Presence Of Influenza Research Articles

Burden of Respiratory Syncytial Virus Infection in Children and Older Patients Hospitalized with Asthma: A Seven-Year Longitudinal Population-Based Study in Spain

(1) Background: To describe hospitalizations due to respiratory syncytial virus (RSV) infection among children and elderly patients with asthma. (2) Methods: We used a nationwide discharge database to select patients with asthma aged 0 to 15 years and ≥65 years admitted to Spanish hospitals from 2016 to 2022. (3) Results: We identified 49,086 children and 471,947 elderly patients hospitalized with asthma (3.52% and 0.51%, respectively, with RSV). The proportion of RSV increased over time in children with asthma (from 1.44% to 7.4%, p < 0.001) and in elderly individuals (from 0.17% to 1.01%, p < 0.001). Among children with RSV infection, the presence of influenza (OR 3.65; 95% CI 1.46–9.1) and pneumonia (OR 1.85; 95% CI 1.02–3.55) increased the risk of poor outcome. The presence of RSV was associated with severity in these patients, defined by use of mechanical ventilation and/or admission to the intensive care unit (OR 1.44; 95% CI 1.11–1.86). In elderly patients with RSV infection, older age, congestive heart failure, COVID-19, and pneumonia increased the risk of in-hospital mortality (IHM). However, RSV infection was not associated with IHM (OR 0.88; 95% CI 0.68–1.15) in these patients. (4) Conclusion: Our results highlight the impact of RSV infection in children and elderly patients hospitalized with asthma. Strategies to improve surveillance, prophylaxis, and management of RSV infection should be evaluated.

Genetic Variation and Phylogenetic Analysis of Influenza A/H3N2 Hemagglutinin Gene in Shiraz, Southern Iran: Implications for Influenza Control and Vaccine Development

Background: Variation in the hemagglutinin (HA) of influenza A/H3N2 can affect antigenicity and virulence, potentially leading to the emergence of vaccine escape variants and antigenic shift viruses. This study aimed to evaluate the genetic variation of the HA gene to enhance global influenza virus surveillance. Objectives: The primary objectives of this research included molecular characterization and phylogenetic analysis of the influenza A/H3N2 HA gene. Therefore, this research aimed to contribute valuable insights to influenza surveillance efforts on a global scale by identifying the variants associated with vaccine escape and antigenic shift. Methods: RNA extraction was performed on 300 nasopharyngeal swab samples from patients with influenza-like illness using a commercial kit. The presence of influenza A/H3N2 was determined using qRT-PCR. Subsequently, positive samples underwent HA gene amplification through RT-PCR using the Sanger method. Variability in HA immunological sites was compared with reference sequences, and genotype/subtype was determined. Alignment and phylogenetic analyses were conducted to construct a tree utilizing an optimal nucleotide substitution model Results: Among the 300 samples, 22 (7.33%) tested positive for influenza A/H3N2, with a male distribution of 13 cases. The mean age of the participants was 35 ± 2.40 years. The analysis of antigenic site mutations revealed significant variations (A, B, D, and E) in the HA gene, with major mutations at positions 140 and 186. Noteworthy mutations such as S159Y and the previously undocumented K83R substitution at antigenic site E. Phylogenetic analysis classified the A/H3N2 strain into clades 3C.2a and 3C.3. Conclusions: The identified mutations in the HA gene suggest potential changes in antigenicity, emphasizing their relevance to vaccine development and surveillance strategies. It is recommended that ongoing molecular investigations be conducted for effective influenza control; also, the ongoing need to monitor influenza viruses is suggested to be highlighted. This research provides valuable insights necessary for maintaining efficient influenza control measures globally.

Clinical characteristics of outpatients with influenza-B-associated pneumonia and molecular evolution of influenza B virus in Beijing, China, during the 2021–2022 influenza season

We analyzed the clinical characteristics of outpatients with influenza-B-associated pneumonia during the 2021–2022 influenza season and analyzed the molecular epidemiology and evolution of influenza B virus. The presence of influenza B virus was confirmed by reverse transcription polymerase chain reaction (RT-PCR). Electronic medical records were used to collect and analyze data of outpatients. The HA and NA genes were phylogenetically analyzed using ClustalW 2.10 and MEGA 11.0. Out of 1569 outpatients who tested positive for influenza B virus, 11.7% (184/1569) developed pneumonia, and of these, 19.0% (35/184) had underlying diseases. Fever, cough, and sore throat were the most common symptoms. Among the complications, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and shock accounted for 2.7% (5/184), 4.9% (9/184), and 1.6% (3/184), respectively. Of the outpatients, 2.7% (5/184) were admitted to the hospital, and 0.5% (1/184) of them died. All of the strains from Beijing were identified as belonging to the B/Victoria lineage. The HA and NA gene sequences of 41 influenza B viruses showed high similarity to each other, and all of them belonged to clade 1A.3. Compared with the vaccine strain B/Washington/02/2019, all of the isolates contained N150K, G181E, and S194D mutations. S194D, E195K, and K200R mutations were detected in the 190 helix of the receptor binding region of HA. Co-mutations of H122Q, A127T, P144L, N150K, G181E, S194D, and K200R in HA and D53N, N59S, and G233E in NA were detected in 78.0% (32/41) of the isolates, and 56.3% (18/32) of these were from outpatients with influenza-B-associated pneumonia. Influenza outpatients with underlying diseases were more likely to develop pneumonia. No significant differences were observed in clinical symptoms or laboratory results between outpatients with and without pneumonia, so testing for influenza virus seems to be a good choice. The observed amino acid variations suggest that current vaccines might not provide effective protection.

Double-antibody-based nano-biosensing system for the onsite monitoring of SARS-CoV-2 variants

The fast and reliable diagnosis of COVID-19 is the foremost priority for promoting public health interventions. Therefore, double-antibody-based immunobiosensor chips were designed, constructed, and exploited for clinical diagnosis. Gold nanoparticles/tungsten oxide/carbon nanotubes (AuNPs/WO3/CNTs) were used as the active working sensor surface to support the chemical immobilization of a mixture of SARS-CoV-2 antibodies (anti-RBD-S and anti-RBD-S-anti-Llama monoclonal antibodies). The morphology and chemical functionalization of the fabricated disposable immunochips was characterized using scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS). After full assay optimization, the immunobiosensor showed a high sensitivity to detect SARS-CoV-2-S protein with limits of detection and quantification of 1.8 and 5.6 pg/mL, respectively. On the other hand, for the SARS-CoV-2 whole virus particle analysis, the detection and quantification limits were determined to be 5.7 and 17 pg/mL, respectively. The biosensor showed a highly selective response toward SARS-CoV-2, even in the presence of influenza, nontargeting human coronaviruses, and Middle East respiratory syndrome coronavirus (MERS-CoV). The immunochips exhibited distinct responses toward the variants of concern: B.1>C.36.3>Omicron> Delta> Alpha coronavirus variants. For biosensor validation, twenty-nine clinical specimens were analyzed, and the impedimetric responses were positively detected for two Delta samples, eighteen Omicron samples, and six B.1-type samples in addition to three negative samples. Eventually, the immunobiosensor was fabricated in the form of ready-to-use chips capable of sensitive detection of virus variants, especially variants of concern (VOC) and interest, in a specimen within 15 min. The chips provided instantaneous detection with the direct application of clinical samples and are considered a point-of-care device that could be used in public places and hot spots.

Respiratory virus concentrations in human excretions that contribute to wastewater: a systematic review and meta-analysis.

Concentrations of nucleic acids from a range of respiratory viruses in wastewater solids collected from wastewater treatment plants correlate to clinical data on disease occurrence in the community contributing to the wastewater. Viral nucleic acids enter wastewater from excretions deposited in toilets or drains. To relate measured concentrations in wastewater at a treatment plant to the number of community infections, viral nucleic-acid concentrations in human excretions are needed as inputs to a mass balance model. Here, we carried out a systematic review and meta-analysis to characterize the concentrations and presence of influenza A and B, respiratory syncytial virus, metapneumovirus, parainfluenza virus, rhinovirus, and seasonal coronaviruses in stool, urine, mucus, sputum, and saliva. We identified 220 data sets from 50 articles and reported viral concentrations and presence in these excretions. Data were unevenly distributed across virus type (with the most available for influenza) and excretion type (with the most available for respiratory excretions). Most articles only reported the presence or absence of the virus in a cross-sectional study design. There is a need for more concentration data, including longitudinal data, across all respiratory virus and excretion types. Such data would allow quantitatively linking virus wastewater concentrations to numbers of infected individuals.

No molecular evidence for influenza A virus and coronavirus in bats belonging to the families Phyllostomidae, Vespertilionidae, and Molossidae in the state of São Paulo, Brazil.

This study aimed to evaluate, by molecular methods, the presence of influenza A virus (IAV) and coronavirus in non-hematophagous bats collected in the state of São Paulo, Brazil. Samples of lung tissue and small intestine from 105 bats belonging to three families (Phyllostomidae, Vespertilionidae, and Molossidae) were collected in 22 municipalities in the state of São Paulo. Genetic identification of bats species was performed by amplification and sequencing of a fragment of 710bp of the mitochondrial COI gene. In the detection of IAV, genomes were performed by RT-PCR, aiming at the amplification of a 245-bp fragment of the IAV matrix (M) protein gene. For coronaviruses, two fragments of 602 and 440bp corresponding to segments along the gene encoding the RNA-dependent RNA polymerase (RdRp) were targeted. The detection limit for each of the PCRs was also determined. All samples analyzed here were negative for both viruses, and the lower limit of detection of the PCRs for the amplification of influenza virus A and coronavirus was estimated at 3.5 × 103 and 4.59 genomic copies per microliter, respectively. Although bats have been shown to harbor a large number of pathogens, the results of the present study support the theory that virus circulation in bats in the wild often occurs at low viral loads and that our understanding of the complex infectious dynamics of these viruses in wild conditions is still limited.

Nonlinear optimal control strategies for a mathematical model of COVID-19 and influenza co-infection

Infectious diseases have remained one of humanity’s biggest problems for decades. Multiple disease infections, in particular, have been shown to increase the difficulty of diagnosing and treating infected people, resulting in worsening human health. For example, the presence of influenza in the population is exacerbating the ongoing COVID-19 pandemic. We formulate and analyze a deterministic mathematical model that incorporates the biological dynamics of COVID-19 and influenza to effectively investigate the co-dynamics of the two diseases in the public. The existence and stability of the disease-free equilibrium of COVID-19-only and influenza-only sub-models are established by using their respective threshold quantities. The result shows that the COVID-19 free equilibrium is locally asymptotically stable when RC<1, whereas the influenza-only model, is locally asymptotically stable when RF<1. Furthermore, the existence of the endemic equilibria of the sub-models is examined while the conditions for the phenomenon of backward bifurcation are presented. A generalized analytical result of the COVID-19-influenza co-infection model is presented. We run a numerical simulation on the model without optimal control to see how competitive outcomes between-hosts and within-hosts affect disease co-dynamics. The findings established that disease competitive dynamics in the population are determined by transmission probabilities and threshold quantities. To obtain the optimal control problem, we extend the formulated model by including three time-dependent control functions. The maximum principle of Pontryagin was used to prove the existence of the optimal control problem and to derive the necessary conditions for optimum disease control. A numerical simulation was performed to demonstrate the impact of different combinations of control strategies on the infected population. The findings show that, while single and twofold control interventions can be used to reduce disease, the threefold control intervention, which incorporates all three controls, will be the most effective in reducing COVID-19 and influenza in the population.

Point-of-Care Lung Ultrasound for Differentiating COVID-19 From Influenza

Background and objectivesPatients infected with influenza and COVID-19 exhibit similar clinical presentations; thus, a point-of-care test to differentiate between the diseases is needed. Here, we sought to identify features of point-of-care lung ultrasound (LUS) that can discriminate between influenza and COVID-19.MethodsIn this prospective, cross-sectional study, LUS clips of patients presenting to the emergency department (ED) with viral-like symptoms were collected via a 10-zone scanning protocol. Deidentified clips were interpreted by emergency ultrasound fellows blinded to patients’ clinical context and influenza or COVID-19 diagnosis. Modified Soldati scores were calculated for each lung zone. Logistic regression identified the association of pulmonary pathologies with each disease.ResultsUltrasound fellows reviewed LUS clips from 165 patients, of which 30.9% (51/165) had confirmed influenza, 33.9% (56/165) had confirmed COVID-19, and 35.1% (58/165) had neither disease. Patients with COVID-19 were more likely to have irregular pleura and B-lines in all lung zones (p<0.01). The median-modified Soldati score for influenza patients was 0/20 (IQR 0-2), 9/20 (IQR 2.5-15.5) for COVID-19 patients, and 2/20 (IQR 0-8) for patients with neither disease (p<0.0001). In multivariate regression analysis adjusted for age, sex, and congestive heart failure (CHF), the presence of B-lines (OR = 1.29, 95% CI 1.09-1.53) was independently associated with COVID-19 diagnosis. The presence of pleural effusion was inversely associated with COVID-19 (OR = 0.09, 95% CI 0.01-0.65).ConclusionsLUS may help providers preferentially identify the presence of influenza versus COVID-19 infection both visually and by calculating a modified Soldati score. Further studies assessing the utility of LUS in differentiating viral illnesses in patients with variable illness patterns and those with variable illness severity are warranted.

Long focus of respiratory diseases and pneumonia formed in Birobidzhan asylum for psychoneurological patients in March-April 2018

Aim. Etiological diagnosis and epidemiological evaluation of long lasting and massive cite of respiratory infections and pneumonia developed in Birobidzhan asylum for psychoneurological patients (BAPP) during March-April of 2018.Materials and methods. Epidemiological analysis of 166 people included 150 out of 523 patients of BAPP (28.7%) and 16 BAPP staff members. Pneumonia was registered in 36 out of 166 surveyed people (21.7%), acute respiratory viral infection and influenza was diagnosed in 130 people (78.3%). All infected people were hospitalized. Lethal cases were registered. PCR analysis was performed for all infected persons in order to identify nucleic acids of viral, atypical respiratory pathogens and several bacterial causative agents. Microbiological studies were performed using the classical method. Bacteriological examination of 26 staff members was performed as well as sanitary-bacteriological inspection of hospital environment (75 samples) and chemical analysis of disinfecting solutions (30 samples).Results. Laboratory confirmed cases of influenza type B and A were revealed in 69 people (41.6%) out of 166 examined patients. Single cases of rhinovirus infection (0.6%) were identified. High levels of S. pneumoniae (55.6%) and H. influenzae (from 44.4 to 16.1% at different stages of the study) were detected. Bacteriological evaluation of 54 patients of BAPP revealed low levels of S. pneumoniae carriage (5.6%) and presence of H. influenzae (3.6%). S. aureus (37.0±6.6%), K. pneumoniae (9.3%), Candida spp. (24.1%) as well as single cases of Enterobacter spp., S. marcescens, Citrobacter spp., non-fermenting Grammnegative bacteria without markers of drug resistance were detected. Bacteriological and virological examination of two autopsy materials obtained from patients died from pneumoniae showed presence of influenza B RNA, DNA of S. pneumoniae and H. influenzaе in one case and К. pneumoniae that ESBL-produced in other. Strains of such type can be formed in hospital environment or in conditions of private community. Circulation of bacterial pathogens was surveyed in one of the institutions that provided medical aid for supervisees of the asylum. Laboratory examination of hospital personnel revealed clinically relevant pathogens (S. aureus, K. pneumoniae, Acinetobacter spp. without markers of drug resistance) in 11 out of 26 staff members (42.3%). Hospital environment evaluation showed presence of bacterial flora in 11.9% of samples including E. coli, A. baumannii and one strain of P. aeruginosa that produced carbapenemases. Violation of disinfection regimen was detected in 60% of disinfection solution samples that had reduced concentration of active agent. Revealed violations characterize hospital environment as potentially dangerous that can cause formation of healthcare-associated infections.Conclusion. Foci of viral-bacterial respiratory infections and pneumonia had developed in BAPP. Presence of multiple risk factors among supervised group of people determined large-scale involvement and duration of the outbreak involving supervisees and personnel of the asylum. Repeated hospitalization of patients in hospitals of the city in which several factors that presumably contributed to formation of healthcare-associated infections played an important role in sustaining the epidemiological process.

Plasmonic/magnetic molybdenum trioxide and graphitic carbon nitride quantum dots-based fluoroimmunosensing system for influenza virus

A novel magnetic/plasmonic-assisted fluoro-immunoassay system is developed for the detection of influenza virus using magnetic-derivatized plasmonic molybdenum trioxide quantum dots (MP-MoO3 QDs) as the plasmonic/magnetic agent and fluorescent graphitic carbon nitride quantum dots (gCNQDs) as the monitoring probe. Specific antibody against influenza A virus was conjugated onto the surface of MP-MoO3 QDs and gCNQDs, respectively. In the presence of influenza A virus (as the test virus), a core-satellite immunocomplex is formed between the antibody-conjugated nanomaterials (Ab-MP-MoO3 QDs and Ab-gCNQDs) and their interaction resulted in the modulation and gradual enhancement of the fluorescence intensity of the detection probe with the influenza virus concentration-dependent increase. In addition, PL change without influenza A virus was not observed. Limits of detection of 0.25 and 0.9 pg/mL were achieved for Influenza virus A/New Caledonia (20/99/IVR/116) (H1N1) detection in deionized water and human serum, respectively. Clinically isolated influenza virus A/Yokohama (110/2009) (H3N2) was detected in the range of 45 – 25,000 PFU/mL, with a limit of detection ca 45 PFU/mL (as opposed to a minimum of 5000 PFU/mL for a commercial test kit). This developed biosensor provides a robust, sensitive as well as a selective platform for influenza virus detection.

Investigation of influenza and respiratory viruses in hospitalised patients with influenza-like illness in an emergency room.

Influenza-like illness (ILI) surveillance is usually performed using outpatient data, and information on the surveillance of patients hospitalised for ILI, which is critical for the complete assessment of the influenza burden, is lacking. In this prospective active surveillance study, patients with community-acquired ILI hospitalised for at least 24 hours in the Emergency Room (ER) of Gazi University Hospital were identified according to the ICD-10 codes at hospital admission through active surveillance of the 2013-2014 and 2014-2015 influenza seasons. The presence of influenza and other respiratory viruses was analysed in the nasopharyngeal or pharyngeal specimens by real-time polymerase chain reaction. 351 patients admitted to emergency room with certain ICD-10 codes were assessed, and 111 patients with ILI were included in the study. We detected 15 influenza and 23 other respiratory viruses in 33 of the 111 patients. More than one virus was detected in 5 patients. No virus was detected in a majority of the patients with ILI. The sensitivity of hospital admission/discharge ICD-10 codes used in the study to detect real influenza cases was low. Patients with influenza were admitted to the hospital more frequently with high fever symptoms compared with patients with influenza virus-negative and other respiratory virus-positive (p < 0.05). This study revealed that non-influenza respiratory viruses were a major contributor to ILI. Patients admitted with fever during the influenza seasons should be evaluated for influenza virus infection, and the use of diagnostic codes in surveillance studies can lead to incorrect results.

Respiratory viruses identified in western Canadian beef cattle by metagenomic sequencing and their association with bovine respiratory disease.

Bovine respiratory disease (BRD) causes considerable economic losses in North America. The pathogenesis involves interactions between bacteria, viruses, environment and management factors. Primary viral infection can increase the risk of secondary fatal bacterial infection. The objective of this study was to use metagenomic sequencing to characterize the respiratory viromes of paired nasal swabs and tracheal washes from western Canadian feedlot cattle, with or without BRD. A total of 116 cattle (116 nasal swabs and 116 tracheal washes) were analysed. The presence of influenza D virus (IDV), bovine rhinitis A virus (BRAV), bovine rhinitis B virus (BRBV), bovine coronavirus (BCV) and bovine respiratory syncytial virus (BRSV) was associated with BRD. Agreement between identification of viruses in nasal swabs and tracheal washes was generally weak, indicating that sampling location may affect detection of infection. This study reported several viruses for the first time in Canada and provides a basis for further studies investigating candidate viruses important to the prevention of BRD.

Influenza C virus in pre-school children with respiratory infections: retrospective analysis of data from the national influenza surveillance system in Germany, 2012 to 2014.

IntroductionRecent data on influenza C virus indicate a possible higher clinical impact in specified patient populations than previously thought.AimWe aimed to investigate influenza C virus circulation in Germany.MethodsA total of 1,588 samples from 0 to 4 year-old children presenting as outpatients with influenza-like illness (ILI) or acute respiratory infection were analysed retrospectively. The samples represented a subset of all samples from the German national surveillance system for influenza in this age group in 2012–14. The presence of influenza C virus was investigated by real-time PCR. For positive samples, information on symptoms as well as other respiratory virus co-infections was considered. Retrieved influenza C viral sequences were phylogenetically characterised.ResultsInfluenza C viral RNA was detected in 20 (1.3% of) samples, including 16 during the 2012/13 season. The majority (18/20) of influenza C-positive patients had ILI according to the European Union definition, one patient had pneumonia. Viruses belonged to the C/Sao Paulo and C/Kanagawa lineages. Most (11/20) samples were co-infected with other respiratory viruses.ConclusionOur data are the first on influenza C virus circulation in Germany and notably from a European national surveillance system. The low detection frequency and the identified virus variants confirm earlier observations outside a surveillance system. More virus detections during the 2012/13 season indicate a variable circulation intensity in the different years studied. Influenza C virus can be considered for ILI patients. Future studies addressing its clinical impact, especially in patients with severe disease are needed.

Severe acute respiratory infections (SARI) from influenza in adult patients in Chile: the experience of a sentinel hospital.

ABSTRACTObjectiveTo 1) describe clinical characteristics of adult patients in Chile with severe acute respiratory infections (SARI) associated with influenza viruses, and 2) analyze virus subtypes identified in specimens collected from those patients, hospital resources used in clinical management, clinical evolution, and risk factors associated with a fatal outcome, using observational data from the SARI surveillance network (SARInet).MethodsAdults hospitalized from 1 July 2011 to 31 December 2015 with influenza-associated SARI at a SARI sentinel surveillance hospital in Santiago were identified and the presence of influenza in all cases confirmed by reverse transcription polymerase chain reaction (RT-PCR), using respiratory samples.ResultsA total of 221 patients (mean age: 74.1 years) were hospitalized with influenza-associated SARI during the study period. Of this study cohort, 91.4% had risk factors for complications and 34.3% had been vaccinated during the most recent campaign. Pneumonia was the most frequent clinical manifestation, occurring in 57.0% of the cohort; other manifestations included influenza-like illness, exacerbated chronic bronchitis, decompensated heart failure, and asthmatic crisis. Cases occurred year-round, with an epidemic peak during autumn–winter. Both influenza A (H1N1pdm09 and H3N2) and B virus co-circulated. Critical care beds were required for 26.7% of the cohort, and 19.5% needed ventilatory assistance. Multivariate analysis identified four significant factors associated with in-hospital mortality: 1) being bedridden (adjusted odds ratio (aOR): 22.3; 95% confidence interval (CI): 3.0–164); 2) admission to critical care unit (aOR: 8.9; CI: 1.44–55); 3) Pa02/Fi02 ratio < 250 (aOR: 5.8; CI: 1.02–33); and 4) increased serum creatinine concentration (> 1 mg/dL) (aOR: 5.47; CI: 1.20–24). Seasonal influenza vaccine was identified as a significant protective factor (aOR: 0.14; CI: 0.021–0.90).ConclusionsInfluenza-associated SARI affected mainly elderly patients with underlying conditions. Most patients evolved to respiratory failure and more than one-quarter required critical care beds. Clinical presentation was variable. Death was associated with host characteristics and disease-associated conditions, and vaccine was protective. Virus type did not influence outcome.

An Exploratory Study in the indonesian Archipelago: Are There Influenza B Virus (B-Victoria Sub-Type) in the Bat's Respiratory Organs?

Bats act as hosts in carrying Influenza B disease and can act as a natural reservoir of various types of viruses, including Nipah virus, Hendra virus, and Ebola virus in mammals. This research aimed to study the presence of Influenza B virus (B-Victoria sub-type) in the respiration organs of bats (Chynoptera sp.) in Indonesian Archipelago. A total of 99 bats from several regions representing the islands in Indonesia were taken in Snowball sampling technique. Samples that had been isolated and passed the incubation period were tested using the Hemagglutination (HA) test and Hemagglutination Inhibition (HI) test. The data obtained were processed descriptively. The result showed that there were 13 samples positively in the Hemagglutination (HA) test (13.13%), but after going through the Hemagglutination Inhibition Test (HI) with B-Victoria antisera, no positive samples were found. We conclude that there was no virus type B influenza virus (B-Victoria sub-type) in the bat respiration organ.

VERY LOW INFLUENZA A VIRUS PREVALENCE IN CERVIDS IN GERMAN NATIONAL PARKS.

Influenza A viruses are one of the most important and most studied pathogens in humans and domestic animals but little is known about viral prevalence in non-avian wildlife. Serum samples from three free-ranging cervid species (red [ Cervus elaphus], fallow [ Dama dama] , and roe deer [ Capreolus capreolus]) were collected from six German national parks between 2000 and 2002. The serum was tested for the presence of influenza A antibodies using a commercial competitive enzyme-linked immunosorbent assay. Only one of 137 samples tested positive.

Evaluating the role of wild songbirds or rodents in spreading avian influenza virus across an agricultural landscape.

BackgroundAvian influenza virus (AIV) infections occur naturally in wild bird populations and can cross the wildlife-domestic animal interface, often with devastating impacts on commercial poultry. Migratory waterfowl and shorebirds are natural AIV reservoirs and can carry the virus along migratory pathways, often without exhibiting clinical signs. However, these species rarely inhabit poultry farms, so transmission into domestic birds likely occurs through other means. In many cases, human activities are thought to spread the virus into domestic populations. Consequently, biosecurity measures have been implemented to limit human-facilitated outbreaks. The 2015 avian influenza outbreak in the United States, which occurred among poultry operations with strict biosecurity controls, suggests that alternative routes of virus infiltration may exist, including bridge hosts: wild animals that transfer virus from areas of high waterfowl and shorebird densities.MethodsHere, we examined small, wild birds (songbirds, woodpeckers, etc.) and mammals in Iowa, one of the regions hit hardest by the 2015 avian influenza epizootic, to determine whether these animals carry AIV. To assess whether influenza A virus was present in other species in Iowa during our sampling period, we also present results from surveillance of waterfowl by the Iowa Department of Natural Resources and Unites Stated Department of Agriculture.ResultsCapturing animals at wetlands and near poultry facilities, we swabbed 449 individuals, internally and externally, for the presence of influenza A virus and no samples tested positive by qPCR. Similarly, serology from 402 animals showed no antibodies against influenza A. Although several species were captured at both wetland and poultry sites, the overall community structure of wild species differed significantly between these types of sites. In contrast, 83 out of 527 sampled waterfowl tested positive for influenza A via qPCR.DiscussionThese results suggest that even though influenza A viruses were present on the Iowa landscape at the time of our sampling, small, wild birds and rodents were unlikely to be frequent bridge hosts.

The impact of 13-valent pneumococcal conjugate vaccination on virus-associated community-acquired pneumonia in elderly: Exploratory analysis of the CAPiTA trial

ObjectivesOur objective was to evaluate whether vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) prevents the incidence of community-acquired pneumonia (CAP) caused by influenza (influenza-associated CAP, IA-CAP) or other respiratory viruses in the elderly. MethodsThis analysis was part of the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA); a double blind, randomized, placebo-controlled trial in 84 496 immunocompetent individuals aged ≥65 years. CAP was defined by clinical and radiological criteria, and oropharyngeal swabs were collected from all individuals referred to a sentinel centre with a clinical suspicion of pneumonia. Presence of influenza A and B, parainfluenza 1, 2, 3 and 4, human adeno-, boca-, corona-, metapneumo-, rhino- and respiratory syncytial viruses was determined by real-time PCR. ResultsOf 3209 episodes of suspected pneumonia, viral aetiology was tested in 2917 and proportions with influenza virus, human metapneumovirus and respiratory syncytial virus were 4.6%, 2.5% and 3.1%, respectively. There were 1653 oropharyngeal swabs for PCR testing available from 1814 episodes that fulfilled criteria for CAP, yielding 23 first episodes of IA-CAP in the PCV13 and 35 in the in placebo group—vaccine efficacy for IA-CAP of 34.4% (95% CI –11.1% to 61.2%; p 0.117). Annual influenza vaccination was received by 672 (87.2%) in the PCV13 group and 719 (87.7%) in the placebo group of the confirmed CAP cases. ConclusionIn a randomized study of 84 496 elderly individuals with a high uptake of influenza vaccination, PCV13 was not associated with a statistically significant reduction of influenza or virus-associated CAP. Overall incidence of non-influenza viral pneumonia was low.

Demographic and ecological risk factors for human influenza A virus infections in rural Indonesia.

BackgroundIndonesia has the world's highest reported mortality for human infections with highly pathogenic avian influenza (HPAI) A(H5N1) virus. Indonesia is an agriculturally driven country where human‐animal mixing is common and provides a unique environment for zoonotic influenza A virus transmission.ObjectivesTo identify potential demographic and ecological risk factors for human infection with seasonal influenza A viruses in rural Indonesia, a population‐based study was conducted in Cileunyi and Soreang subdistricts near Bandung in western Java from 2008 to 2011.MethodsPassive influenza surveillance with RT‐PCR confirmation of influenza A viral RNA in respiratory specimens was utilized for case ascertainment. A population census and mapping were utilized for population data collection. The presence of influenza A(H3N2) and A(H1N1)pdm09 virus infections in a household was modeled using Generalized Estimating Equations.ResultsEach additional child aged <5 years in a household increased the odds of H3N2 approximately 5 times (OR=4.59, 95%CI: 3.30‐6.24) and H1N1pdm09 by 3.5 times (OR=3.53, 95%CI: 2.51‐4.96). In addition, the presence of 16‐30 birds in the house was associated with an increased odds of H3N2 (OR=5.08, 95%CI: 2.00‐12.92) and H1N1pdm09 (OR=12.51 95%CI: 6.23‐25.13).ConclusionOur findings suggest an increase in influenza A virus infections in rural Indonesian households with young children and poultry.

Comparison of two new generation influenza rapid diagnostic tests with instrument-based digital readout systems for influenza virus detection

Introduction: Influenza rapid diagnostic tests (RDTs) have been developed to supply scientists with more sensitive and specific techniques. Newly developed digital reader-based techniques require test evaluations before their clinical application.Methods: Two types of digital influenza RDTs using a digital readout system and one conventional RDT were compared using 314 nasopharyngeal swabs of influenza. The swabs originated from symptomatic individuals suspected of influenza infection, and the presence of influenza was confirmed with influenza real-time polymerase chain reaction (PCR) testing and influenza subtyping. Methods were the Sofia® Influenza A + B Fluorescence Immunoassay (FIA), which uses a portable fluorescence analyser, the BD Veritor™ System Flu A + B, which uses a colorimetric immunochromatographic method with a reflectance-based measurement digital device, and the SD Bioline assay, which is based on a traditional immunochromatographic method.Results: The Sofia® Influenza A + B system, the BD Veritor™ System Flu A + B and the SD Bioline assay showed sensitivities in relative real-time PCR results of 74.2, 73.0 and 53.9%, respectively, for influenza A, and 82.5, 72.8 and 71.0%, respectively, for influenza B. All three RDTs showed 100% specificities for influenza A and influenza B. The Sofia® Influenza A + B Fluorescence Immunoassay showed sensitive and specific results for the detection of influenza B in contrast to the BD Veritor™ System Flu A + B. The two digital RDTs showed higher sensitivity and specificity than the conventional RDT in the detection of the influenza H3 subtype.Conclusions: Digital-based readout systems for the detection of the influenza virus can be applied for more sensitive diagnosis in clinical settings than conventional RDTs.