Influenza Virus Type Research Articles

Prevalence of respiratory viruses among hospitalized children with lower respiratory tract infections during the COVID-19 pandemic in Wuhan, China

ObjectivesWe aimed to investigate the continuous changes in respiratory virus epidemics in hospitalized children with lower respiratory tract infections (LRTIs) persisting from January 2019 to December 2022 in Wuhan, China. MethodsWe retrospectively enrolled children with LRTIs admitted to the Wuhan Children's Hospital. Specimens were nasopharyngeal aspirates which had been collected and detected the following microorganisms with direct immunofluorescence: influenza virus types A and B, respiratory syncytial virus, parainfluenza virus types 1-3, and adenovirus. We also analyzed demographic data and laboratory test results. ResultsA total of 22,660 patients were enrolled. The total virus detection rate in 2019, 2021, and 2022 significantly declined gradually (36.96% vs 29.47% vs 22.62%, P value < 0.001). All the detected viruses did not follow previously observed seasonal patterns during the COVID-19 pandemic. Children hospitalized for LRTIs were older during the COVID-19 pandemic in contrast to the pre-period, particularly notable in cases attributed to respiratory syncytial virus and parainfluenza virus type 3 infections. ConclusionsThis work adds to our knowledge of the epidemiology characteristics of respiratory viruses spanning the COVID-19 pandemic among children with LRTIs. The circulation of respiratory viruses changed consistently, and active LRTI surveillance in children remains critical for defining the healthcare burden of respiratory viruses.

Viricide activity of antimicrobial blue light (405 nm) against the SARS-CoV-2 and influenza virus

Abstract Background Over the years, antimicrobial blue light (aBL) at a 405 nm wavelength has emerged as a potential alternative treatment for reducing the environmental contamination. It is well accepted that aBL is much less detrimental to host cells than UV-C irradiation and can be used in the presence of people. This study aims to determine the viricide activity, against the SARS-CoV-2 and influenza virus types A and B, of the nUV-A radiation, using a customized nUV-A ceiling lamp System. Methods The experiment took place in March 2023. An nUV-A ceiling lamp prototype, composed of 9 LEDs at 405 nm, was fixed on a metal scaffold, on which the outline of a multiwell plate (24 wells) was traced to carry out the tests correctly. Each plate well was inoculated with 100 µL of SARS-CoV2 or influenza virus types A or B suspension. The multiwell plate was irradiated at 32 cm for 45 and 90 minutes, with an emitted energy dose of 12 J/cm2 and 24 J/cm2. Three samples were inoculated with viruses and subjected to the action of nUV-A as per protocol, and 3 samples were inoculated but not treated with nUV-A to determine viral titer after recovery and examined immediately after inoculation. The re-collected suspensions were used to inoculate a wells plate into which the VERO E6 cell cultures were fixed and then incubated for 3 days at 37° C. Results The results showed that after a 45 min exposition, the measurable log10 mean reduction was 1.50 for SARS-CoV2, 0.13 for influenza virus type A and 0.12 for type B; after 90 min the log10 mean reduction was 2.33 for SARS-CoV2, 0.16 for influenza virus type A and 0.17 for type B. Conclusions Tests have shown that aBL can be effective in reducing the viral load of the SARS-CoV2 virus and, to a lesser extent, the influenza A/B viruses. Disinfection with aBL appears effective and avoid the adverse effects of using UV-C. Further studies will evaluate how to improve the results on influenza viruses and the application on other viruses such as RSV. Key messages • NearUV-A lamp has proven to reduce the virucide activity of all viruses, more for sars-cov2. • Using aBL avoids the adverse UV-C’s effects.

In‐vitro antiviral screening of some thiopyranothiazoles

Thiopyranothiazoles represent a promising class of drug-like molecules with broad pharmacological profiles. Some novel derivatives of isothiochromeno[4a,4-d]thiazole and chromeno[4′,3':4,5]thiopyrano[2,3-d]thiazole were synthesized and screened against diverse viruses: coronavirus SARS, Influenza Viruses of type A and type B, Adeno- and Rhinovirus, Dengue Fever Virus, Respiratory Syncytial Virus, Rift Valley Fever Virus, Tacaribe Virus, Venezuelan Equine Encephalitis Virus, as well as Vaccinia and Human Cytomegalovirus. The antiviral activity assays revealed highly active isothiochromeno[4a,4-d]thiazole bearing phenazone fragment towards Influenza Virus type A (H1N1) with the selectivity index (SI) within 150. 5,8-Dihydro-2H-[1,3]thiazolo [5′,4':5,6]thiopyrano [2,3-d][1,3]thiazol-2,6(3H)-diones showed moderate antiviral activity against influenza viruses and SARS-CoV. The obtained data indicate thiopyranothiazoles as promising class of fused 4-thiazolidinone derivatives possessing antiviral effects.

Existing Evidence for Influenza B Virus Adaptations to Drive Replication in Humans as the Primary Host.

Influenza B virus (IBV) is one of the two major types of influenza viruses that circulate each year. Unlike influenza A viruses, IBV does not harbor pandemic potential due to its lack of historical circulation in non-human hosts. Many studies and reviews have highlighted important factors for host determination of influenza A viruses. However, much less is known about the factors driving IBV replication in humans. We hypothesize that similar factors influence the host restriction of IBV. Here, we compile and review the current understanding of host factors crucial for the various stages of the IBV viral replication cycle. While we discovered the research in this area of IBV is limited, we review known host factors that may indicate possible host restriction of IBV to humans. These factors include the IBV hemagglutinin (HA) protein, host nuclear factors, and viral immune evasion proteins. Our review frames the current understanding of IBV adaptations to replication in humans. However, this review is limited by the amount of research previously completed on IBV host determinants and would benefit from additional future research in this area.

Impact of non-pharmaceutical interventions during COVID-19 on future influenza trends in Mainland China

BackgroundInfluenza is a common illness for its high rates of morbidity and transmission. The implementation of non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic to manage its dissemination could affect the transmission of influenza.MethodsA retrospective analysis, between 2018 and 2023, was conducted to examine the incidence of influenza virus types A and B among patients in sentinel cities located in North or South China as well as in Wuhan City. For validations, data on the total count of influenza patients from 2018 to 2023 were collected at the Central Hospital of Wuhan, which is not included in the sentinel hospital network. Time series methods were utilized to examine seasonal patterns and to forecast future influenza trends.ResultsNorthern and southern cities in China had earlier outbreaks during the NPIs period by about 8 weeks compared to the 2018–2019. The implementation of NPIs significantly reduced the influenza-like illness (ILI) rate and infection durations. Influenza B Victoria and H3N2 were the first circulating strains detected after the relaxation of NPIs, followed by H1N1 across mainland China. The SARIMA model predicted synchronized H1N1 outbreak cycles in North and South China, with H3N2 expected to occur in the summer in southern cities and in the winter in northern cities over the next 3 years. The ILI burden is expected to rise in both North and South China over the next 3 years, with higher ILI% levels in southern cities throughout the year, especially in winter, and in northern cities mainly during winter. In Wuhan City and the Central Hospital of Wuhan, influenza levels are projected to peak in the winter of 2024, with 2 smaller peaks expected during the summer of 2023.ConclusionsIn this study, we report the impact of NPIs on future influenza trends in mainland China. We recommend that local governments encourage vaccination during the transition period between summer and winter to mitigate economic losses and mortality associated with influenza.

Severity of influenza-associated hospitalisations by influenza virus type and subtype in the USA, 2010–19: a repeated cross-sectional study

Influenza burden varies across seasons, partly due to differences in circulating influenza virus types or subtypes. Using data from the US population-based surveillance system, Influenza Hospitalization Surveillance Network (FluSurv-NET), we aimed to assess the severity of influenza-associated outcomes in individuals hospitalised with laboratory-confirmed influenza virus infections during the 2010-11 to 2018-19 influenza seasons. To evaluate the association between influenza virus type or subtype causing the infection (influenza A H3N2, A H1N1pdm09, and B viruses) and in-hospital severity outcomes (intensive care unit [ICU] admission, use of mechanical ventilation or extracorporeal membrane oxygenation [ECMO], and death), we used FluSurv-NET to capture data for laboratory-confirmed influenza-associated hospitalisations from the 2010-11 to 2018-19 influenza seasons for individuals of all ages living in select counties in 13 US states. All individuals had to have an influenza virus test within 14 days before or during their hospital stay and an admission date between Oct 1 and April 30 of an influenza season. Exclusion criteria were individuals who did not have a complete chart review; cases from sites that contributed data for three or fewer seasons; hospital-onset cases; cases with unidentified influenza type; cases of multiple influenza virus type or subtype co-infection; or individuals younger than 6 months and ineligible for the influenza vaccine. Logistic regression models adjusted for influenza season, influenza vaccination status, age, and FluSurv-NET site compared odds of in-hospital severity by virus type or subtype. When missing, influenza A subtypes were imputed using chained equations of known subtypes by season. Data for 122 941 individuals hospitalised with influenza were captured in FluSurv-NET from the 2010-11 to 2018-19 seasons; after exclusions were applied, 107 941 individuals remained and underwent influenza A virus imputation when missing A subtype (43·4%). After imputation, data for 104 969 remained and were included in the final analytic sample. Averaging across imputed datasets, 57·7% (weighted percentage) had influenza A H3N2, 24·6% had influenza A H1N1pdm09, and 17·7% had influenza B virus infections; 16·7% required ICU admission, 6·5% received mechanical ventilation or ECMO, and 3·0% died (95% CIs had a range of less than 0·1% and are not displayed). Individuals with A H1N1pdm09 had higher odds of in-hospital severe outcomes than those with A H3N2: adjusted odds ratios (ORs) for A H1N1pdm09 versus A H3N2 were 1·42 (95% CI 1·32-1·52) for ICU admission; 1·79 (1·60-2·00) for mechanical ventilation or ECMO use; and 1·25 (1·07-1·46) for death. The adjusted ORs for individuals infected with influenza B versus influenza A H3N2 were 1·06 (95% CI 1·01-1·12) for ICU admission, 1·14 (1·05-1·24) for mechanical ventilation or ECMO use, and 1·18 (1·07-1·31) for death. Despite a higher burden of hospitalisations with influenza A H3N2, we found an increased likelihood of in-hospital severe outcomes in individuals hospitalised with influenza A H1N1pdm09 or influenza B virus. Thus, it is important for individuals to receive an annual influenza vaccine and for health-care providers to provide early antiviral treatment for patients with suspected influenza who are at increased risk of severe outcomes, not only when there is high influenza A H3N2 virus circulation but also when influenza A H1N1pdm09 and influenza B viruses are circulating. The US Centers for Disease Control and Prevention.

Development and application of influenza virus wastewater surveillance in Hong Kong

Wastewater surveillance is considered as a powerful tool in providing cost-effective, population-wide and near real-time surveillance results for controlling infectious diseases (i.e., SARS-CoV-2, influenza virus), complementary to clinical surveillance. To facilitate the utility of this emerging tool, we developed two preanalytical protocols (supernatant-based and pellet-based) for influenza A/B virus (IAV/IBV) wastewater surveillance and applied them to the established wastewater surveillance network for large-scale longitudinal monitoring in Hong Kong. We tested 724 wastewater samples from 24 stationary sites for weekly surveillance for 8 months and 458 wastewater samples from 11 wastewater treatment plants (WWTPs) for more frequent (three times per week) city-wide surveillance for 4 months when influenza season commenced. We found the city-wide IAV virus concentration in wastewater were associated with the detection rate and influenza-like illness plus rates (ILI+) of clinical respiratory specimens and increased significantly after the cancelling of mask mandate that was in place for COVID-19. IBV was at low detection rates and low virus concentration levels, consistent with the low detection rates observed by clinical surveillance. In addition, we conducted virus subtype identification in selected wastewater samples, and observed the H1pdm was the major circulation subtype. Moreover, the obtained virus signals were confirmed by Sanger sequencing of PCR products, suggesting the feasibility and applicability of established methods for rapid detection of influenza virus types and subtypes in wastewater surveillance. This study demonstrates the applicability of IAV/IBV wastewater surveillance to current wastewater infrastructures and it could be used as a rapid and cost-effective surveillance strategy to track virus transmission patterns in the community for timely public health actions in the future.

Changes in Influenza Activities Impacted by NPI Based on 4-Year Surveillance in China: Epidemic Patterns and Trends.

Since the Non-pharmaceutical Intervention (NPI) by COVID-19 emerged, influenza activity has been somewhat altered. The aim of this study was to explore changes in influenza activities in the context of COVID-19 based on the sentinel hospitals/units in Guangdong, southern China. The surveillance data in influenza-like illness (ILI) were collected from 21 cities in Guangdong between September 2017 and August 2021, while 43 hospitals/units were selected to analyze the predominant types of influenza, population characteristics, and seasonal features by three methods (the concentration ratio, the seasonal index, and the circulation distribution), based on a descriptive epidemiological approach. During the four consecutive influenza seasons, a total of 157345 ILIs were tested, of which 9.05% were positive for influenza virus (n = 14238), with the highest positive rates for both IAV (13.20%) and IBV (5.41%) in the 2018-2019 season. After the emergence of COVID-19, influenza cases decreased near to zero from March 2020 till March 2021, and the dominant type of influenza virus changed from IAV to IBV. The highest positive rate of influenza existed in the age-group of 5 ~ < 15years in each season for IAV (P < 0.001), which was consistent with that for IBV (P < 0.001). The highest annual positive rates for IBV emerged in eastern Guangdong, while the highest annual positive rates of IAV in different seasons existed in different regions. Furthermore, compared with the epidemic period (ranged from December to June) during 2017-2019, the period ended three months early (March 2020) in 2019-2020, and started by five months behind (April 2021) during 2020-2021. The highest positive rates in 5 ~ < 15 age-group suggested the susceptible in this age-group mostly had infected with infected B/Victoria. Influenced by the emergence of COVID-19 and NPI responses, the epidemic patterns and trends of influenza activities have changed in Guangdong, 2017-2021.

Clinical characteristics of hospitalized children with community-acquired pneumonia and respiratory infections: Using machine learning approaches to support pathogen prediction at admission.

Acute respiratory infections (ARIs) are common in children. We developed machine learning models to predict pediatric ARI pathogens at admission. We included hospitalized children with respiratory infections between 2010 and 2018. Clinical features were collected within 24h of admission to construct models. The outcome of interest was the prediction of 6 common respiratory pathogens, including adenovirus, influenza virus types A and B, parainfluenza virus (PIV), respiratory syncytial virus (RSV), and Mycoplasma pneumoniae (MP). Model performance was estimated using area under the receiver operating characteristic curve (AUROC). Feature importance was measured using Shapley Additive exPlanation (SHAP) values. A total of 12,694 admissions were included. Models trained with 9 features (age, event pattern, fever, C-reactive protein, white blood cell count, platelet count, lymphocyte ratio, peak temperature, peak heart rate) achieved the best performance (AUROC: MP 0.87, 95% CI 0.83-0.90; RSV 0.84, 95% CI 0.82-0.86; adenovirus 0.81, 95% CI 0.77-0.84; influenza A 0.77, 95% CI 0.73-0.80; influenza B 0.70, 95% CI 0.65-0.75; PIV 0.73, 95% CI 0.69-0.77). Age was the most important feature to predict MP, RSV and PIV infections. Event patterns were useful for influenza virus prediction, and C-reactive protein had the highest SHAP value for adenovirus infections. We demonstrate how artificial intelligence can assist clinicians identify potential pathogens associated with pediatric ARIs upon admission. Our models provide explainable results that could help optimize the use of diagnostic testing. Integrating our models into clinical workflows may lead to improved patient outcomes and reduce unnecessary medical costs.

Etiological spectrum of pneumonia in children in Kyiv, Ukraine

Background. In Ukraine over the past 20 years, the incidence of pneumonia in children has increased. The aim of the study is to assess the contribution of respiratory viruses and bacteria to pneumonia in children in Ukraine. Materials and methods. The etiology of community-acquired pneumonia was studied in 175 children at Medical Center “Eurolab” and Clinical Hospital 2 (Kyiv, Ukraine) over 2018–2022. Viral and bacterial pathogens were detected using polymerase chain reaction, chromatographic immunoassay. Results. The prevalence of viral pneumonia among total cases of pneumonia was 78.9 % in Kyiv during 2018–2022. Thirty-seven (21.1 %) cases of CAP were classified as bacterial. The most common were respiratory syncytial virus (18.1 %), metapneumovirus (13 %), adenovirus (10.1 %), parainfluenza virus (10.1 %). The other causative viral agents were influenza virus type A (7.2 %), rhinovirus (5 %), bocavirus (2.9 %), SARS-CoV-2 (1.4 %) and measles virus (1.4 %). Etiological spectrum is similar to the results of studies conducted in other European countries. Conclusions. Respiratory viruses, particularly respiratory syncytial virus and metapneumovirus, are the major contributors to community-acquired pneumonia in children in Kyiv.

End-of-season influenza vaccine effectiveness during the Southern Hemisphere 2022 influenza season – Chile, Paraguay, and Uruguay

ObjectivesThis study estimated the 2022 end-of-season influenza vaccine effectiveness (VE) against severe acute respiratory illness (SARI) hospitalization in Chile, Paraguay, and Uruguay. MethodsWe pooled surveillance data from SARI cases in 18 sentinel surveillance hospitals in Chile (n = 9), Paraguay (n = 2), and Uruguay (n = 7) from March 16-November 30, 2022. VE was estimated using a test-negative design and logistic regression models adjusted for country, age, sex, presence of ≥1 comorbidity, and week of illness onset. VE estimates were stratified by influenza virus type and subtype (when available) and influenza vaccine target population, categorized as children, individuals with comorbidities, and older adults, defined per countries’ national immunization policies. ResultsAmong the 3147 SARI cases, there were 382 (12.1%) influenza test-positive case patients; 328 (85.9%) influenza case patients were in Chile, 33 (8.6%) were in Paraguay, and 21 (5.5%) were in Uruguay. In all countries, the predominant subtype was influenza A(H3N2) (92.6% of influenza cases). Adjusted VE against any influenza-associated SARI hospitalization was 33.8% (95% confidence interval: 15.3%, 48.2%); VE against influenza A(H3N2)-associated SARI hospitalization was 30.4% (95% confidence interval: 10.1%, 46.0%). VE estimates were similar across target populations. ConclusionDuring the 2022 influenza season, influenza vaccination reduced the odds of hospitalization among those vaccinated by one-third. Health officials should encourage influenza vaccination in accordance with national recommendations.

Host-targeted self-attenuated influenza virus as an effective nasal spray vaccine in aged population

Abstract The elderly are at high risk for influenza infection and its complication. However, current inactivated influenza vaccines are often modestly immunogenic and show low protective immunity in the elderly, due to immunosenescence. New approaches are urgently needed for developing effective vaccines against influenza for the elderly. In current study, we have constructed new recombinant influenza viruses, named host-targeted self-attenuated influenza viruses (SAIVs), which can express functional mammalian species-specific artificial microRNAs (amiRNAs). The expression of these amiRNAs can inhibit expression of some host factors critical for influenza replication, and therefore the resultant recombinant influenza viruses are replication restricted and attenuated in the host cells. One of these SAIVs, which can express an amiRNA that inhibits expression of the host cellular Cdc2-like kinase 1 (CLK1), was produced in embryonic chicken eggs and evaluated in an aged mouse model of influenza infection. It elicited robust antibody and T cell responses against influenza virus and demonstrated significantly protective efficacy against lethal infection with wild type influenza virus H1N1 PR8 after single dose of intranasal vaccination. Our research finding provided a proof of concept that the new host targeted self-attenuated influenza virus can be further used as an effective vaccine against influenza in aged population. Supported by a research grant from National Institute of Allergy and Infectious Diseases (AI133207).

SARS-CoV-2 and other Coronaviruses: A matter of variations

Since the appearance of COVID-19 disease as an epidemic and pandemic disease, many studies are performed to uncover the genetic nature of the newly discovered coronavirus with unique clinical features. The last three human coronavirus outbreaks, SARS-CoV, MERS-CoV and SARS-CoV-2 are caused by Beta-Coronaviruses. Horizontal genetic materials transfer was proven from one coronavirus to the other coronavirus of non-human origin like infectious bronchitis virus (IBV) of avian. Horizontal genetic materials transfer was also from non-corona viruses like astroviruses and equine rhinovirus (ERV-2) or from coronavirus-unrelated viruses, like influenza virus type C. However, SARS-CoV-2 is identical to SARS-CoV and MERS-CoV. Interestingly, Wuhan city-SARS-CoV-2 is very similar to two types of bats Coronavirus in RdRp nucleotide sequence to RdRp of SARS-CoV-2 suggesting possible transmission from bats. Moreover, many genomic mutations are found in SARS-CoV-2 genomes suggesting the mutations are developed and the virus is constantly changed. The newly discovered SARS-CoV-2 has a new open reading frame (ORF) that encodes for thirty-eight amino acid peptide chains and has no similar sequence in all reported NCBI data regarding respiratory viruses. The short peptide can serve as an identification target for SARS-CoV-2 detection.

Influenza and Influenza-Like Virus Infection in Children Under 14 Years of Age: An Investigation of 725 Cases in the 2021/2022 Influenza Epidemic Season in Poland.

BACKGROUND Influenza in children poses a significant health problem worldwide. In this study we investigated 725 cases of influenza and influenza-like virus infection in children under 14 years of age in the 2021/2022 influenza epidemic season in Poland. MATERIAL AND METHODS The material for the study (nose and throat swabs) was collected during the 2021/2022 epidemic season. We analyzed 725 samples from the National Influenza Center, Department of Influenza Research at the National Institute of Public Health NIH-NRI or at 16 Voivodship Sanitary Epidemiological Stations across Poland. Quantitative polymerase chain reaction (qRT-PCR) was applied to determine the influenza virus type and subtype (in RNA isolated from positive samples). RESULTS This study shows the high incidence of influenza among children under the age of 14. Most confirmed infections were caused by influenza A. The genetic material of the A/H1N1/pdm09 subtype was not found among the analyzed samples. The highest number of influenza A infections was among the youngest children (the 0-4 years age group). The most common influenza-like virus was respiratory syncytial virus (RSV). The greatest number of cases caused by this respiratory virus was registered among the youngest children (0-4 years). CONCLUSIONS This study, which shows the high incidence of influenza among children under the age of 14, highlights the importance of regular influenza vaccination. Since children often play a dominant role in spreading influenza virus in the community, regular vaccination can have both health and economic benefits for all age groups.

Avian Influenza: Strategies to Manage an Outbreak.

Avian influenza (AI) is a contagious disease among the poultry population with high avian mortality, which generates significant economic losses and elevated costs for disease control and outbreak eradication. AI is caused by an RNA virus part of the Orthomyxoviridae family; however, only Influenzavirus A is capable of infecting birds. AI pathogenicity is based on the lethality, signs, and molecular characteristics of the virus. Low pathogenic avian influenza (LPAI) virus has a low mortality rate and ability to infect, whereas the highly pathogenic avian influenza (HPAI) virus can cross respiratory and intestinal barriers, diffuse to the blood, damage all tissues of the bird, and has a high mortality rate. Nowadays, avian influenza is a global public health concern due to its zoonotic potential. Wild waterfowl is the natural reservoir of AI viruses, and the oral-fecal path is the main transmission route between birds. Similarly, transmission to other species generally occurs after virus circulation in densely populated infected avian species, indicating that AI viruses can adapt to promote the spread. Moreover, HPAI is a notifiable animal disease; therefore, all countries must report infections to the health authorities. Regarding laboratory diagnoses, the presence of influenza virus type A can be identified by agar gel immunodiffusion (AGID), enzyme immunoassay (EIA), immunofluorescence assays, and enzyme-linked immunoadsorption assay (ELISAs). Furthermore, reverse transcription polymerase chain reaction is used for viral RNA detection and is considered the gold standard for the management of suspect and confirmed cases of AI. If there is suspicion of a case, epidemiological surveillance protocols must be initiated until a definitive diagnosis is obtained. Moreover, if there is a confirmed case, containment actions should be prompt and strict precautions must be taken when handling infected poultry cases or infected materials. The containment measures for confirmed cases include the sanitary slaughter of infected poultry using methods such as environment saturation with CO2, carbon dioxide foam, and cervical dislocation. For disposal, burial, and incineration, protocols should be followed. Lastly, disinfection of affected poultry farms must be carried out. The present review aims to provide an overview of the avian influenza virus, strategies for its management, the challenges an outbreak can generate, and recommendations for informed decision making.

Influenza outbreak in India: A course ahead

“Influenza” is commonly known as “flu” caused by a single-stranded RNA virus. There are four types of Influenza viruses A, B, C and D, of which type A and B are mainly known to cause respiratory tract infection in humans, especially during the winter and post-monsoon season. It is transmitted rapidly through infectious droplets in crowded places, including schools and hospitals.[1] The incubation period of influenza ranges from1 to 4 days with its period of communicability ranges from one day before the onset of symptoms to 7 days after the symptoms begin.[2] It has already caused multiple pandemics in the past, with a recent one in year 2009 was caused by the Influenza subtype A H1N1 variant (pdm09). Millions of deaths have occurred during these pandemics. The vulnerable population like under-five children, elderly people (? 65years of age), pregnant women, and people with comorbidity like diabetes, chronic kidney disease, chronic obstructive pulmonary disease, chronic heart disease, chronic liver disease and immunocompromised conditions (i.e., HIV/ AIDS, malignancy, individuals on chemotherapy or steroid) are at higher risk of developing severe illness due to infection by Influenza viruses.

Synthesis of Spirolactones and Functionalized Benzofurans via Addition of 3-Sulfonylphthalides to 2-Formylaryl Triflates and Conversion to Benzofuroisocoumarins.

A convenient protocol for the synthesis of spirobenzofuran-isobenzofurans and substituted benzofurans via a modified Hauser-Kraus reaction of 3-sulfonylphthalide with 2-formylaryl triflates is reported here. The initial reaction involved 1,2-addition of phthalide to the formyl group and intramolecular cyclization via substitution of triflate followed by a cascade of rearrangements leading to spirolactone or benzofuran derivatives. The electronic nature of substituents on aryl triflates affected the course and outcome of the reaction. The mechanism was supported by successful characterization of one of the intermediates by mass spectrometry. A medicinally relevant influenza virus type B inhibitor, benzofuroisocoumarin, was synthesized in a single step from the spiro compound, thus demonstrating the synthetic utility of our methodology.

Changes in the Epidemiological Features of Influenza After the COVID-19 Pandemic in China, the United States, and Australia: Updated Surveillance Data for Influenza Activity.

There has been a global decrease in seasonal influenza activity since the onset of the COVID-19 pandemic. We aimed to describe influenza activity during the 2021/2022 season and compare it to the trends from 2012 to 2023. We also explored the influence of social and public health prevention measures during the COVID-19 pandemic on influenza activity. We obtained influenza data from January 1, 2012, to February 5, 2023, from publicly available platforms for China, the United States, and Australia. Mitigation measures were evaluated per the stringency index, a composite index with 9 measures. A general additive model was used to assess the stringency index and the influenza positivity rate correlation, and the deviance explained was calculated. We used over 200,000 influenza surveillance data. Influenza activity remained low in the United States and Australia during the 2021/2022 season. However, it increased in the United States with a positive rate of 26.2% in the 49th week of 2022. During the 2021/2022 season, influenza activity significantly increased compared with the previous year in southern and northern China, with peak positivity rates of 28.1% and 35.1% in the second week of 2022, respectively. After the COVID-19 pandemic, the dominant influenza virus genotype in China was type B/Victoria, during the 2021/2022 season, and accounted for >98% (24,541/24,908 in the South and 20,543/20,634 in the North) of all cases. Influenza virus type B/Yamagata was not detected in all these areas after the COVID-19 pandemic. Several measures individually significantly influence local influenza activity, except for influenza type B in Australia. When combined with all the measures, the deviance explained values for influenza A and B were 87.4% (P<.05 for measures of close public transport and restrictions on international travel) and 77.6% in southern China and 83.4% (P<.05 for measures of school closing and close public transport) and 81.4% in northern China, respectively. In the United States, the association was relatively stronger, with deviance-explained values of 98.6% for influenza A and 99.1% (P<.05 for measures of restrictions on international travel and public information campaign) for influenza B. There were no discernible effects on influenza B activity in Australia between 2020 and 2022 due to the incredibly low positive rate of influenza B. Additionally, the deviance explained values were 95.8% (P<.05 for measures of restrictions on gathering size and restrictions on international travel) for influenza A and 72.7% for influenza B. Influenza activity has increased gradually since 2021. Mitigation measures for COVID-19 showed correlations with influenza activity, mainly driven by the early stage of the pandemic. During late 2021 and 2022, the influence of mitigation management for COVID-19 seemingly decreased gradually, as the activity of influenza increased compared to the 2020/2021 season.

Case-control study of relationship of infection by respiratory viruses with acute otitis media in Chinese children

BackgroundAcute otitis media (AOM) may occur as a complication of viral upper respiratory infection (URI) in children. Our objective was to examine children with URI + AOM or URI alone to determine the association of infection by different common respiratory viruses with AOM. MethodsNasopharyngeal swabs were collected from March 2014 to February 2015. Quantitative PCR was then used to identify the following 10 common respiratory viruses: respiratory syncytial virus (RSV); parainfluenza viruses 1–4 (PIVs); influenza virus type A (IFVA); influenza virus type B; human rhinovirus (HRV); enterovirus; human metapneumovirus; human coronavirus OC43, 229E, NL63, and HKU1; adenovirus; and human bocavirus. ResultsWe examined 255 children with URIs (mean age: 32.9 ± 18.7 months), and 164 (64.1%) of them tested positive for at least one respiratory virus. The most common viruses were RSV (44, 24.3%), PIVs (28, 15.5%), and IFVA (25, 13.8%). Positivity for RSV was significantly greater in the URI + AOM group than in the URI group, but these groups did not differ in infection rates for the other 9 viruses. There were also significant seasonal differences in positivity for RSV, IFVA, HRV,HBoV, PIVs and EV. ConclusionOur results indicated a relationship between infection by common respiratory viruses and AOM in children from Beijing. A URI with RSV significantly increased the risk of AOM in these children.

Potential probiotics for regulation of the gut-lung axis to prevent or alleviate influenza in vulnerable populations.

Influenza, also known as "flu", is an infectious disease caused by influenza viruses. Three types of influenza virus, A, B, and C, are able to infect humans. In most people, influenza causes mild symptoms, but it can also induce severe complications and death. Annual influenza vaccines are currently the main intervention used to minimize mortality and morbidity. However, vaccination frequently fails to provide adequate protection, especially in the elderly. Traditional flu vaccine targets hemagglutinin to prevent virus infection, but the constant mutation of hemagglutinin means that it is a challenge to develop vaccines quickly enough to keep up with mutations. Thus, other methods of curbing influenza incidence would be welcomed, especially for vulnerable populations. Although influenza viruses primarily infect the respiratory tract, influenza virus infection also induces intestinal dysbiosis. Through gut microbiota-derived secreted products and the circulating immune cells, gut microbiota can affect pulmonary immunity. The crosstalk between the respiratory tract and gut microbiota, termed the "gut-lung axis", is observed in the regulation of immune responses against influenza virus infection or inflammation-induced lung damage, indicating the possibility of using probiotics to prevent influenza virus infection or alleviate respiratory symptoms. In this review, we summarize the current findings on the antiviral functions of particular probiotics and/or combinations and discuss the antiviral mechanisms and immunomodulatory activities of probiotics invitro, in mice, and in humans. Clinical studies show probiotic supplements can provide health benefits, not only to the elderly or children with compromised immune systems, but also to young- and middle-aged adults.