogens varied among patients across all age groups. Conclusions Our study reported the high prevalence of respiratory pathogens in ARI patients of all ages after the COVID-19 pandemic. The most prevalent respiratory pathogens among ARI cases were viruses, particularly rhino/enterovirus. The data hold significance for physician awareness regarding diagnosis, treatment, and the implementation of infection control strategies in cases of ARIs.

Epidemiological impact of human adenovirus as causative agent of respiratory infections: An Italian multicentre retrospective study, 2022–2023

Human adenoviruses are the causative agents of 5–7% of viral respiratory infections, mainly caused by species B and C. They can infect all age groups, but children are usually at high risk of infections. Adenovirus epidemiology is well documented in East-Asian countries but little is known about adenovirus circulation in Europe in recent years. This multicentre retrospective study aimed to investigate the circulation and molecular epidemiology of hAdVs. This surveillance collected a total of 54463 respiratory specimens between January 1, 2022 and June 20, 2023 were tested for the presence of respiratory viruses. Our results showed that adenovirus was detected in 6.6 % of all cases of acute respiratory infection included in the study and the median age of positive patients was 3 years, with male children in 1–2 years age group being the most affected. 43.5 % of adenovirus cases were co-infected with at least one other respiratory virus, and rhinovirus was co-detected in 54 % of cases. Genotyping of adenovirus allowed the identification of 6 different genotypes circulating in Italy, among which type B3 was the most frequently detected.

Analysis of the Causes and Conditions for the Formation of a High Incidence of Acute Respiratory Infections in the Population of the Altai Krai (Part 2. Environmental factors, diagnosis of coxiellosis and tick­borne rickettsiosis)

Relevance. Altai Krai (AK) is one of the least prosperous subjects of the Russian Federation in terms of the incidence of acute respiratory infections (ARI). Results of studying long-term and intra-annual dynamics of the incidence of ARI and community-acquired pneumonia (CAP) in various population groups of the AK in 2011–2021 led to a conclusion about possible connection between the characteristics of the epidemic process of ARI and environmental factors, primarily air pollution, as well as the widespread distribution of natural and atropurgic foci of tick-borne transmissible and zoonotic infections in the territory of the AK, along with the problems of diagnostics. Aim. Assessment of the possible influence of environmental factors on the formation of a high level of registered incidence of ARI in the Altai Territory, as well as diagnostics of some natural focal and zoonotic infections with fever and respiratory symptoms. Materials and methods. A retrospective epidemiological study was conducted based on annual and monthly official statistical reporting during 2011–2021 about the morbidity of the population, demographic and environmental features of the territory of the AK for each of the municipalities (MU), the average long-term incidence rates of ARI, VBP, tuberculosis, Siberian tick typhus (STT), ixodid tick-borne borreliosis, tick-borne viral encephalitis were calculated; appeals of the population regarding tick bites; population density and annual average sulfur dioxide (SO2) emissions. Pearson correlation coefficient was used to assess the strength of the relationship between the analyzed indicators; and seasonality coefficients and the method of trend-seasonal decomposition were used to assess the intra-annual dynamics of the incidence of ARI and CAP (for the period 2011-2019). To study seroprevalence of antibodies to C. burnetii, R. sibirica and SARS-CoV-2 in febrile patients with symptoms of ARI blood samples were collected in October 2022 from ten rural districts of the AK. Results and discussion. It was established that there was a significant direct correlation between the incidence of ARI and the amount of SO2 emissions into the atmosphere (r = 0.61, p < 0.001), as well as between the incidence of ARI and population density (r = 0.53, p < 0.001). The largest share (69%) of the total number of ARI cases in the Altai Territory in 2011–2021 was attributed to the cities of Barnaul, Biysk, Rubtsovsk, Zarinsk and Novoaltaisk, which are characterized by maximum SO2 emissions and population density. An additional contribution (8% total) to the incidence of ARI in the Altai Territory was attributed to 7 rural areas with the highest levels of SO2 emissions. Regardless of the ranking for the incidence of ARI and CAP, in 9 out of 10 areas selected for the study, patients had both anamnestic and diagnostic titers of antibodies to C. burnetii and/or R. sibirica. At the same time, coxiellosis cases in these areas were not registered for 12 years, and the number of cases of STT was much less than the probable number based on the proportion of patients which were seropositive to R. sibirica and had symptoms of ARI. IgM to SARS-CoV-2 were detected in 5 out of 203 examined samples, IgG – in 188 out of 203 examined samples, moreover 13.8% of samples had 118 to 499 BAU/ml, 40.9% of samples had 500 to 5000 BAU/ml, and the rest of samples had more than 5000 BAU/ml. Conclusion. Among all the variables analyzed in the study, the greatest role in the formation of the high level of registered incidence of ARI in the AK for many years belong to the high level of air pollution with SO2 emissions, high population density and, especially, their combination. Underdiagnosis of tick-borne rickettsioses and coxiellosis is of particular importance due to the unavailability of test kits for laboratory verification. Starting from 2020, a new coronavirus infection made some contribution to the registered incidence of ARI.

Epidemiological characteristics of human respiratory syncytial virus among acute respiratory infection cases in 16 provinces of China from 2009 to 2023

Objective: To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023. Methods: The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed. Results: A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M (Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant (P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age (P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion: Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Variability in the Timing of Respiratory Syncytial Virus Epidemics in Guatemala, 2008-2018.

The description of local seasonality patterns in respiratory syncytial virus (RSV) incidence is important to guide the timing of administration of RSV immunization products. We characterized RSV seasonality in Guatemala using the moving epidemic method (MEM) with absolute counts of RSV-associated acute respiratory infections (ARI) from hospital surveillance in Santa Rosa and Quetzaltenango departments of Guatemala. From Week 17 of 2008 through Week 16 of 2018, 8487 ARI cases tested positive for RSV by rRT-PCR. Season onsets varied up to 5 months; early seasons starting in late May to early August and finishing in September to November were most common, but late seasons starting in October to November and finishing in March to April were also observed. Both epidemic patterns had similar durations ranging from 4 to 6 months. Epidemic thresholds (the levels of virus activity that signal the onset and end of a seasonal epidemic) calculated prospectively using previous seasons' data captured between 70% and 99% of annual RSV detections. Onset weeks differed by 2-10 weeks, and offset weeks differed by 2-16 weeks between the two surveillance sites. Variability in the timing of seasonal RSV epidemics in Guatemala demonstrates the difficulty in precisely predicting the timing of seasonal RSV epidemics based on onset weeks from past seasons and suggests that maximal reduction in RSV disease burden would be achieved through year-round vaccination and immunoprophylaxis administration to at-risk infants.

The Relationship between Home Environmental Sanitation and ISPA Incidence in Toddlers in Kaleroang Village, South Bungku District, Morowali Regency

Background: Acute Respiratory Infection (ARI) is the main cause of death in toddlers which is still a health problem in Indonesia, especially in the Kaleroang Health Center UPT work area which is increasing every year. Namely, in 2020 the prevalence of ARI cases is as much as (21.7%) in 2021 as many as (28.5%) and in 2022 the prevalence will increase (28.9%). The purpose of this study was to determine the relationship between home environmental sanitation and the incidence of ARI in toddlers in Kaleroang Village, South Bungku District, Morowali Regency. Methods: This type of research is a quantitative study with a cross sectional study design. The population in this study were all mothers who had toddlers in Kaleroang Village, namely 106 people, the total sample was 84 people who were taken by random sampling . Retrieval of data using observation sheets and questionnaires. Data were analyzed statistically using the Chi-Square test. Results: The results of this study indicate that there is a relationship between home ventilation and the incidence of ARI in toddlers with a value of X2 counts (5.841) &gt; X2 tables (3.841), house occupancy density2 counts (7.171) &gt; X2 tables (3.841), members smoking habits family X2 counts (4,701) &gt; X2 tables (3,841), use of mosquito coils X2 counts (10,903) &gt; X2 tables (3,841), and immunization status X2 counts (5,409) &gt; X2 tables (3,841). Conclusions: it can be concluded that house ventilation, house occupancy density, smoking habits of family members, use of mosquito coils, and immunization status are related to the incidence of ARI in toddlers in Kaleroang Village. It is suggested to the UPT Kaleroang Health Center to further increase education related to the risk of ARI transmission based on the environment.

Genotype and epidemiological characteristics of human metapneumovirus among hospitalized cases of acute respiratory infection in children in Changchun City, Jilin Province from 2019 to 2023

Objective: To investigate the genotype and epidemiological characteristics of human metapneumovirus (HMPV) among hospitalized cases with acute respiratory infections (ARI) in children in Changchun City, Jilin Province, China. Methods: From June 2019 to June 2023, throat swabs of ARI inpatients in Changchun Children's Hospital were collected, and their epidemiological and clinical information were also collected. Quantitative reverse transcription-PCR was used to identify HMPV-positive cases, followed by the amplification of the G gene and genetic analysis in the HMPV-positive cases. Results: A total of 3 311 children hospitalized with ARI were included in this study. Their age ranged from 0 to 17 years old, and the M (Q1, Q3) of age was 2 (1, 3) years. About 1 811 (54.70%) cases were males. A total of 167 HMPV-positive cases were detected with a positive rate of 5.04%, of which 92.81% (155/167) were children under 5 years old. The positive rate of HMPV in 2019 was 6.37% (30/471), which dropped to the lowest in 2020 (2.31%, 10/432). The HMPV-positive rate was then rebounded in 2021 (4.70%, 60/1 277) and 2022 (4.56%, 21/461), which increased to 6.87% (46/670) in 2023. The difference in HMPV-positive rate among each year was statistically significant (P<0.05). The prevalence peak of HMPV varied in different years, showing either a unimodal or bimodal distribution in one year. A total of 79 HMPV G gene sequences were obtained, of which subtype A and subtype B accounted for 48.10% and 51.90%, respectively. All of the subtype A sequences were clarified as A2c duplicated variants, and subtype B was mainly B2 genotype. Besides, subtypes A and B were prevalent alone or co-circulated in different years, and there was a subtype replacement pattern in HMPV. Conclusion: The positive rate of HMPV in hospitalized ARI cases in children is significantly different from 2019 to 2023 in Changchun City. Notably, there are certain switch patterns of HMPV subtypes A and B in different years.

Acute respiratory infections and acute bronchial asthma crises addressed by mathematical modeling

Acute Respiratory Infections (ARI) and Acute Bronchial Asthma Crises (AABC) are diseases that can be monitored well in advance. The objective of the research consisted in making a prognosis one year in advance of these two variables, obtaining highly significant correlations and small errors. Daily data from the hospital of Sagua La Grande, Villa Clara, Cuba, were used for the period from January 2006 to February 28, 2011. The prediction period or long-term independent sample comprised from March 1, 2010 to March 28, 2011, with a total of 365 cases. A modeling was also performed by first calculating the long-term forecast, where the predicted value was used as a predictor for the short-term model; errors were calculated for the independent sample, obtaining an improvement in the errors in the case of CAAB, where the mean error decreased from 18.7 cases to 1.68. It is concluded that it is possible to predict daily ARI and CAAB cases one year in advance using the Objective Regression Regressive methodology.

Genomic characterization of Influenza A (H1N1)pdm09 and SARS-CoV-2 from Influenza Like Illness (ILI) and Severe Acute Respiratory Illness (SARI) cases reported between July–December, 2022

Influenza Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) cases are more prone to Influenza and SARS-CoV-2 infection. Accordingly, we genetically characterized Influenza and SARS-CoV-2 in 633 ILI and SARI cases by rRT-PCR and WGS. ILI and SARI cases showed H1N1pdm09 prevalence of 20.9% and 23.2% respectively. 135 (21.3%) H1N1pdm09 and 23 (3.6%) H3N2 and 5 coinfection (0.78%) of H1N1pdm09 and SARS-CoV-2 were detected. Phylogenetic analysis revealed H1N1pdm09 resemblance to clade 6B.1A.5a.2 and their genetic relatedness to InfA/Perth/34/2020, InfA/Victoria/88/2020 and InfA/Victoria/2570/2019. Pan 24 HA and 26 NA nonsynonymous mutations and novel HA (G6D, Y7F, Y78H, P212L, G339R, T508K and S523T) and NA (S229A) mutations were observed. S74R, N129D, N156K, S162N, K163Q and S164T alter HA Cb and Sa antibody recognizing site. Similarly, M19T, V13T substitution and multiple mutations in transmembrane and NA head domain drive antigenic drift. SARS-CoV-2 strains genetically characterized to Omicron BA.2.75 lineage containing thirty nonsynonymous spike mutations exhibited enhanced virulence and transmission rates. Coinfection although detected very minimal, the mutational changes in H1N1pdm09 and SARS-CoV-2 virus infected individuals could alter antibody receptor binding sites, allowing the viruses to escape immune response resulting in better adaptability and transmission. Thus continuous genomic surveillance is required to tackle any future outbreak.

Exploring the effect of clinical case definitions on influenza vaccine effectiveness estimation at primary care level: Results from the end-of-season 2022–23 VEBIS multicentre study in Europe

BackgroundWithin influenza vaccine effectiveness (VE) studies at primary care level with a laboratory-confirmed outcome, clinical case definitions for recruitment of patients can vary. We used the 2022–23 VEBIS primary care European multicentre study end-of-season data to evaluate whether the clinical case definition affected IVE estimates. MethodsWe estimated VE using a multicentre test-negative case-control design. We measured VE against any influenza and influenza (sub)types, by age group (0–14, 15–64, ≥65 years) and by influenza vaccine target group, using logistic regression. We estimated IVE among patients meeting the European Union (EU) acute respiratory infection (ARI) case definition and among those meeting the EU influenza-like illness (ILI) case definition, including only sites providing information on specific symptoms and recruiting patients using an ARI case definition (as the EU ILI case definition is a subset of the EU ARI one). ResultsWe included 24 319 patients meeting the EU ARI case definition, of whom 21 804 patients (90 %) meet the EU ILI case definition, for the overall pooled VE analysis against any influenza. The overall and influenza (sub)type-specific VE varied by ≤2 % between EU ILI and EU ARI populations. DiscussionAmong all analyses, we found similar VE estimates between the EU ILI and EU ARI populations, with few (10%) additional non-ILI ARI patients recruited. These results indicate that VE in the 2022–23 influenza season was not affected by use of a different clinical case definition for recruitment, although we recommend investigating whether this holds true for next seasons.

Commentary on the adoption of a test-based versus syndromic-based approach to outbreak declaration and management in hospital and institutional settings.

At present, Ontario, like most other jurisdictions in Canada, uses a syndromic-based surveillance definition for acute respiratory infection (ARI) outbreaks in institutions and public hospitals. Confirmed outbreaks are defined as either two or more ARIs in 48 hours with any common epidemiological link and at least one that is laboratory-confirmed; or three cases of ARIs occurring within 48 hours with any common epidemiological link, and not necessarily with lab confirmation. However, with the adoption of broader test-based approaches for sick patients/residents throughout the pandemic, new challenges have surfaced regarding the declaration and management of ARI outbreaks with a variety of scenarios in respiratory testing results. Decisions, including the determination of epidemiological linkage when there are discordant/negative test results, have become more complicated with the addition of virus-specific test results for every sick individual. The ARI outbreak case definition and management guidance was updated in 2018. The purpose of this commentary is to highlight epidemiological trends in ARI outbreaks in Ontario over the 2022-2023 season compared to the 2018-2019 and 2019-2020 pre-pandemic seasons. This is followed by a discussion around some of the benefits and challenges of implementing a test-based versus syndromic-based approach to ARI outbreaks.

Studi Perbandingan Kualitas Udara di Kota Indonesia Terdampak Infeksi Saluran Pernapasan Akut

Air quality affects the activities carried out by humans. Healthy air quality will support human activities. On the other hand, unhealthy air quality will disrupt human activities by causing respiratory tract diseases. The aim of the research carried out was a comparative study of the air quality of Indonesian cities based on cases of acute respiratory infections. The research method is descriptive analysis of the air quality index (AQI) and air particles (PM) in the city of Palembang, the city of Cileungsir, the city of Serang, the city of Jambi, the city of South Tangerang, the city of Bandung, the city of Jakarta, the city of Pekanbaru, the city of Denpasar and the city of Semarang on effective work, weekends and morning, afternoon, evening and night time periods. The results of the research show that the air quality is quite good in the cities of Denpasar and the city of Semarang and the city with high pollution is the city of Palembang. This research provides information and awareness in maintaining air quality so that it can maintain and strive for healthy air quality so that it supports human activities and does not cause respiratory infections

Post-pandemic trends: Epidemiological and etiological insights into acute respiratory infections in southern China

Data on people suspected with acute respiratory infections (ARIs) from August 2022 to December 2023 in southern China were analyzed. Following the COVID-19 pandemic, the positive detection rates of respiratory pathogens increased to 56.9%. Influenza A virus (IAV) emerged as the predominant prevalence pathogen (52.1%), followed by Mycoplasma pneumoniae (Mp: 21.2%), and SARS-CoV-2 (11.6%). Mp, IAV, and Human rhinovirus (HRV) infection were the primary etiologies of ARIs patients under age 18, accounting for 49.4%, 48.6%, and 21.7%, respectively. Mp, HRV, Respiratory syncytial virus (RSV), and Adenovirus (ADV) contributed to ARIs cases in virtually every month in this group, with Mp being particularly notable for its consistent presence and high co-infection rate (31.0%). IAV was predominant in the 19 to 59 age group (88.6%), SARS-CoV-2 was responsible for most of ARIs in the elderly group (82.5%). This study provides valuable insights into the dynamic nature of respiratory pathogens post COVID-19 era.