The first announcement about the 1918 "Spanish flu" pandemic in Greece through the writings of the pioneer newspaper "Thessalia" almost a century ago.

PubMed

Tsoucalas, Gregory; Karachaliou, Fotini; Kalogirou, Vasiliki; Gatos, Giorgos; Mavrogiannaki, Eirini; Antoniou, Antonios; Gatos, Konstantinos

2015-03-01

A local pioneer newspaper, "Thessalia", was the first to announce the arrival of "Spanish Flu" in Greece. It was July 19th 1918 when an epidemic outbreak occurred in the city of Patras. Until then, "Thessalia" had dealt in depth with the flu pandemic in the Greek district of Thessaly, informing the readers of the measures taken, as well as the social and economic aspects of the flu.

H1N1 Flu & U.S. Schools: Answers to Frequently Asked Questions

ERIC Educational Resources Information Center

US Department of Education, 2009

2009-01-01

A severe form of influenza known as H1N1, commonly being called swine flu, has health officials around the world concerned. In the United States, the outbreak of H1N1 has prompted school closures and cancellation of school-related events. As the flu spreads, the Department of Education encourages school leaders, parents and students to know how to…

From SARS to H7N9: the mechanism of responding to emerging communicable diseases has made great progress in China.

PubMed

Yao, Linong; Chen, Enfu; Chen, Zhiping; Gong, Zhenyu

2013-12-01

The outbreak of severe acute respiratory syndrome (SARS) in 2003 indicated that China's existing former mechanism for emergency management was very vulnerable. The Chinese Government has since established a new mechanism for responding to emerging communicable diseases. This paper examined the current status of and developments in China's response to emerging communicable diseases from the outbreak of SARS in 2003 to the outbreak of H7N9 virus infection in 2013. Results indicated that the current mechanism for emergency responses to emerging communicable diseases in China has made great achievements in terms of command and decision-making, organization and collaboration, monitoring and early warning systems, protection, and international communication and cooperation. This mechanism for responding to emerging communicable diseases allowed China to successfully deal with outbreaks of the H5N1 bird flu, H1N1 flu, and H7N9 bird flu. However, a better coordination system, a more complete Office of Responses to Public Health Emergencies, administrative responsibility and error correction, better personnel training, and government responsibility may help to improve the response to emerging communicable diseases. Such improvements are eagerly anticipated.

Who is sceptical about emerging public health threats? Results from 39 national surveys in the United Kingdom.

PubMed

Rubin, G J; Finn, Y; Potts, H W W; Michie, S

2015-12-01

Members of the public are often sceptical about warnings of an impending public health crisis. Breaking through this scepticism is important if we are to convince people to take urgent protective action. In this paper we explored correlates of perceiving that 'too much fuss' was being made about the 2009/10 influenza A H1N1v ('swine flu') pandemic. A secondary analysis of data from 39 nationally representative telephone surveys conducted in the UK during the pandemic. Each cross-sectional survey (combined n = 42,420) collected data over a three day period and asked participants to state whether they agreed or disagreed that 'too much fuss is being made about the risk of swine flu.' Overall, 55.1% of people agreed or strongly agreed with this sentiment. Perceiving that too much fuss was being made was associated with: being male, being white, being generally healthy, trusting most in a primary care physician to provide advice, not knowing someone who had contracted the illness, believing you know a lot about the outbreak, not wishing to receive additional information about the outbreak and possessing worse factual knowledge about the outbreak than other people. In future disease outbreaks merely providing factual information is unlikely to engage people who are sceptical about the need to take action. Instead, messages which challenge their perceived knowledge and which present case studies of people who have been affected may prove more effective, especially when delivered through trusted channels. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Challenges and Strategies of Laboratory Diagnosis for Newly Emerging Influenza Viruses in Taiwan: A Decade after SARS

PubMed Central

Wu, Ho-Sheng

2015-01-01

Since the first case of severe acute respiratory syndrome (SARS) in Taiwan was identified in March 2003, viral respiratory infections, in particular the influenza virus, have become a national public health concern. Taiwan would face a serious threat of public health problems if another SARS epidemic overlapped with a flu outbreak. After SARS, the Taiwan Centers for Disease Control accelerated and strengthened domestic research on influenza and expanded the exchange of information with international counterparts. The capacity of influenza A to cross species barriers presents a potential threat to human health. Given the mutations of avian flu viruses such as H7N9, H6N1, and H10N8, all countries, including Taiwan, must equip themselves to face a possible epidemic or pandemic. Such preparedness requires global collaboration. PMID:26290876

Incentives for Reporting Infectious Disease Outbreaks

ERIC Educational Resources Information Center

Malani, Anup; Laxminarayan, Ramanan

2011-01-01

The global spread of diseases such as swine flu and SARS highlights the difficult decision governments face when presented with evidence of a local outbreak. Reporting the outbreak may bring medical assistance but is also likely to trigger trade sanctions by countries hoping to contain the disease. Suppressing the information may avoid trade…

Carcass Management During Avian Influenza Outbreaks

EPA Pesticide Factsheets

This page on Avian Influenza (AI) describes carcass management during Avian Flu outbreaks, including who oversees carcass management, how they're managed, environmental concerns from carcass management, and disinfection. The page also describes what AI is.

Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

PubMed

O'Connor, L; Boland, M; Murphy, H

2015-01-01

Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

How Colleges Can Plan for Bird Flu

ERIC Educational Resources Information Center

Turner, James C.

2005-01-01

Media coverage of the worldwide outbreak of avian flu and the potential for a pandemic has resulted in anxiety and consternation among members of the US public. The US President George W. Bush has released the federal pandemic-preparedness plan that calls on communities to coordinate plans with local and state health departments and other…

Influenza: a world of discoveries, outbreaks and controversy.

PubMed

Barclay, Wendy S

2017-05-01

Working in an area such as influenza is a free ticket into science communication, a pathway aided amply by the amazing evolutionary powers of the virus; regular outbreaks keep the media engaged and the audience keen. Everyone has heard of flu, and they probably already have an opinion: 'I don't take the vaccine, it gives me the flu anyway.' 'Didn't the government waste loads of money on that Tamiflu drug that doesn't work?' 'I've never had flu because I eat a banana every day and sleep with a boiled onion when I've sat next to someone on the train who was coughing.' Such muddled messages and folklore fallacies could be very damaging unless we as scientists stand up and correct them. In addition, there are wider ethical debates around sharing data from clinical trials and the acceptable limits of scientific research to which we must all contribute.

Mathematical modeling of Avian Influenza epidemic with bird vaccination in constant population

NASA Astrophysics Data System (ADS)

Kharis, M.; Amidi

2018-03-01

The development of the industrial world and human life is increasingly modern and less attention to environmental sustainability causes the virus causes the epidemic has a high tendency to mutate so that the virus that initially only attack animals, is also found to have the ability to attack humans. The epidemics that lasted some time were bird flu epidemics and swine flu epidemics. The flu epidemic led to several deaths and many people admitted to the hospital. Strain (derivatives) of H5N1 virus was identified as the cause of the bird flu epidemic while the H1N1 strain of the virus was identified as the cause of the swine flu epidemic. The symptoms are similar to seasonal flu caused by H3N2 strain of the virus. Outbreaks of bird flu and swine flu initially only attacked animals, but over time some people were found to be infected with the virus.

Initial psychological responses to Influenza A, H1N1 ("Swine flu").

PubMed

Goodwin, Robin; Haque, Shamsul; Neto, Felix; Myers, Lynn B

2009-10-06

The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses. 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001). 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened. Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

The Evaluations of Swine Flu Magnitudes in TV News: A Comparative Analysis of Paired Influenza Pandemics.

PubMed

Pan, Po-Lin; Meng, Juan

2015-01-01

This study examined how major TV news networks covered two flu pandemics in 1976 and 2009 in terms of news frames, mortality exemplars, mortality subject attributes, vaccination, evaluation approaches, and news sources. Results showed that the first pandemic was frequently framed with the medical/scientific and political/legal issues, while the second pandemic was emphasized with the health risk issue in TV news. Both flu pandemics were regularly reported with mortality exemplars, but the focus in the first pandemic was on the flu virus threat and vaccination side effects, while the vaccination shortage was frequently revealed in the second outbreak.

Help make your school a flu-free zone.

PubMed

Baker, Carol J

2011-11-01

Schools are a particular "hot spot" for influenza because children can spread the disease a day or two before they show symptoms and can continue to spread the virus for at least a week after symptoms have subsided. School-age children have also been identified as key transmitters in communitywide outbreaks. The best way to prevent influenza outbreaks in schools and communities is through vaccination. Communities are encouraged to join efforts to vaccinate increasing numbers of children and youth. School nurses play an important role in helping to not only promote this national effort but also model it by receiving an annual flu shot.

Preparing for a Pandemic Flu Outbreak

ERIC Educational Resources Information Center

Dittbenner, Richard

2009-01-01

This article discusses the things college leaders should know and do in case of a pandemic influenza outbreak. The author talks about four principles that will guide college leaders in developing a pandemic influenza plan and presents the 10 elements of an effective college pandemic planning process.

Swine-Flu Scare Offers Lessons for Study-Abroad Programs

ERIC Educational Resources Information Center

Fischer, Karin

2009-01-01

Reports of swine flu have led some colleges to pull students and faculty members out of Mexico, the epicenter of the outbreak, and to cancel study-abroad programs there. But even as the number of new cases appears to be falling, the health scare offers some lasting lessons for colleges, says Gary Rhodes, director of the Center for Global Education…

Schools Urged to Prepare for Flu

ERIC Educational Resources Information Center

Honawar, Vaishali

2005-01-01

If a flu pandemic breaks out in the United States, as many as 4 in 10 school-age children will become sick, according to the U.S. Department of Health and Human Services, which released a comprehensive plan on how it would deal with such an outbreak. The nearly 400-page plan says the department would consider measures such as closing schools early…

Is the reporting timeliness gap for avian flu and H1N1 outbreaks in global health surveillance systems associated with country transparency?

PubMed

Tsai, Feng-Jen; Tseng, Eva; Chan, Chang-Chuan; Tamashiro, Hiko; Motamed, Sandrine; Rougemont, André C

2013-03-25

This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap. We recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging diseases, from 2003 to the end of June 2009. The timeliness gap was calculated as the difference in days between the report release dates of the matching outbreaks in the WHO and ProMED-mail systems. Civil liberties scores were collected as indicators of the transparency of each country. The Human Development Index and data indicating the density of physicians and nurses were collected to reflect countries' development and health workforce statuses. Then, logistic regression was performed to determine the correlation between the timeliness gap and civil liberties, human development, and health workforce status, controlling for year. The reporting timeliness gap for avian flu and H1N1 outbreaks significantly decreased after 2003. On average, reports were posted 4.09 (SD = 7.99) days earlier by ProMED-mail than by the WHO. Countries with partly free (OR = 5.77) and free civil liberties scores (OR = 10.57) had significantly higher likelihoods of longer timeliness gaps than non-free countries. Similarly, countries with very high human development status had significantly higher likelihoods of longer timeliness gaps than countries with middle or low human development status (OR = 5.30). However, no association between the timeliness gap and health workforce density was found. The study found that the adoption of IHR 2005, which contributed to countries' awareness of the importance of timely reporting, had a significant impact in improving the reporting timeliness gap. In addition, the greater the civil liberties in a country (e.g., importance of freedom of the media), the longer the timeliness gap.

Impact of quarantine on the 2003 SARS outbreak: a retrospective modeling study.

PubMed

Hsieh, Ying-Hen; King, Chwan-Chuan; Chen, Cathy W S; Ho, Mei-Shang; Hsu, Sze-Bi; Wu, Yi-Chun

2007-02-21

During the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, traditional intervention measures such as quarantine and border control were found to be useful in containing the outbreak. We used laboratory verified SARS case data and the detailed quarantine data in Taiwan, where over 150,000 people were quarantined during the 2003 outbreak, to formulate a mathematical model which incorporates Level A quarantine (of potentially exposed contacts of suspected SARS patients) and Level B quarantine (of travelers arriving at borders from SARS affected areas) implemented in Taiwan during the outbreak. We obtain the average case fatality ratio and the daily quarantine rate for the Taiwan outbreak. Model simulations is utilized to show that Level A quarantine prevented approximately 461 additional SARS cases and 62 additional deaths, while the effect of Level B quarantine was comparatively minor, yielding only around 5% reduction of cases and deaths. The combined impact of the two levels of quarantine had reduced the case number and deaths by almost a half. The results demonstrate how modeling can be useful in qualitative evaluation of the impact of traditional intervention measures for newly emerging infectious diseases outbreak when there is inadequate information on the characteristics and clinical features of the new disease-measures which could become particularly important with the looming threat of global flu pandemic possibly caused by a novel mutating flu strain, including that of avian variety.

Swine Flu -A Comprehensive View

NASA Astrophysics Data System (ADS)

Singh, Vandana; Sood, Meenakshi

2012-07-01

The present article is aimed on comprehensive view of Swine flu. It was first isolated from pigs in 1930 in USA. Pandemic caused by H1N1 in 2009 brought it in limelight. Itís a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, and listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from infected person to healthy person by inhalation or ingestion of droplets contaminated with virus while sneezing or coughing. Two antiviral agents have been reported to help prevent or reduce the effects of swine flu, flu shot and nasal spray. WHO recommended for pandemic period to prevent its future outbreaks through vaccines or non-vaccines means. Antiviral drugs effective against this virus are Tamiflu and Relenza. Rapid antigen testing (RIDT), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory

Contract Support and Facilitation of Epidemic Outbreak Surveillance (EOS) Program Final Operating Capability (FOC)

DTIC Science & Technology

2007-08-01

Community Acquired Pneumonia . The principal investigator is William Weisburg, Ph.D. of Nanogen, and the Medical College of Wisconsin (MCW) is a...captures the most important viruses involved in community - acquired respiratory infections: 1. Influenza A (fluA) 2. Influenza B (fluB) 3. Respiratory...Adenovirus subtype 4, Human Parainfluenza Virus 1, Human Parainfluenza Virus 2, Human Parainfluenza Virus 3, Human Metapneumovirus, Streptococcus pneumonia

Strain Interactions as a Mechanism for Dominant Strain Alternation and Incidence Oscillation in Infectious Diseases: Seasonal Influenza as a Case Study

PubMed Central

Zhang, Xu-Sheng

2015-01-01

Background Many human infectious diseases are caused by pathogens that have multiple strains and show oscillation in infection incidence and alternation of dominant strains which together are referred to as epidemic cycling. Understanding the underlying mechanisms of epidemic cycling is essential for forecasting outbreaks of epidemics and therefore important for public health planning. Current theoretical effort is mainly focused on the factors that are extrinsic to the pathogens themselves (“extrinsic factors”) such as environmental variation and seasonal change in human behaviours and susceptibility. Nevertheless, co-circulation of different strains of a pathogen was usually observed and thus strains interact with one another within concurrent infection and during sequential infection. The existence of these intrinsic factors is common and may be involved in the generation of epidemic cycling of multi-strain pathogens. Methods and Findings To explore the mechanisms that are intrinsic to the pathogens themselves (“intrinsic factors”) for epidemic cycling, we consider a multi-strain SIRS model including cross-immunity and infectivity enhancement and use seasonal influenza as an example to parameterize the model. The Kullback-Leibler information distance was calculated to measure the match between the model outputs and the typical features of seasonal flu (an outbreak duration of 11 weeks and an annual attack rate of 15%). Results show that interactions among strains can generate seasonal influenza with these characteristic features, provided that: the infectivity of a single strain within concurrent infection is enhanced 2−7 times that within a single infection; cross-immunity as a result of past infection is 0.5–0.8 and lasts 2–9 years; while other parameters are within their widely accepted ranges (such as a 2–3 day infectious period and the basic reproductive number of 1.8–3.0). Moreover, the observed alternation of the dominant strain among epidemics emerges naturally from the best fit model. Alternative modelling that also includes seasonal forcing in transmissibility shows that both external mechanisms (i.e. seasonal forcing) and the intrinsic mechanisms (i.e., strain interactions) are equally able to generate the observed time-series in seasonal flu. Conclusions The intrinsic mechanism of strain interactions alone can generate the observed patterns of seasonal flu epidemics, but according to Kullback-Leibler information distance the importance of extrinsic mechanisms cannot be excluded. The intrinsic mechanism illustrated here to explain seasonal flu may also apply to other infectious diseases caused by polymorphic pathogens. PMID:26562668

Data modeling for detection of epidemic outbreak

NASA Astrophysics Data System (ADS)

Jaenisch, Holger M.; Handley, James W.; Jaenisch, Kristina L.; Conn, Michael S.; Faucheux, Jeffrey P.

2005-05-01

Data Modeling is successfully applied to outbreak detection using epidemicological time series data. With proper selection of features, same day detection was demonstrated. Predictive Data Models are derived from the features in the form of integro-differential equations or their solution. These models are used as real-time change detectors. Data Modeling enables change detection using only nominal (no-outbreak) examples for training. Modeling naturally occurring dynamics due to assignable causes such as flu season enables distinction to be made of chemical and biological (chem-bio) causes.

Human temperatures for syndromic surveillance in the emergency department: data from the autumn wave of the 2009 swine flu (H1N1) pandemic and a seasonal influenza outbreak.

PubMed

Bordonaro, Samantha F; McGillicuddy, Daniel C; Pompei, Francesco; Burmistrov, Dmitriy; Harding, Charles; Sanchez, Leon D

2016-03-09

The emergency department (ED) increasingly acts as a gateway to the evaluation and treatment of acute illnesses. Consequently, it has also become a key testing ground for systems that monitor and identify outbreaks of disease. Here, we describe a new technology that automatically collects body temperatures during triage. The technology was tested in an ED as an approach to monitoring diseases that cause fever, such as seasonal flu and some pandemics. Temporal artery thermometers that log temperature measurements were placed in a Boston ED and used for initial triage vital signs. Time-stamped measurements were collected from the thermometers to investigate the performance a real-time system would offer. The data were summarized in terms of rates of fever (temperatures ≥100.4 °F [≥38.0 °C]) and were qualitatively compared with regional disease surveillance programs in Massachusetts. From September 2009 through August 2011, 71,865 body temperatures were collected and included in our analysis, 2073 (2.6 %) of which were fevers. The period of study included the autumn-winter wave of the 2009-2010 H1N1 (swine flu) pandemic, during which the weekly incidence of fever reached a maximum of 5.6 %, as well as the 2010-2011 seasonal flu outbreak, during which the maximum weekly incidence of fever was 6.6 %. The periods of peak fever rates corresponded with the periods of regionally elevated flu activity. Temperature measurements were monitored at triage in the ED over a period of 2 years. The resulting data showed promise as a potential surveillance tool for febrile disease that could complement current disease surveillance systems. Because temperature can easily be measured by non-experts, it might also be suitable for monitoring febrile disease activity in schools, workplaces, and transportation hubs, where many traditional syndromic indicators are impractical. However, the system's validity and generalizability should be evaluated in additional years and settings.

Infodemiology: Tracking Flu-Related Searches on the Web for Syndromic Surveillance

PubMed Central

Eysenbach, Gunther

2006-01-01

Background Syndromic surveillance uses health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response. Objective While most syndromic surveillance systems rely on data from clinical encounters with health professionals, I started to explore in 2004 whether analysis of trends in Internet searches can be useful to predict outbreaks such as influenza epidemics and prospectively gathered data on Internet search trends for this purpose. Results There is an excellent correlation between the number of clicks on a keyword-triggered link in Google with epidemiological data from the flu season 2004/2005 in Canada (Pearson correlation coefficient of current week clicks with the following week influenza cases r=.91). The “Google ad sentinel method” proved to be more timely, more accurate and – with a total cost of Can$365.64 for the entire flu-season – considerably cheaper than the traditional method of reports on influenza-like illnesses observed in clinics by sentinel physicians. Conclusion Systematically collecting and analyzing health information demand data from the Internet has considerable potential to be used for syndromic surveillance. Tracking web searches on the Internet has the potential to predict population-based events relevant for public health purposes, such as real outbreaks, but may also be confounded by “epidemics of fear”. Data from such “infodemiology studies” should also include longitudinal data on health information supply. PMID:17238340

Factors Affecting Intention among Students to Be Vaccinated against A/H1N1 Influenza: A Health Belief Model Approach

PubMed Central

Teitler-Regev, Sharon; Shahrabani, Shosh; Benzion, Uri

2011-01-01

The outbreak of A/H1N1 influenza (henceforth, swine flu) in 2009 was characterized mainly by morbidity rates among young people. This study examined the factors affecting the intention to be vaccinated against the swine flu among students in Israel. Questionnaires were distributed in December 2009 among 387 students at higher-education institutions. The research questionnaire included sociodemographic characteristics and Health Belief Model principles. The results show that the factors positively affecting the intention to take the swine flu vaccine were past experience with seasonal flu shot and three HBM categories: higher levels of perceived susceptibility for catching the illness, perceived seriousness of illness, and lower levels of barriers. We conclude that offering the vaccine at workplaces may raise the intention to take the vaccine among young people in Israel. PMID:22229099

Mitigation Approaches to Combat the Flu Pandemic

PubMed Central

Chawla, Raman; Sharma, Rakesh Kumar; Madaan, Deepali; Dubey, Neha; Arora, Rajesh; Goel, Rajeev; Singh, Shefali; Kaushik, Vinod; Singh, Pankaj Kumar; Chabbra, Vivek; Bhardwaj, Janak Raj

2009-01-01

Management of flu pandemic is a perpetual challenge for the medical fraternity since time immemorial. Animal to human transmission has been observed thrice in the last century within an average range of 11-39 years of antigenic recycling. The recent outbreak of influenza A (H1N1, also termed as swine flu), first reported in Mexico on April 26, 2009, occurred in the forty first year since last reported flu pandemic (July 1968). Within less than 50 days, it has assumed pandemic proportions (phase VI) affecting over 76 countries with 163 deaths/35,928 cases (as on 15th June 2009). It indicated the re-emergence of genetically reassorted virus having strains endemic to humans, swine and avian (H5N1). The World Health Organisation (WHO) member states have already pulled up their socks and geared up to combat such criticalities. Earlier outbreaks of avian flu (H5N1) in different countries led WHO to develop pandemic preparedness strategies with national/regional plans on pandemic preparedness. Numerous factors related to climatic conditions, socio-economic strata, governance and sharing of information/logistics at all levels have been considered critical indicators in monitoring the dynamics of escalation towards a pandemic situation. The National Disaster Management Authority (NDMA), Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies), nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its effective implementation at national, state and local levels. PMID:20300402

Mitigation approaches to combat the flu pandemic.

PubMed

Chawla, Raman; Sharma, Rakesh Kumar; Madaan, Deepali; Dubey, Neha; Arora, Rajesh; Goel, Rajeev; Singh, Shefali; Kaushik, Vinod; Singh, Pankaj Kumar; Chabbra, Vivek; Bhardwaj, Janak Raj

2009-07-01

Management of flu pandemic is a perpetual challenge for the medical fraternity since time immemorial. Animal to human transmission has been observed thrice in the last century within an average range of 11-39 years of antigenic recycling. The recent outbreak of influenza A (H1N1, also termed as swine flu), first reported in Mexico on April 26, 2009, occurred in the forty first year since last reported flu pandemic (July 1968). Within less than 50 days, it has assumed pandemic proportions (phase VI) affecting over 76 countries with 163 deaths/35,928 cases (as on 15(th) June 2009). It indicated the re-emergence of genetically reassorted virus having strains endemic to humans, swine and avian (H5N1). The World Health Organisation (WHO) member states have already pulled up their socks and geared up to combat such criticalities. Earlier outbreaks of avian flu (H5N1) in different countries led WHO to develop pandemic preparedness strategies with national/regional plans on pandemic preparedness. Numerous factors related to climatic conditions, socio-economic strata, governance and sharing of information/logistics at all levels have been considered critical indicators in monitoring the dynamics of escalation towards a pandemic situation.The National Disaster Management Authority (NDMA), Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies), nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its effective implementation at national, state and local levels.

Detecting a trend change in cross-border epidemic transmission

NASA Astrophysics Data System (ADS)

Maeno, Yoshiharu

2016-09-01

A method for a system of Langevin equations is developed for detecting a trend change in cross-border epidemic transmission. The equations represent a standard epidemiological SIR compartment model and a meta-population network model. The method analyzes a time series of the number of new cases reported in multiple geographical regions. The method is applicable to investigating the efficacy of the implemented public health intervention in managing infectious travelers across borders. It is found that the change point of the probability of travel movements was one week after the WHO worldwide alert on the SARS outbreak in 2003. The alert was effective in managing infectious travelers. On the other hand, it is found that the probability of travel movements did not change at all for the flu pandemic in 2009. The pandemic did not affect potential travelers despite the WHO alert.

Pandemic influenza computer model (no soundtrack)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Los Alamos National Lab

2009-05-01

Simulation of a pandemic flu outbreak in the continental United States, initially introduced by the arrival of 10 infected individuals in Los Angeles. ----------The spatiotemporal dynamics of the prevalence (number of symptomatic cases at any point in

A history of the 1918 Spanish influenza pandemic and its impact on Iran.

PubMed

Azizi, Mohammad Hossein; Raees Jalali, Ghanbar Ali; Azizi, Farzaneh

2010-05-01

Approximately ninety two years ago, the worst influenza pandemic or "Spanish flu" occurred in 1918, at the end of the First World War (WWI, 1914-1918) which resulted in the deaths of millions of people worldwide. The death toll exceeded the total number of victims of WWI. The 1918 Spanish flu was a deadly, major global event that affected many countries, including Iran. In Iran, it was accompanied by a high mortality rate estimated to be more than one million. However, detailed information on the impact of this outbreak in Iran is scarce. The present paper describes a brief history of the influenza pandemics in the world as well as the spread of the 1918 Spanish flu to Iran.

The neuropsychiatric aspects of influenza/swine flu: A selective review

PubMed Central

Manjunatha, Narayana; Math, Suresh Bada; Kulkarni, Girish Baburao; Chaturvedi, Santosh Kumar

2011-01-01

The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu) pandemic is believed to be the legacy of the influenza pandemic (1918-19). The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine ‘PUBMED’ to search for published articles with different MeSH terms using Boolean operator (AND). Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson's disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research. PMID:23271861

The neuropsychiatric aspects of influenza/swine flu: A selective review.

PubMed

Manjunatha, Narayana; Math, Suresh Bada; Kulkarni, Girish Baburao; Chaturvedi, Santosh Kumar

2011-07-01

The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu) pandemic is believed to be the legacy of the influenza pandemic (1918-19). The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine 'PUBMED' to search for published articles with different MeSH terms using Boolean operator (AND). Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson's disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

Visible light powered self-disinfecting coatings for influenza viruses

NASA Astrophysics Data System (ADS)

Weng, Ding; Qi, Hangfei; Wu, Ting-Ting; Yan, Ming; Sun, Ren; Lu, Yunfeng

2012-04-01

Influenza A viruses, the pathogens responsible for the recent swine flu outbreak and many historical pandemics, remain a threat to the public health. We report herein the fabrication of self-disinfecting surfaces from photoactive building nanocrystals, which can inactivate influenza viruses rapidly, spontaneously and continuously under visible light illumination.Influenza A viruses, the pathogens responsible for the recent swine flu outbreak and many historical pandemics, remain a threat to the public health. We report herein the fabrication of self-disinfecting surfaces from photoactive building nanocrystals, which can inactivate influenza viruses rapidly, spontaneously and continuously under visible light illumination. Electronic supplementary information (ESI) available: XRD, UV-Vis absorbance, TEM, AFM of as-prepared nanocrystals and as-fabricated self-disinfecting surfaces, disinfection of influenza A virus by TiO2 (P25) with UV irradiation as reference control, photoinactivation of influenza A virus envelope proteins and photoinactivation of trypsin. See DOI: 10.1039/c2nr30388d

[Study on risk awareness and preparedness for pandemic flu among staff members from enterprises].

PubMed

Wu, Jiang; Lv, Min; Wang, Quan-yi; Dong, Zhen-ying; Yi, Qing; Zhang, Xiantao

2007-01-01

To evaluate the risk awareness and preparedness related to pandemic flu in China. Two groups of people, mainly employers and employees from enterprises, were covered in the survey, using quantitative (questionnaire) and qualitative (in-depth interview) methods. The employers and employees were from joint-ventured corporations, large state-owned corporations and private companies which were randomly selected from 7 major cities in China. (1) 82% of the people surveyed and interviewed had basic knowledge on pandemic flu. (2) 60% of the joint-ventured corporations had worked out or were working on their business continuity plan in the event of pandemic flu, compared to that of state-owned corporations and private companies that the figure was only 21% . (3) 67% of the joint-ventured corporations had informed their preparedness plan on pandemic flu to their employees, while that of the state-owned and private corporations, it was only 42 %. (4) About 70 % of the corporations was establishing policies for restricting travel to affected geographic areas (both domestic and international), evacuating the employees who working in or near the affected area when an outbreak began. (5) Nearly 60 % of the corporations thought annual flu vaccination was important and hence encouraging and tracking annual flu vaccination for employees. (6) 70% of the corporations paid high attention on providing sufficient and accessible supplies (e. g. hand - hygiene products, tissues and receptacles for their disposal) to control the epidemics in all business locations while nearly 76 % of the corporations were interested in purchasing commercial medical insurance. Joint-verntured corporation were doing better than domestic corporations in terms of risk awareness and preparedness on pandemic flu, suggesting that the domestic corporation should learn from them regarding on pandemic flu preparedness to limit the negative impact of pandemic flu.

Planning for avian flu disruptions on global operations: a DMAIC case study.

PubMed

Kumar, Sameer

2012-01-01

The author aims to assess the spread of avian flu, its impact on businesses operating in the USA and overseas, and the measures required for corporate preparedness. Six Sigma DMAIC process is used to analyze avian flu's impact and how an epidemic could affect large US business operations worldwide. Wal-Mart and Dell Computers were chosen as one specializes in retail and the other manufacturing. The study identifies avian flu pandemic risks including failure modes on Wal-Mart and Dell Computers global operations. It reveals the factors that reinforce avian-flu pandemic's negative impact on company global supply chains. It also uncovers factors that balance avian-flu pandemic's impact on their global supply chains. Avian flu and its irregularity affect the research outcomes because its spread could fluctuate based on so many factors that could come into play. Further, the potential cost to manufacturers and other supply chain partners is relatively unknown. As a relatively new phenomenon, quantitative data were not available to determine immediate costs. In this decade, the avian influenza H5N1 virus has killed millions of poultry in Asia, Europe and Africa. This flu strain can infect and kill humans who come into contact with this virus. An avian influenza H5N1 outbreak could lead to a devastating effect on global food supply, business services and business operations. The study provides guidance on what global business operation managers can do to prepare for such events, as well as how avian flu progression to a pandemic can disrupt such operations. This study raises awareness about avian flu's impact on businesses and humans and also highlights the need to create contingency plans for corporate preparedness to avoid incurring losses.

Pandemic Flu Planning in Africa: Thoughts from a Nigerian Case Study

DTIC Science & Technology

2009-07-01

of bubonic plague , known as the Plague of Justinian, occurred in 541, killing thousands of people in Constantinople, Egypt, and elsewhere along the...unburied when their servants predeceased them.5 The second major outbreak of bubonic plague , known then as the Black Death, appeared in 1346...high as 60 percent). Poor sanitation and severe overcrowding in cities further led to the rapid spread of disease. Small outbreaks of bubonic plague

Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic.

PubMed

Gagnon, Alain; Acosta, Enrique; Hallman, Stacey; Bourbeau, Robert; Dillon, Lisa Y; Ouellette, Nadine; Earn, David J D; Herring, D Ann; Inwood, Kris; Madrenas, Joaquin; Miller, Matthew S

2018-01-16

Recent outbreaks of H5, H7, and H9 influenza A viruses in humans have served as a vivid reminder of the potentially devastating effects that a novel pandemic could exert on the modern world. Those who have survived infections with influenza viruses in the past have been protected from subsequent antigenically similar pandemics through adaptive immunity. For example, during the 2009 H1N1 "swine flu" pandemic, those exposed to H1N1 viruses that circulated between 1918 and the 1940s were at a decreased risk for mortality as a result of their previous immunity. It is also generally thought that past exposures to antigenically dissimilar strains of influenza virus may also be beneficial due to cross-reactive cellular immunity. However, cohorts born during prior heterosubtypic pandemics have previously experienced elevated risk of death relative to surrounding cohorts of the same population. Indeed, individuals born during the 1890 H3Nx pandemic experienced the highest levels of excess mortality during the 1918 "Spanish flu." Applying Serfling models to monthly mortality and influenza circulation data between October 1997 and July 2014 in the United States and Mexico, we show corresponding peaks in excess mortality during the 2009 H1N1 "swine flu" pandemic and during the resurgent 2013-2014 H1N1 outbreak for those born at the time of the 1957 H2N2 "Asian flu" pandemic. We suggest that the phenomenon observed in 1918 is not unique and points to exposure to pandemic influenza early in life as a risk factor for mortality during subsequent heterosubtypic pandemics. IMPORTANCE The relatively low mortality experienced by older individuals during the 2009 H1N1 influenza virus pandemic has been well documented. However, reported situations in which previous influenza virus exposures have enhanced susceptibility are rare and poorly understood. One such instance occurred in 1918-when those born during the heterosubtypic 1890 H3Nx influenza virus pandemic experienced the highest levels of excess mortality. Here, we demonstrate that this phenomenon was not unique to the 1918 H1N1 pandemic but that it also occurred during the contemporary 2009 H1N1 pandemic and 2013-2014 H1N1-dominated season for those born during the heterosubtypic 1957 H2N2 "Asian flu" pandemic. These data highlight the heretofore underappreciated phenomenon that, in certain instances, prior exposure to pandemic influenza virus strains can enhance susceptibility during subsequent pandemics. These results have important implications for pandemic risk assessment and should inform laboratory studies aimed at uncovering the mechanism responsible for this effect. Copyright © 2018 Gagnon et al.

Adjuvant solution for pandemic influenza vaccine production.

PubMed

Clegg, Christopher H; Roque, Richard; Van Hoeven, Neal; Perrone, Lucy; Baldwin, Susan L; Rininger, Joseph A; Bowen, Richard A; Reed, Steven G

2012-10-23

Extensive preparation is underway to mitigate the next pandemic influenza outbreak. New vaccine technologies intended to supplant egg-based production methods are being developed, with recombinant hemagglutinin (rHA) as the most advanced program for preventing seasonal and avian H5N1 Influenza. Increased efforts are being focused on adjuvants that can broaden vaccine immunogenicity against emerging viruses and maximize vaccine supply on a worldwide scale. Here, we test protection against avian flu by using H5N1-derived rHA and GLA-SE, a two-part adjuvant system containing glucopyranosyl lipid adjuvant (GLA), a formulated synthetic Toll-like receptor 4 agonist, and a stable emulsion (SE) of oil in water, which is similar to the best-in-class adjuvants being developed for pandemic flu. Notably, a single submicrogram dose of rH5 adjuvanted with GLA-SE protects mice and ferrets against a high titer challenge with H5N1 virus. GLA-SE, relative to emulsion alone, accelerated induction of the primary immune response and broadened its durability against heterosubtypic H5N1 virus challenge. Mechanistically, GLA-SE augments protection via induction of a Th1-mediated antibody response. Innate signaling pathways that amplify priming of Th1 CD4 T cells will likely improve vaccine performance against future outbreaks of lethal pandemic flu.

Societal and economic consequences of influenza.

PubMed

Piedra, Pedro A

2008-10-01

High rates of vaccination coverage for preschool and school-aged children can reduce morbidity and mortality related to influenza outbreak. More focused and effective influenza prevention strategies are necessary to improve quality of life and to limit the burden of flu complications.

Early Warning and Outbreak Detection Using Social Networking Websites: The Potential of Twitter

NASA Astrophysics Data System (ADS)

de Quincey, Ed; Kostkova, Patty

Epidemic Intelligence is being used to gather information about potential diseases outbreaks from both formal and increasingly informal sources. A potential addition to these informal sources are social networking sites such as Facebook and Twitter. In this paper we describe a method for extracting messages, called "tweets" from the Twitter website and the results of a pilot study which collected over 135,000 tweets in a week during the current Swine Flu pandemic.

Pathogens gone wild? Medical anthropology and the "swine flu" pandemic.

PubMed

Singer, Merrill

2009-07-01

Beginning in April 2009, global attention began focusing on the emergence in Mexico of a potentially highly lethal new influenza strain of porcine origin that has successfully jumped species barriers and is now being transmitted around the world. Reported on extensively by the mass media, commented on by public health and government officials across the globe, and focused on with nervous attention by the general public, the so-called swine flu pandemic raises important questions, addressed here, concerning the capacity of medical anthropology to respond usefully to such disease outbreaks and their health and social consequences.

Representations of swine flu: perspectives from a Malaysian pig farm.

PubMed

Goodwin, Robin; Haque, Shamsul; Hassan, Sharifah Binti Syed; Dhanoa, Amreeta

2011-07-01

Novel influenza viruses are seen, internationally, as posing considerable health challenges, but public responses to such viruses are often rooted in cultural representations of disease and risk. However, little research has been conducted in locations associated with the origin of a pandemic. We examined representations and risk perceptions associated with swine flu amongst 120 Malaysian pig farmers. Thirty-seven per cent of respondents felt at particular risk of infection, two-thirds were somewhat or very concerned about being infected. Those respondents who were the most anxious believed particular societal "out-groups" (homosexuals, the homeless and prostitutes) to be at higher infection risk. Although few (4%) reported direct discrimination, 46% claimed friends had avoided them since the swine flu outbreak. Findings are discussed in the context of evolutionary, social representations and terror management theories of response to pandemic threat.

Avian flu school: a training approach to prepare for H5N1 highly pathogenic avian influenza.

PubMed

Beltran-Alcrudo, Daniel; Bunn, David A; Sandrock, Christian E; Cardona, Carol J

2008-01-01

Since the reemergence of highly pathogenic avian influenza (H5N1 HPAI) in 2003, a panzootic that is historically unprecedented in the number of infected flocks, geographic spread, and economic consequences for agriculture has developed. The epidemic has affected a wide range of birds and mammals, including humans. The ineffective management of outbreaks, mainly due to a lack of knowledge among those involved in detection, prevention, and response, points to the need for training on H5N1 HPAI. The main challenges are the multidisciplinary approach required, the lack of experts, the need to train at all levels, and the diversity of outbreak scenarios. Avian Flu School addresses these challenges through a three-level train-the-trainer program intended to minimize the health and economic impacts of H5N1 HPAI by improving a community's ability to prevent and respond, while protecting themselves and others. The course teaches need-to-know facts using highly flexible, interactive, and relevant materials.

Swine-origin influenza a outbreak 2009 at Shinshu University, Japan.

PubMed

Uchida, Mitsuo; Tsukahara, Teruomi; Kaneko, Minoru; Washizuka, Shinsuke; Kawa, Shigeyuki

2011-02-04

A worldwide outbreak of swine flu H1N1 pandemic influenza occurred in April 2009. To determine the mechanism underlying the spread of infection, we prospectively evaluated a survey implemented at a local university. Between August 2009 and March 2010, we surveyed 3 groups of subjects: 2318 children in six schools attached to the Faculty of Education, 11424 university students, and 3344 staff members. Subjects with influenza-like symptoms who were diagnosed with swine flu at hospitals or clinics were defined as swine flu patients and asked to make a report using a standardized form. After the start of the pandemic, a total of 2002 patients (11.7%) were registered in the survey. These patients included 928 schoolchildren (40.0%), 1016 university students (8.9%), and 58 staff members (1.7%). The incidence in schoolchildren was significantly higher than in the other 2 groups (P < 0.0001) but there were no within group differences in incidence rate between males and females. During the period of the survey, three peaks of patient numbers were observed, in November 2009, December 2009, and January 2010. The first peak consisted mainly of schoolchildren, whereas the second and third peaks included many university students. Staff members did not contribute to peak formation. Among the university students, the most common suspected route of transmission was club activity. Interventions, such as closing classes, schools, and clubs, are likely to affect the epidemic curves. Schoolchildren and university students are vulnerable to swine flu, suggesting that avoidance of close contact, especially among these young people, may be effective way in controlling future severe influenza pandemics, especially at educational institutions.

Crying wolf? Biosecurity and metacommunication in the context of the 2009 swine flu pandemic.

PubMed

Nerlich, Brigitte; Koteyko, Nelya

2012-07-01

This article explores how the 2009 pandemic of swine flu (H1N1) intersected with issues of biosecurity in the context of an increasing entanglement between the spread of disease and the spread of information. Drawing on research into metacommunication, the article studies the rise of communication about ways in which swine flu was communicated, both globally and locally, during the pandemic. It examines and compares two corpora of texts, namely UK newspaper articles and blogs, written between 28 March and 11 June 2009, that is, the period from the start of the outbreak till the WHO announcement of the pandemic. Findings show that the interaction between traditional and digital media as well as the interaction between warnings about swine flu and previous warnings about other epidemics contributed to a heightened discourse of blame and counter-blame but also, more surprisingly, self-blame and reflections about the role the media in pandemic communication. The consequences of this increase in metacommunication for research into crisis communication are explored. Copyright © 2011 Elsevier Ltd. All rights reserved.

Public anxiety and information seeking following the H1N1 outbreak: blogs, newspaper articles, and Wikipedia visits.

PubMed

Tausczik, Yla; Faasse, Kate; Pennebaker, James W; Petrie, Keith J

2012-01-01

Web-based methodologies may provide a new and unique insight into public response to an infectious disease outbreak. This naturalistic study investigates the effectiveness of new web-based methodologies in assessing anxiety and information seeking in response to the 2009 H1N1 outbreak by examining language use in weblogs ("blogs"), newspaper articles, and web-based information seeking. Language use in blogs and newspaper articles was assessed using Linguistic Inquiry and Word Count, and information seeking was examined using the number of daily visits to H1N1-relevant Wikipedia articles. The results show that blogs mentioning "swine flu" used significantly higher levels of anxiety, health, and death words and lower levels of positive emotion words than control blogs. Change in language use on blogs was strongly related to change in language use in newspaper coverage for the same day. Both the measure of anxiety in blogs mentioning "swine flu" and the number of Wikipedia visits followed similar trajectories, peaking shortly after the announcement of H1N1 and then declining rapidly. Anxiety measured in blogs preceded information seeking on Wikipedia. These results show that the public reaction to H1N1 was rapid and short-lived. This research suggests that analysis of web behavior can provide a source of naturalistic data on the level and changing pattern of public anxiety and information seeking following the outbreak of a public health emergency.

When Disaster Strikes, Move Your School Online

ERIC Educational Resources Information Center

LaPrairie, Kimberly N.; Hinson, Janice M.

2007-01-01

Hurricanes Katrina and Rita displaced thousands of K-12 students and demonstrated that when K-12 schools close unexpectedly and indefinitely, educational chaos results. Events such as deadly flu outbreaks or bioterrorist attacks will have the same impact on education. These possibilities demonstrate the need for state and local officials to begin…

Confidence in government and vaccination willingness in the USA.

PubMed

Mesch, Gustavo S; Schwirian, Kent P

2015-06-01

The most recent internationally widespread disease outbreak occurred during the flu season of 2009 and 2010. On April 2009, the first cases of influenza A (H1N1) (Popularly called, Swine Flu) were confirmed in the USA and UK following a novel virus that was first identified in Mexico. As the virus spread rapidly, the risk of morbidity and mortality increased in several countries. In this paper, we rely on the social cognitive theory of risk to assess the willingness of the US public to comply with vaccination and reduce the risk of sickness and death from the flu. We conduct a secondary data analysis of the Pew Research for the People and Press October 2009 and investigate the factors associated with willingness to take the swine flu vaccine (n = 1000). The findings indicate that the decision to take the swine flu vaccination was highly polarized across partisan lines. Controlling for education, income and demographic factors, the likelihood of taking the vaccine was associated with party identification. Individuals that identified themselves as Democrats were more likely to be willing to take the swine vaccine than individuals that identify themselves as Republicans and Independents. Confidence in the ability of the government to deal with the swine flu crisis seems to explain party identification differences in the willingness to take the vaccine. The implications of the findings are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Humidity-Driven Prediction System for Influenza Outbreaks

NASA Astrophysics Data System (ADS)

Thrastarson, H. T.; Teixeira, J.

2015-12-01

Recent studies have highlighted the role of absolute (or specific) humidity conditions as a leading explanation for the seasonal behavior of influenza outbreaks in temperate regions. If the timing and intensity of seasonal influenza outbreaks can be forecast, this would be of great value for public health response efforts. We have developed and implemented a SIRS (Susceptible-Infectious-Recovered-Susceptible) type numerical prediction system that is driven by specific humidity to predict influenza outbreaks. For the humidity, we have explored using both satellite data from the AIRS (Atmospheric Infrared Sounder) instrument as well as ERA-Interim re-analysis data. We discuss the development, testing, sensitivities and limitations of the prediction system and show results for influenza outbreaks in the United States during the years 2010-2014 (modeled in retrospect). Comparisons are made with other existing prediction systems and available data for influenza outbreaks from Google Flu Trends and the CDC (Center for Disease Control), and the incorporation of these datasets into the forecasting system is discussed.

Plasma Treatment for Severe Influenza Deemed Well-Tolerated in Clinical Study | Frederick National Laboratory for Cancer Research

Cancer.gov

The upcoming flu season is just around the corner, and an ongoing challenge for researchers has been how to best respond to cases of severe influenza in the event of an outbreak. The Frederick National Laboratory for Cancer Research has helped the Na

Social media and outbreaks of emerging infectious diseases: A systematic review of literature.

PubMed

Tang, Lu; Bie, Bijie; Park, Sung-Eun; Zhi, Degui

2018-04-05

The public often turn to social media for information during emerging infectious diseases (EIDs) outbreaks. This study identified the major approaches and assessed the rigors in published research articles on EIDs and social media. We searched 5 databases for published journal articles on EIDs and social media. We then evaluated these articles in terms of EIDs studied, social media examined, theoretical frameworks, methodologic approaches, and research findings. Thirty articles were included in the analysis (published between January 1, 2010, and March 1, 2016). EIDs that received most scholarly attention were H1N1 (or swine flu, n = 15), Ebola virus (n = 10), and H7N9 (or avian flu/bird flu, n = 2). Twitter was the most often studied social media (n = 17), followed by YouTube (n = 6), Facebook (n = 6), and blogs (n = 6). Three major approaches in this area of inquiry are identified: (1) assessment of the public's interest in and responses to EIDs, (2) examination of organizations' use of social media in communicating EIDs, and (3) evaluation of the accuracy of EID-related medical information on social media. Although academic studies of EID communication on social media are on the rise, they still suffer from a lack of theorization and a need for more methodologic rigor. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Factors affecting nurses' decision to get the flu vaccine.

PubMed

Shahrabani, Shosh; Benzion, Uri; Yom Din, Gregory

2009-05-01

The objective of this study was to identify factors that influence the decision whether or not to get the influenza (flu) vaccine among nurses in Israel by using the health belief model (HBM). A questionnaire distributed among 299 nurses in Israel in winter 2005/2006 included (1) socio-demographic information; (2) variables based on the HBM, including susceptibility, seriousness, benefits, barriers and cues to action; and (3) knowledge about influenza and the vaccine, and health motivation. A probit model was used to analyze the data. In Israel, the significant HBM categories affecting nurses' decision to get a flu shot are the perceived benefits from vaccination and cues to action. In addition, nurses who are vaccinated have higher levels of (1) knowledge regarding the vaccine and influenza, (2) perceived seriousness of the illness, (3) perceived susceptibility, and (4) health motivation than do those who do not get the vaccine. Immunization of healthcare workers may reduce the risk of flu outbreaks in all types of healthcare facilities and reduce morbidity and mortality among high-risk patients. In order to increase vaccination rates among nurses, efforts should be made to educate them regarding the benefits of vaccination and the potential health consequences of influenza for their patients, and themselves.

A review of influenza detection and prediction through social networking sites.

PubMed

Alessa, Ali; Faezipour, Miad

2018-02-01

Early prediction of seasonal epidemics such as influenza may reduce their impact in daily lives. Nowadays, the web can be used for surveillance of diseases. Search engines and social networking sites can be used to track trends of different diseases seven to ten days faster than government agencies such as Center of Disease Control and Prevention (CDC). CDC uses the Illness-Like Influenza Surveillance Network (ILINet), which is a program used to monitor Influenza-Like Illness (ILI) sent by thousands of health care providers in order to detect influenza outbreaks. It is a reliable tool, however, it is slow and expensive. For that reason, many studies aim to develop methods that do real time analysis to track ILI using social networking sites. Social media data such as Twitter can be used to predict the spread of flu in the population and can help in getting early warnings. Today, social networking sites (SNS) are used widely by many people to share thoughts and even health status. Therefore, SNS provides an efficient resource for disease surveillance and a good way to communicate to prevent disease outbreaks. The goal of this study is to review existing alternative solutions that track flu outbreak in real time using social networking sites and web blogs. Many studies have shown that social networking sites can be used to conduct real time analysis for better predictions.

OpenFluDB, a database for human and animal influenza virus

PubMed Central

Liechti, Robin; Gleizes, Anne; Kuznetsov, Dmitry; Bougueleret, Lydie; Le Mercier, Philippe; Bairoch, Amos; Xenarios, Ioannis

2010-01-01

Although research on influenza lasted for more than 100 years, it is still one of the most prominent diseases causing half a million human deaths every year. With the recent observation of new highly pathogenic H5N1 and H7N7 strains, and the appearance of the influenza pandemic caused by the H1N1 swine-like lineage, a collaborative effort to share observations on the evolution of this virus in both animals and humans has been established. The OpenFlu database (OpenFluDB) is a part of this collaborative effort. It contains genomic and protein sequences, as well as epidemiological data from more than 27 000 isolates. The isolate annotations include virus type, host, geographical location and experimentally tested antiviral resistance. Putative enhanced pathogenicity as well as human adaptation propensity are computed from protein sequences. Each virus isolate can be associated with the laboratories that collected, sequenced and submitted it. Several analysis tools including multiple sequence alignment, phylogenetic analysis and sequence similarity maps enable rapid and efficient mining. The contents of OpenFluDB are supplied by direct user submission, as well as by a daily automatic procedure importing data from public repositories. Additionally, a simple mechanism facilitates the export of OpenFluDB records to GenBank. This resource has been successfully used to rapidly and widely distribute the sequences collected during the recent human swine flu outbreak and also as an exchange platform during the vaccine selection procedure. Database URL: http://openflu.vital-it.ch. PMID:20624713

[THE CHARACTERISTICS OF CARDIOVASCULAR SYSTEM IN CHILDREN WITH INFLUENZA INFECTION].

PubMed

Dudnik, V; Mantak, G; Andrikevych, I; Roizman, A

2015-01-01

Clinical changes in the cardiovascular system observed in most patients. The extent and nature of these changes may depend on the characteristics of epidemic outbreaks, such as virus, immune responsiveness, age composition patients. Flu-like lesions of the cardiovascular system in most cases occurring beneficial--quickly disappear change of heart, normal pulse and blood pressure.

Determinants of adherence to seasonal influenza vaccination among healthcare workers from an Italian region: results from a cross-sectional study

PubMed Central

Durando, P; Dini, G; Barberis, I; Bagnasco, A M; Iudici, R; Zanini, M; Martini, M; Toletone, A; Paganino, C; Massa, E; Sasso, L

2016-01-01

Objectives Notwithstanding decades of efforts to increase the uptake of seasonal influenza (flu) vaccination among European healthcare workers (HCWs), the immunisation rates are still unsatisfactory. In order to understand the reasons for the low adherence to flu vaccination, a study was carried out among HCWs of two healthcare organisations in Liguria, a region in northwest Italy. Methods A cross-sectional study based on anonymous self-administered web questionnaires was carried out between October 2013 and February 2014. Through univariate and multivariate regression analysis, the study investigated the association between demographic and professional characteristics, knowledge, beliefs and attitudes of the study participants and (i) the seasonal flu vaccination uptake in the 2013/2014 season and (ii) the self-reported number of flu vaccination uptakes in the six consecutive seasons from 2008/2009 to 2013/2014. Results A total of 830 HCWs completed the survey. Factors statistically associated with flu vaccination uptake in the 2013/2014 season were: being a medical doctor and agreeing with the statements ‘flu vaccine is safe’, ‘HCWs have a higher risk of getting flu’ and ‘HCWs should receive flu vaccination every year’. A barrier to vaccination was the belief that pharmaceutical companies influence decisions about vaccination strategies. Discussion All the above-mentioned factors, except the last one, were (significantly) associated with the number of flu vaccination uptakes self-reported by the respondents between season 2008/2009 and season 2013/2014. Other significantly associated factors appeared to be level of education, being affected by at least one chronic disease, and agreeing with mandatory flu vaccination in healthcare settings. Conclusions This survey allows us to better understand the determinants of adherence to vaccination as a fundamental preventive strategy against flu among Italian HCWs. These findings should be used to improve and customise any future promotion campaigns to overcome identified barriers to immunisation. PMID:27188810

Cross reactivity of serum antibody responses elicited by DNA vaccines expressing HA antigens from H1N1 subtype influenza vaccines in the past 30 years.

PubMed

Almansour, Iman; Chen, Huaiqing; Wang, Shixia; Lu, Shan

2013-10-01

In the past three decades, ten H1 subtype influenza vaccines have been recommended for global seasonal flu vaccination. Some of them were used only for one year before being replaced by another H1 flu vaccine while others may be used for up to seven years. While the selection of a new seasonal flu vaccine was based on the escape of a new emerging virus that was not effectively protected by the existing flu formulation, there is limited information on the magnitude and breadth of cross reactivity among H1 subtype virus circulation over a long period. In the current study, HA-expressing DNA vaccines were constructed to express individual HA antigens from H1 subtype vaccines used in the past 30 y. Rabbits naïve to HA antibody responses were immunized with these HA DNA vaccines and the cross reactivity of these sera against HA antigen and related H1 viruses in the same period was studied. Our data indicate that the level of cross reactivity was different for different viral isolates and the key mutations responsible for the cross reactivity may involve only a limited number of residues. Our results provide useful information for the development of improved seasonal vaccines than can achieve broad protection against viruses within the same H1 subtype.

[Influenza A/H5N1 virus outbreaks and prepardness to avert flu pandemic].

PubMed

Haque, A; Lucas, B; Hober, D

2007-01-01

This review emphasizes the need to improve the knowledge of the biology of H5N1 virus, a candidate for causing the next influenza pandemic. In-depth knowledge of mode of infection, mechanisms of pathogenesis and immune response will help in devising an efficient and practical control strategy against this flu virus. We have discussed limitations of currently available vaccines and proposed novel approaches for making better vaccines against H5N1 influenza virus. They include cell-culture system, reverse genetics, adjuvant development. Our review has also underscored the concept of therapeutic vaccine (anti-disease vaccine), which is aimed at diminishing 'cytokine storm' seen in acute respiratory distress syndrome and/or hemophagocytosis.

Understanding newsworthiness of an emerging pandemic: international newspaper coverage of the H1N1 outbreak.

PubMed

Smith, Katherine C; Rimal, Rajiv N; Sandberg, Helena; Storey, John D; Lagasse, Lisa; Maulsby, Catherine; Rhoades, Elizabeth; Barnett, Daniel J; Omer, Saad B; Links, Jonathan M

2013-09-01

During an evolving public health crisis, news organizations disseminate information rapidly, much of which is uncertain, dynamic, and difficult to verify. We examine factors related to international news coverage of H1N1 during the first month after the outbreak in late April 2009 and consider the news media's role as an information source during an emerging pandemic. Data on H1N1 news were compiled in real time from newspaper websites across twelve countries between April 29, 2009 and May 28, 2009. A news sample was purposively constructed to capture variation in countries' prior experience with avian influenza outbreaks and pandemic preparation efforts. We analyzed the association between H1N1 news volume and four predictor variables: geographic region, prior experience of a novel flu strain (H5N1), existence of a national pandemic plan, and existence of a localized H1N1 outbreak. H1N1 news was initially extensive but declined rapidly (OR = 0.85, P < .001). Pandemic planning did not predict newsworthiness. However, countries with prior avian flu experience had higher news volume (OR = 1.411, P < .05), suggesting that H1N1 newsworthiness was bolstered by past experiences. The proportion of H1N1 news was significantly lower in Europe than elsewhere (OR = 0.388, P < 0.05). Finally, coverage of H1N1 increased after a first in-country case (OR = 1.415, P < .01), interrupting the pattern of coverage decline. Findings demonstrate the enhanced newsworthiness of localized threats, even during an emerging pandemic. We discuss implications for news media's role in effective public health communication throughout an epidemic given the demonstrated precipitous decline in news interest. © 2012 John Wiley & Sons Ltd.

Evaluation of Wondfo influenza A&B fast test based on immunochromatography assay for rapid diagnosis of influenza A H1N1.

PubMed

Peng, Yunping; Wu, Junlin; Liu, Xiaoyun; Wang, Jihua; Li, Wenmei

2013-01-01

Influenza viruses cause significant morbidity and mortality in both children and adults during local outbreaks or epidemics. Therefore, a rapid test for influenza A&B would be useful. This study was conducted to evaluate the clinical performance of the Wondfo influenza A&B test for rapid diagnosis of influenza A H1N1 Infection. The rapid testing assay could distinguish infection of influenza A and B virus. The reference viral strains were cultured in MDCK cells while TCID50 if the viruses were determined. The analytical sensitivity of the Wondfo kit was 100TCID50/ml. The Wondfo kit did not show cross reactivity with other common viruses. 1928 suspected cases of influenza A (H1N1) virus infection were analyzed in the Wondfo influenza A&B test and other commercially available products. Inconsistent results were further confirmed by virus isolation in cell culture. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100%, 98.23%, 92.45%, and 100% for flu A, and 96.39%, 99.95%, 98.77%, and 99.84% for flu B respectively. 766 suspected cases of influenza A (H1N1) virus infection were analyzed in the Wondfo influenza A&B test and RT-PCR. The sensitivity, specificity, PPV and NPV were 56.5%, 99.75%, 99.52% and 71.04% for flu A, 25.45%, 99.86%, 93.33% and 94.54% for flu B respectively. These results indicate that the Wondfo influenza A&B test has high positive and negative detection rates. One hundred fifty-six specimens of influenza A (H1N1) confirmed by RT-PCR were analyzed by the Wondfo influenza A&B test and 66.67% were positive while only 18.59% were positive by the reference kit. These results indicate that our rapid diagnostic assay may be useful for analyzing influenza A H1N1 infections in patient specimen. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

The changing nature and scope of public health emergencies in response to annual flu.

PubMed

Hodge, James G

2013-06-01

The rapid spread of influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts. The legal effects of these types of declarations are profound. Public and private actors are given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health.

Influenza forecasting with Google Flu Trends.

PubMed

Dugas, Andrea Freyer; Jalalpour, Mehdi; Gel, Yulia; Levin, Scott; Torcaso, Fred; Igusa, Takeru; Rothman, Richard E

2013-01-01

We developed a practical influenza forecast model based on real-time, geographically focused, and easy to access data, designed to provide individual medical centers with advanced warning of the expected number of influenza cases, thus allowing for sufficient time to implement interventions. Secondly, we evaluated the effects of incorporating a real-time influenza surveillance system, Google Flu Trends, and meteorological and temporal information on forecast accuracy. Forecast models designed to predict one week in advance were developed from weekly counts of confirmed influenza cases over seven seasons (2004-2011) divided into seven training and out-of-sample verification sets. Forecasting procedures using classical Box-Jenkins, generalized linear models (GLM), and generalized linear autoregressive moving average (GARMA) methods were employed to develop the final model and assess the relative contribution of external variables such as, Google Flu Trends, meteorological data, and temporal information. A GARMA(3,0) forecast model with Negative Binomial distribution integrating Google Flu Trends information provided the most accurate influenza case predictions. The model, on the average, predicts weekly influenza cases during 7 out-of-sample outbreaks within 7 cases for 83% of estimates. Google Flu Trend data was the only source of external information to provide statistically significant forecast improvements over the base model in four of the seven out-of-sample verification sets. Overall, the p-value of adding this external information to the model is 0.0005. The other exogenous variables did not yield a statistically significant improvement in any of the verification sets. Integer-valued autoregression of influenza cases provides a strong base forecast model, which is enhanced by the addition of Google Flu Trends confirming the predictive capabilities of search query based syndromic surveillance. This accessible and flexible forecast model can be used by individual medical centers to provide advanced warning of future influenza cases.

Child Care and Preschool Pandemic Influenza Planning Checklist

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2006

2006-01-01

A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges that people have little or no immunity to and for which there may be no vaccine. The disease spreads easily person-to-person and causes serious illness. It can sweep across the country and around the world very quickly. It is hard to predict when the…

[The role of primary care professionals in preventive activitites during epidemics. Focus group assessment of the management of flu pandemic in 2009/2010].

PubMed

Hajnal, Ferenc; Busa, Csilla; Papp, Renáta; Balogh, Sándor

2017-04-01

The experiences gained during the H1N1 flu pandemic in 2009/2010 could serve for a better planning and management of later outbreaks. The EU-sponsored TELL ME project aimed to provide evidence and develop models for improved risk communication during infectious disease crisis. Among its objectives was to develop original communication strategies regarding appropriate messages related to preventative behavior and advice based on uncertainties also addressing vaccine-resistant groups. Focus groups involving family physicians (FPs) were called upon for assessing the main issues during the H1N1 pandemic, the possibilities for improving the preventative process and outcomes. The study demonstrated the key-role of family doctors during outbreaks; patients put their trust in their elected FP, he or she representing a personal example of health behavior. The evidence based information about effectiveness and safety of vaccines are needed in communication towards health professionals. Involvement of health care professionals in the communication provides validity, the communication routine of opinion leaders meant to be used for such purpose. The main media message should be: "For prevention go to see your family doctor". Orv. Hetil., 2017, 158(14), 523-532.

Dynamics of two-strain influenza model with cross-immunity and no quarantine class.

PubMed

Chung, K W; Lui, Roger

2016-12-01

The question about whether a periodic solution can exists for a given epidemiological model is a complicated one and has a long history (Hethcote and Levin, Applied math. ecology, biomathematics, vol 18. Springer, Berlin, pp 193-211, 1989). For influenza models, it is well known that a periodic solution can exists for a single-strain model with periodic contact rate (Aron and Schwartz, J Math Biol 110:665-679, 1984; Kuznetsov and Piccardi, J Math Biol 32:109-121, 1994), or a multiple-strain model with cross-immunity and quarantine class or age-structure (Nuño et al., Mathematical epidemiology. Lecture notes in mathematics, vol 1945. Springer, Berlin, 2008, chapter 13). In this paper, we prove the local asymptotic stability of the interior steady-state of a two-strain influenza model with sufficiently close cross-immunity and no quarantine class or age-structure. We also show that if the cross-immunity between two strains are far apart; then it is possible for the interior steady-state to lose its stability and bifurcation of periodic solutions can occur. Our results extend those obtained by Nuño et.al. (SIAM J Appl Math 65:964-982, 2005). This problem is important because understanding the reasons behind periodic outbreaks of seasonal flu is an important issue in public health.

Public risk perceptions and preventive behaviors during the 2009 H1N1 influenza pandemic.

PubMed

Kim, Yushim; Zhong, Wei; Jehn, Megan; Walsh, Lauren

2015-04-01

This study examines the public perception of the 2009 H1N1 influenza risk and its association with flu-related knowledge, social contexts, and preventive behaviors during the second wave of the influenza outbreak in Arizona. Statistical analyses were conducted on survey data, which were collected from a random-digit telephone survey of the general public in Arizona in October 2009. The public perceived different levels of risk regarding the likelihood and their concern about contracting the 2009 H1N1 flu. These measures of risk perception were primarily correlated with people of Hispanic ethnicity, having children in the household, and recent seasonal flu experience in the previous year. The perceived likelihood was not strongly associated with preventive behaviors, whereas the perceived concern was significantly associated with precautionary and preparatory behaviors. The association between perceived concern and precautionary behavior persisted after controlling for demographic characteristics. Pandemic preparedness and response efforts need to incorporate these findings to help develop effective risk communication strategies that properly induce preventive behaviors among the public.

The swine flu immunization program: scientific venture or political folly?

PubMed

Wecht, C H

The author of this Article, an internationally recognized coroner perhaps best known among laymen for his incisive and tenacious criticism of the Warren Commission report on the Kennedy assassination, turns his attention to the federal government's 1976--1977 Swine Flu Immunization Program. Dr. Wecht contends that although this program may have been viewed by its key proponents as having great public health importance, or perhaps even political value, its creation and continuation nevertheless were scientifically unjustified. Furthermore, he contends, the federal government failed to inform the public adequately of important facts about the program's origins and progress, and it mismanaged the program in several important respects. Among the topics he discusses are swine flu's epidemiological history (including the 1976 Fort Dix outbreak that propelled swine flu into the national consciousness); the key elements leading to the government's decision to immunize; the government's failure to reevaluate the program seriously as problems arose; the shortcomings of the federal swine flu statute; the inadequacy of the government's investigation of the deaths of three persons in Pittsburgh within a few hours after being vaccinated (a matter that was of immediate concern to the author in his role as Coroner of Allegheny County, Pennsylvania); the long-delayed termination of the program following the emergence of a possible statistical link between the immunizations and an increase in the incidence of the Guillain-Barré Syndrome; the financial and human costs of the program; and the need for calmer, more objective decision making in future situations where immunization of the general populace is being considered.

Flu and Finances: Influenza Outbreaks and Loan Defaults in US Cities, 2004-2012.

PubMed

Houle, Jason N; Collins, J Michael; Schmeiser, Maximilian D

2015-09-01

We examined the association between influenza outbreaks in 83 metropolitan areas and credit card and mortgage defaults, as measured in quarterly zip code-level credit data over the period of 2004 to 2012. We used ordinary least squares, fixed effects, and 2-stage least squares instrumental variables regression strategies to examine the relationship between influenza-related Google searches and 30-, 60-, and 90-day credit card and mortgage delinquency rates. We found that a proxy for influenza outbreaks is associated with a small but statistically significant increase in credit card and mortgage default rates, net of other factors. These effects are largest for 90-day defaults, suggesting that influenza outbreaks have a disproportionate impact on vulnerable borrowers who are already behind on their payments. Overall, it appears there is a relationship between exogenous health shocks (such as influenza) and credit default. The results suggest that consumer finances could benefit from policies that aim to reduce the financial shocks of illness, particularly for vulnerable borrowers.

Comparison of Heterosubtypic Protection in Ferrets and Pigs Induced by a Single-Cycle Influenza Vaccine.

PubMed

Holzer, Barbara; Morgan, Sophie B; Matsuoka, Yumi; Edmans, Matthew; Salguero, Francisco J; Everett, Helen; Brookes, Sharon M; Porter, Emily; MacLoughlin, Ronan; Charleston, Bryan; Subbarao, Kanta; Townsend, Alain; Tchilian, Elma

2018-06-15

Influenza is a major health threat, and a broadly protective influenza vaccine would be a significant advance. Signal Minus FLU (S-FLU) is a candidate broadly protective influenza vaccine that is limited to a single cycle of replication, which induces a strong cross-reactive T cell response but a minimal Ab response to hemagglutinin after intranasal or aerosol administration. We tested whether an H3N2 S-FLU can protect pigs and ferrets from heterosubtypic H1N1 influenza challenge. Aerosol administration of S-FLU to pigs induced lung tissue-resident memory T cells and reduced lung pathology but not the viral load. In contrast, in ferrets, S-FLU reduced viral replication and aerosol transmission. Our data show that S-FLU has different protective efficacy in pigs and ferrets, and that in the absence of Ab, lung T cell immunity can reduce disease severity without reducing challenge viral replication. Copyright © 2018 The Authors.

Comparison of Heterosubtypic Protection in Ferrets and Pigs Induced by a Single-Cycle Influenza Vaccine

PubMed Central

Holzer, Barbara; Morgan, Sophie B.; Edmans, Matthew; Everett, Helen; Brookes, Sharon M.; Charleston, Bryan

2018-01-01

Influenza is a major health threat, and a broadly protective influenza vaccine would be a significant advance. Signal Minus FLU (S-FLU) is a candidate broadly protective influenza vaccine that is limited to a single cycle of replication, which induces a strong cross-reactive T cell response but a minimal Ab response to hemagglutinin after intranasal or aerosol administration. We tested whether an H3N2 S-FLU can protect pigs and ferrets from heterosubtypic H1N1 influenza challenge. Aerosol administration of S-FLU to pigs induced lung tissue-resident memory T cells and reduced lung pathology but not the viral load. In contrast, in ferrets, S-FLU reduced viral replication and aerosol transmission. Our data show that S-FLU has different protective efficacy in pigs and ferrets, and that in the absence of Ab, lung T cell immunity can reduce disease severity without reducing challenge viral replication. PMID:29703861

Application of Humidity Data for Predictions of Influenza Outbreaks.

NASA Astrophysics Data System (ADS)

Teixeira, J.; Thrastarson, H. T.; Yeo, E.

2016-12-01

Seasonal influenza outbreaks infect millions of people, cause hundreds of thousands of deaths worldwide, and leave an immense economic footprint. Potential forecasting of the timing and intensity of these outbreaks can help mitigation and response efforts (e.g., the management and organization of vaccines, drugs and other resources). Absolute (or specific) humidity has been identified as an important driver of the seasonal behavior of influenza outbreaks in temperate regions. Building upon this result, we incorporate humidity data from both NASA's AIRS (Atmospheric Infra-Red Sounder) instrument and ERA-Interim re-analysis into a SIRS (Susceptible-Infectious-Recovered-Susceptible) type numerical epidemiological model, comprising a prediction system for influenza outbreaks. Data for influenza activity is obtained from sources such as Google Flu Trends and the CDC (Center for Disease Control) and used for comparison and assimilation. The accuracy and limitations of the prediction system are tested with hindcasts of outbreaks in the United States for the years 2005-2015. Our results give support to the hypothesis that local weather conditions drive the seasonality of influenza in temperate regions. The implementation of influenza forecasts that make use of NCEP humidity forecasts is also discussed.

Outbreaks Associated with Treated Recreational Water - United States, 2000-2014.

PubMed

Hlavsa, Michele C; Cikesh, Bryanna L; Roberts, Virginia A; Kahler, Amy M; Vigar, Marissa; Hilborn, Elizabeth D; Wade, Timothy J; Roellig, Dawn M; Murphy, Jennifer L; Xiao, Lihua; Yates, Kirsten M; Kunz, Jasen M; Arduino, Matthew J; Reddy, Sujan C; Fullerton, Kathleen E; Cooley, Laura A; Beach, Michael J; Hill, Vincent R; Yoder, Jonathan S

2018-05-18

Outbreaks associated with exposure to treated recreational water can be caused by pathogens or chemicals in venues such as pools, hot tubs/spas, and interactive water play venues (i.e., water playgrounds). During 2000-2014, public health officials from 46 states and Puerto Rico reported 493 outbreaks associated with treated recreational water. These outbreaks resulted in at least 27,219 cases and eight deaths. Among the 363 outbreaks with a confirmed infectious etiology, 212 (58%) were caused by Cryptosporidium (which causes predominantly gastrointestinal illness), 57 (16%) by Legionella (which causes Legionnaires' disease, a severe pneumonia, and Pontiac fever, a milder illness with flu-like symptoms), and 47 (13%) by Pseudomonas (which causes folliculitis ["hot tub rash"] and otitis externa ["swimmers' ear"]). Investigations of the 363 outbreaks identified 24,453 cases; 21,766 (89%) were caused by Cryptosporidium, 920 (4%) by Pseudomonas, and 624 (3%) by Legionella. At least six of the eight reported deaths occurred in persons affected by outbreaks caused by Legionella. Hotels were the leading setting, associated with 157 (32%) of the 493 outbreaks. Overall, the outbreaks had a bimodal temporal distribution: 275 (56%) outbreaks started during June-August and 46 (9%) in March. Assessment of trends in the annual counts of outbreaks caused by Cryptosporidium, Legionella, or Pseudomonas indicate mixed progress in preventing transmission. Pathogens able to evade chlorine inactivation have become leading outbreak etiologies. The consequent outbreak and case counts and mortality underscore the utility of CDC's Model Aquatic Health Code (https://www.cdc.gov/mahc) to prevent outbreaks associated with treated recreational water.

Swine Flu: Knowledge, Attitude, and Practices Survey of Medical and Dental Students of Karachi.

PubMed

Hasan, Fariha; Khan, Mohammad O; Ali, Mukarram

2018-01-09

Introduction Pakistan is extremely susceptible to an influenza outbreak, as it shares borders with the most affected countries, namely China and India. The medical and dental students come into direct contact with the affected population and should be aware of the risk factors and signs and symptoms pertaining to swine influenza virus (SIV). Hence, this survey was conducted to assess the knowledge, perceptions and self-care practices of the medical and dental students with regards to this pandemic. Methods A descriptive, cross-sectional study was conducted to evaluate the swine flu-related knowledge, attitudes and practices of the medical and dental students at various institutions in Karachi, Pakistan. We approached 613 students that were available on the dates of this survey, keeping a medical to dental student ratio of 75:25. All students from first to final year comprised of the study population, and no internists or medical personnel were included. The questionnaire was divided into three sections, namely knowledge, attitudes and, practices. All questions were based on a multiple choice format. The data were entered and interpreted using the IBM Statistical Package for the Social Sciences 23.0 (IBM Corp., Armonk, New York). Results The majority of the students were aware that the swine flu is a transmittable disease (n=485, 80.8%). Most students identified the signs and symptoms correctly; however, diarrhea (15.5%) and vomiting (32.2%) were the least correct answers (n=93, n=193 respectively). Most of the preventative measures were reported accurately by the participants. Despite this, only 15.5% students (n=93) reported the use of a facemask when suffering from fever, cough and a runny nose. Conclusion There is a dire need for the routine integration of the awareness and management programs in the medical and dental schools. There exists a gap between the policy and practice, and it is high time we bridge the divide. The students should also be vaccinated annually for influenza A.

Swine Flu: Knowledge, Attitude, and Practices Survey of Medical and Dental Students of Karachi

PubMed Central

Khan, Mohammad O; Ali, Mukarram

2018-01-01

Introduction Pakistan is extremely susceptible to an influenza outbreak, as it shares borders with the most affected countries, namely China and India. The medical and dental students come into direct contact with the affected population and should be aware of the risk factors and signs and symptoms pertaining to swine influenza virus (SIV). Hence, this survey was conducted to assess the knowledge, perceptions and self-care practices of the medical and dental students with regards to this pandemic. Methods A descriptive, cross-sectional study was conducted to evaluate the swine flu-related knowledge, attitudes and practices of the medical and dental students at various institutions in Karachi, Pakistan. We approached 613 students that were available on the dates of this survey, keeping a medical to dental student ratio of 75:25. All students from first to final year comprised of the study population, and no internists or medical personnel were included. The questionnaire was divided into three sections, namely knowledge, attitudes and, practices. All questions were based on a multiple choice format. The data were entered and interpreted using the IBM Statistical Package for the Social Sciences 23.0 (IBM Corp., Armonk, New York). Results The majority of the students were aware that the swine flu is a transmittable disease (n=485, 80.8%). Most students identified the signs and symptoms correctly; however, diarrhea (15.5%) and vomiting (32.2%) were the least correct answers (n=93, n=193 respectively). Most of the preventative measures were reported accurately by the participants. Despite this, only 15.5% students (n=93) reported the use of a facemask when suffering from fever, cough and a runny nose. Conclusion There is a dire need for the routine integration of the awareness and management programs in the medical and dental schools. There exists a gap between the policy and practice, and it is high time we bridge the divide. The students should also be vaccinated annually for influenza A. PMID:29541569

Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain.

PubMed

Johal, Sarbjit S

2009-06-05

The threat of outbreak of infectious disease such as non-seasonal influenza A (H1N1), commonly referred to as Swine Flu, can provoke the implementation of public health control measures such as quarantine. This paper summarises the psychosocial consequences that may follow for patients and health care and other front-line workers when using quarantine controls. Those affected by quarantine are likely to report distress due to fear and risk perceptions. This distress can be amplified in the face of unclear information and communication that is common in the initial period of disease outbreaks. This paper outlines recommendations for care of those in quarantine and those working with them, such as helping to identify stressors and normalising their impact as much as possible. This should take place at all levels of response, from public information and communication messages to individual face-to-face advice and support.

Rapid and broad detection of H5 hemagglutinin by an immunochromatographic kit using novel monoclonal antibody against highly pathogenic avian influenza virus belonging to the genetic clade 2.3.4.4.

PubMed

Nguyen, Lam Thanh; Nakaishi, Kazunari; Motojima, Keiko; Ohkawara, Ayako; Minato, Erina; Maruyama, Junki; Hiono, Takahiro; Matsuno, Keita; Okamatsu, Masatoshi; Kimura, Takashi; Takada, Ayato; Kida, Hiroshi; Sakoda, Yoshihiro

2017-01-01

Highly pathogenic avian influenza viruses (HPAIVs) of H5 subtype have persistently caused outbreaks in domestic poultry and wild birds worldwide and sporadically infected humans. Rapid and accurate diagnosis is one of the key strategies for the control of H5 HPAIVs. However, the sensitivity of the diagnosis of H5 HPAIVs has gradually reduced due to extensive antigenic variation during their evolution. Particularly, the previously developed immunochromatographic diagnosis kit for H5 viruses, Linjudge Flu A/H5, exhibits reduced detection of H5 HPAIVs isolated in recent years. In the present study, we established a new advanced H5 rapid immunochromatographic detection kit (New Linjudge Flu A/H5) by a combination of two anti-H5 hemagglutinin monoclonal antibodies, A64/1 previously applied in the Linjudge Flu A/H5 and A32/2, a novel monoclonal antibody generated from a clade 2.3.4.4 H5 HPAIV. The new kit broadly detected all classical and recent H5 influenza viruses and showed a higher specificity and sensitivity than the original Linjudge Flu A/H5 with recently circulating H5 HPAIVs. Furthermore, the applicability of the New Linjudge Flu A/H5 was demonstrated by detecting antigens from the swabs and tissue homogenates of naturally infected birds and experimentally infected chickens with H5N6 HPAIVs belonging to the genetic clade 2.3.4.4. Our study, therefore, can provide an effective point-of-care rapid antigen detection kit for the surveillance of H5 avian influenza viruses and as a prompt countermeasure against the current widespread of the clade 2.3.4.4 H5 HPAIVs in domestic and wild birds.

A knowledge representation of local pandemic influenza planning models.

PubMed

Islam, Runa; Brandeau, Margaret L; Das, Amar K

2007-10-11

Planning for pandemic flu outbreak at the small-government level can be aided through the use of mathematical policy models. Formulating and analyzing policy models, however, can be a time- and expertise-expensive process. We believe that a knowledge-based system for facilitating the instantiation of locale- and problem-specific policy models can reduce some of these costs. In this work, we present the ontology we have developed for pandemic influenza policy models.

Emerging Infectious Disease Surveillance in Southeast Asia: Cambodia, Indonesia, and the Naval Area Medical Research Unit 2

DTIC Science & Technology

2012-01-22

departments-enduring-contributions-global- health, accessed 8 October 2011. Restuadhi, H. (2008). Bird flu : chicken consumption, rearing practices...up to the outbreaks, and the chicken consumption pattern that remains unchanged. While the communication campaigns are very intense, the follow-up... chickens . This enables them to be categorized as backyard operations. What is certainly true is that the arrival of the new minister of health

Flu and Finances: Influenza Outbreaks and Loan Defaults in US Cities, 2004–2012

PubMed Central

Collins, J. Michael; Schmeiser, Maximilian D.

2015-01-01

Objectives. We examined the association between influenza outbreaks in 83 metropolitan areas and credit card and mortgage defaults, as measured in quarterly zip code–level credit data over the period of 2004 to 2012. Methods. We used ordinary least squares, fixed effects, and 2-stage least squares instrumental variables regression strategies to examine the relationship between influenza-related Google searches and 30-, 60-, and 90-day credit card and mortgage delinquency rates. Results. We found that a proxy for influenza outbreaks is associated with a small but statistically significant increase in credit card and mortgage default rates, net of other factors. These effects are largest for 90-day defaults, suggesting that influenza outbreaks have a disproportionate impact on vulnerable borrowers who are already behind on their payments. Conclusions. Overall, it appears there is a relationship between exogenous health shocks (such as influenza) and credit default. The results suggest that consumer finances could benefit from policies that aim to reduce the financial shocks of illness, particularly for vulnerable borrowers. PMID:26180971

Atmospheric Infrared Sounder on NASA's Aqua Satellite: Applications for Volcano Rapid Response, Influenza Outbreak Prediction, and Drought Onset Prediction

NASA Astrophysics Data System (ADS)

Ray, S. E.; Fetzer, E. J.; Lambrigtsen, B.; Olsen, E. T.; Licata, S. J.; Hall, J. R.; Penteado, P. F.; Realmuto, V. J.; Thrastarson, H. T.; Teixeira, J.; Granger, S. L.; Behrangi, A.; Farahmand, A.

2017-12-01

The Atmospheric Infrared Sounder (AIRS) has been returning daily global observations of Earth's atmospheric constituents and properties since 2002. With its 15-year data record and near real-time capability, AIRS data are being used in the development of applications that fall within many of the NASA Applied Science focus areas. An automated alert system for volcanic plumes has been developed that triggers on threshold breaches of SO2, ash and dust in granules of AIRS data. The system generates a suite of granule-scale maps that depict both plume and clouds, all accessible from the AIRS web site. Alerts are sent to a curated list of volcano community members, and links to views in NASA Worldview and Google Earth are also available. Seasonal influenza epidemics are major public health concern with millions of cases of severe illness and large economic impact. Recent studies have highlighted the role of absolute or specific humidity as a likely player in the seasonal nature of these outbreaks. A quasi-operational influenza outbreak prediction system has been developed based on the SIRS model which uses AIRS and NCEP humidity data, Center for Disease Control reports on flu and flu-like illnesses, and results from Google Flu Trends. Work is underway to account for diffusion (spatial) in addition to the temporal spreading of influenza. The US Drought Monitor (USDM) is generated weekly by the National Drought Mitigation Center (NDMC) and is used by policymakers for drought decision-making. AIRS data have demonstrated utility in monitoring the development and detection of meteorological drought with both AIRS-derived standardized vapor pressure deficit and standardized relative humidity, showing early detection lead times of up to two months. An agreement was secured with the NDMC to begin a trial period using AIRS products in the production of the USDM, and in July of 2017 the operational delivery of weekly CONUS AIRS images of Relative Humidity, Surface Air Temperature, and Vapor Pressure Deficit to the National Drought Mitigation Center commenced. Next objectives include determining whether AIRS drought products can also be useful in the NDMC's VegDRI and QuickDRI products. This poster provides an overview of the work being done in these three application areas and summarize additional application efforts using data from AIRS.

Community awareness, use and preference for pandemic influenza vaccines in Pune, India

PubMed Central

Sundaram, Neisha; Purohit, Vidula; Schaetti, Christian; Kudale, Abhay; Joseph, Saju; Weiss, Mitchell G

2015-01-01

Vaccination is a cornerstone of influenza prevention, but limited vaccine uptake was a problem worldwide during the 2009–2010 pandemic. Community acceptance of a vaccine is a critical determinant of its effectiveness, but studies have been confined to high-income countries. We conducted a cross-sectional, mixed-method study in urban and rural Pune, India in 2012–2013. Semi-structured explanatory model interviews were administered to community residents (n = 436) to study awareness, experience and preference between available vaccines for pandemic influenza. Focus group discussions and in-depth interviews complemented the survey. Awareness of pandemic influenza vaccines was low (25%). Some respondents did not consider vaccines relevant for adults, but nearly all (94.7%), when asked, believed that a vaccine would prevent swine flu. Reported vaccine uptake however was 8.3%. Main themes identified as reasons for uptake were having heard of a death from swine flu, health care provider recommendation or affiliation with the health system, influence of peers and information from media. Reasons for non-use were low perceived personal risk, problems with access and cost, inadequate information and a perceived lack of a government mandate endorsing influenza vaccines. A majority indicated a preference for injectable over nasal vaccines, especially in remote rural areas. Hesitancy from a lack of confidence in pandemic influenza vaccines appears to have been less of an issue than access, complacency and other sociocultural considerations. Recent influenza outbreaks in 2015 highlight a need to reconsider policy for routine influenza vaccination while paying attention to sociocultural factors and community preferences for effective vaccine action. PMID:26110454

Combining Participatory Influenza Surveillance with Modeling and Forecasting: Three Alternative Approaches.

PubMed

Brownstein, John S; Chu, Shuyu; Marathe, Achla; Marathe, Madhav V; Nguyen, Andre T; Paolotti, Daniela; Perra, Nicola; Perrotta, Daniela; Santillana, Mauricio; Swarup, Samarth; Tizzoni, Michele; Vespignani, Alessandro; Vullikanti, Anil Kumar S; Wilson, Mandy L; Zhang, Qian

2017-11-01

Influenza outbreaks affect millions of people every year and its surveillance is usually carried out in developed countries through a network of sentinel doctors who report the weekly number of Influenza-like Illness cases observed among the visited patients. Monitoring and forecasting the evolution of these outbreaks supports decision makers in designing effective interventions and allocating resources to mitigate their impact. Describe the existing participatory surveillance approaches that have been used for modeling and forecasting of the seasonal influenza epidemic, and how they can help strengthen real-time epidemic science and provide a more rigorous understanding of epidemic conditions. We describe three different participatory surveillance systems, WISDM (Widely Internet Sourced Distributed Monitoring), Influenzanet and Flu Near You (FNY), and show how modeling and simulation can be or has been combined with participatory disease surveillance to: i) measure the non-response bias in a participatory surveillance sample using WISDM; and ii) nowcast and forecast influenza activity in different parts of the world (using Influenzanet and Flu Near You). WISDM-based results measure the participatory and sample bias for three epidemic metrics i.e. attack rate, peak infection rate, and time-to-peak, and find the participatory bias to be the largest component of the total bias. The Influenzanet platform shows that digital participatory surveillance data combined with a realistic data-driven epidemiological model can provide both short-term and long-term forecasts of epidemic intensities, and the ground truth data lie within the 95 percent confidence intervals for most weeks. The statistical accuracy of the ensemble forecasts increase as the season progresses. The Flu Near You platform shows that participatory surveillance data provide accurate short-term flu activity forecasts and influenza activity predictions. The correlation of the HealthMap Flu Trends estimates with the observed CDC ILI rates is 0.99 for 2013-2015. Additional data sources lead to an error reduction of about 40% when compared to the estimates of the model that only incorporates CDC historical information. While the advantages of participatory surveillance, compared to traditional surveillance, include its timeliness, lower costs, and broader reach, it is limited by a lack of control over the characteristics of the population sample. Modeling and simulation can help overcome this limitation as well as provide real-time and long-term forecasting of influenza activity in data-poor parts of the world. ©John S Brownstein, Shuyu Chu, Achla Marathe, Madhav V Marathe, Andre T Nguyen, Daniela Paolotti, Nicola Perra, Daniela Perrotta, Mauricio Santillana, Samarth Swarup, Michele Tizzoni, Alessandro Vespignani, Anil Kumar S Vullikanti, Mandy L Wilson, Qian Zhang. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 01.11.2017.

Discovery of a missing disease spreader

NASA Astrophysics Data System (ADS)

Maeno, Yoshiharu

2011-10-01

This study presents a method to discover an outbreak of an infectious disease in a region for which data are missing, but which is at work as a disease spreader. Node discovery for the spread of an infectious disease is defined as discriminating between the nodes which are neighboring to a missing disease spreader node, and the rest, given a dataset on the number of cases. The spread is described by stochastic differential equations. A perturbation theory quantifies the impact of the missing spreader on the moments of the number of cases. Statistical discriminators examine the mid-body or tail-ends of the probability density function, and search for the disturbance from the missing spreader. They are tested with computationally synthesized datasets, and applied to the SARS outbreak and flu pandemic.

Sources of information and health beliefs related to SARS and avian influenza among Chinese communities in the United Kingdom and The Netherlands, compared to the general population in these countries.

PubMed

Voeten, Helene A C M; de Zwart, Onno; Veldhuijzen, Irene K; Yuen, Cicely; Jiang, Xinyi; Elam, Gillian; Abraham, Thomas; Brug, Johannes

2009-01-01

Ethnic minorities in Europe such as the Chinese may need a special strategy with regard to risk communication about emerging infectious diseases. To engage them in precautionary actions, it is important to know their information sources, knowledge, and health beliefs. This study's purpose is to study the use of information sources, knowledge, and health beliefs related to SARS and avian flu of Chinese people in the UK and The Netherlands, and to make comparisons with the general population in these countries. Results of a self-administered questionnaire among 300 British/Dutch Chinese were compared to data obtained from a computer-assisted phone survey among the general population (n = 800). British/Dutch Chinese got most information about emerging diseases from family and friends, followed by Chinese media and British/Dutch TV. They had less confidence than general groups in their doctor, government agencies, and consumer/patient interest groups. Their knowledge of SARS was high. They had a lower perceived threat than general populations with regard to SARS and avian flu due to a lower perceived severity. They had higher self-efficacy beliefs regarding SARS and avian flu. In case of new outbreaks of SARS/avian flu in China, local authorities in the UK and The Netherlands can best reach Chinese people through informal networks and British/Dutch TV, while trying to improve confidence in information from the government. In communications, the severity of the disease rather than the susceptibility appears to need most attention.

East Asia Summit: Steps toward Community to Prevent Great Power Hegemony and Implications for U.S. Policy

DTIC Science & Technology

2006-03-15

collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 15 MAR 2006 2. REPORT TYPE 3. DATES COVERED 4...eastward with the takeover of India and the establishment of English rule over the Malay Peninsula and parts of Borneo. While China was defeated by...attacks in Indonesia in October 2002 and 2004, the Severe Acute Respiratory Syndrome (SARS) scare of 2003, repeated outbreaks of Avian Flu, and the

The 2009 Influenza A(H1N1) ’Swine Flu’ Outbreak: U.S. Responses to Global Human Cases

DTIC Science & Technology

2009-05-26

deaths. The United Nations Food and Agricultural Organization (FAO), the World Organization for Animal Health (OIE), and WHO agree that there is no...Organization (FAO), the World Organization for Animal Health (OIE), and WHO agree that there is no risk of contracting the virus from consumption of...Coordinator (UNSIC), the World Organization for Animal Health (OIE), and the U.N. Children’s Fund (UNICEF); • $123 million for regional programs

Legionnaires' disease: respiratory infections caused by Legionella bacteria.

PubMed

Davis, G S; Winn, W C

1987-09-01

This article provides a review of Legionnaire's Disease, a bacterial pneumonia caused by Legionella species, and of Pontiac Fever, the flu-like illness caused by these microorganisms. The authors draw on their personal experience with major human outbreaks of Legionnaire's Disease and with animal models of Legionella pneumonia. Emphasis is placed on the sources in nature from which legionellosis is acquired, the means of dissemination of bacteria, the epidemiology of human infections, the pathogenetic mechanisms of disease and host defense, the clinical manifestations, and the treatment.

The Influenza Virus and the 2009 H1N1 Outbreak

DTIC Science & Technology

2016-04-08

Envelope L’ol • Sequencing Figure 1 Influenza Virus Anatomy -Neuramlnldase (Sialldase) ’ Hemagglutlnln 9 Key laboratory techniques...discover the 2009 H1 N1 influenza virus Phylogenetic Tree Out of the over 400 human H1 ’s USAFSAM sequenced this season no specimen has had less than a...surveillance/vaccine contents • Shot Versus Flu Mist • How does Tamiflu work • Sequencing HA - Culture, HAI, PCR, Serology ••• • t.tt

[Outbreak of pandemic virus (H1N1) 2009 in a residence for mentally disabled persons in Balearic Island, Spain].

PubMed

Giménez Duran, Jaume; Galmés Truyols, Antònia; Nicolau Riutort, Antonio; Reina Prieto, Jorge; Gallegos Álvarez, Maria de Carmen; Pareja Bezares, Antonio; Vanrell Berga, Juana María

2010-01-01

The flu season 2009-2010 has been shorter and less severe than expected. Since January 2010, influenza surveillance systems indicated rates of very low incidence of influenza without detection of virus circulation. In this context, a hospital reported a suspected outbreak of severe respiratory disease, the aetiology proved influenza A(H1N1)v. We describe the outbreak and public health measures for their control. Descriptive study of an outbreak of pandemic influenza virus in a residency home for mentally disabled. Establishment of active surveillance. The case definition of influenza was very sensitive to detect new cases early, treated early and minimize transmission. Steps were taken to contain the influenza virus infection. Among 38 cases detected 7 had serious complications(all of them with risk factors). There were no deaths. The overall attack rate was 35.2%. The first cases were workers. The residents were ill at the peak of the outbreak, and among workers the presentation was more dispersed. None of the workers and only three of residents had been vaccinated. Workers possibly have initiated and contributed to the maintenance of transmission. We emphasize the need to comply with vaccination recommendations, not just those with risk factors, but particularly for workers in contact with those.

Nonreplicating Influenza A Virus Vaccines Confer Broad Protection against Lethal Challenge

PubMed Central

Baz, Mariana; Boonnak, Kobporn; Paskel, Myeisha; Santos, Celia; Powell, Timothy; Townsend, Alain

2015-01-01

ABSTRACT New vaccine technologies are being investigated for their ability to elicit broadly cross-protective immunity against a range of influenza viruses. We compared the efficacies of two intranasally delivered nonreplicating influenza virus vaccines (H1 and H5 S-FLU) that are based on the suppression of the hemagglutinin signal sequence, with the corresponding H1N1 and H5N1 cold-adapted (ca) live attenuated influenza virus vaccines in mice and ferrets. Administration of two doses of H1 or H5 S-FLU vaccines protected mice and ferrets from lethal challenge with homologous, heterologous, and heterosubtypic influenza viruses, and two doses of S-FLU and ca vaccines yielded comparable effects. Importantly, when ferrets immunized with one dose of H1 S-FLU or ca vaccine were challenged with the homologous H1N1 virus, the challenge virus failed to transmit to naive ferrets by the airborne route. S-FLU technology can be rapidly applied to any emerging influenza virus, and the promising preclinical data support further evaluation in humans. PMID:26489862

FluBlok, a next generation influenza vaccine manufactured in insect cells.

PubMed

Cox, Manon M J; Hollister, Jason R

2009-06-01

FluBlok, a recombinant trivalent hemagglutinin (rHA) vaccine produced in insect cell culture using the baculovirus expression system, provides an attractive alternative to the current egg-based trivalent inactivated influenza vaccine (TIV). Its manufacturing process presents the possibility for safe and expeditious vaccine production. FluBlok contains three times more HA than TIV and does not contain egg-protein or preservatives. The high purity of the antigen enables administration at higher doses without a significant increase in side-effects in human subjects. The insect cell-baculovirus production technology is particularly suitable for influenza where annual adjustment of the vaccine is required. The baculovirus-insect expression system is generally considered a safe production system, with limited growth potential for adventitious agents. Still regulators question and challenge the safety of this novel cell substrate as FluBlok continues to advance toward product approval. This review provides an overview of cell substrate characterization for expresSF cell line used for the manufacturing of FluBlok. In addition, this review includes an update on the clinical development of FluBlok. The highly purified protein vaccine, administered at three times higher antigen content than TIV, is well tolerated and results in stronger immunogenicity, a long lasting immune response and provides cross-protection against drift influenza viruses.

Recognizing flu-like symptoms from videos.

PubMed

Thi, Tuan Hue; Wang, Li; Ye, Ning; Zhang, Jian; Maurer-Stroh, Sebastian; Cheng, Li

2014-09-12

Vision-based surveillance and monitoring is a potential alternative for early detection of respiratory disease outbreaks in urban areas complementing molecular diagnostics and hospital and doctor visit-based alert systems. Visible actions representing typical flu-like symptoms include sneeze and cough that are associated with changing patterns of hand to head distances, among others. The technical difficulties lie in the high complexity and large variation of those actions as well as numerous similar background actions such as scratching head, cell phone use, eating, drinking and so on. In this paper, we make a first attempt at the challenging problem of recognizing flu-like symptoms from videos. Since there was no related dataset available, we created a new public health dataset for action recognition that includes two major flu-like symptom related actions (sneeze and cough) and a number of background actions. We also developed a suitable novel algorithm by introducing two types of Action Matching Kernels, where both types aim to integrate two aspects of local features, namely the space-time layout and the Bag-of-Words representations. In particular, we show that the Pyramid Match Kernel and Spatial Pyramid Matching are both special cases of our proposed kernels. Besides experimenting on standard testbed, the proposed algorithm is evaluated also on the new sneeze and cough set. Empirically, we observe that our approach achieves competitive performance compared to the state-of-the-arts, while recognition on the new public health dataset is shown to be a non-trivial task even with simple single person unobstructed view. Our sneeze and cough video dataset and newly developed action recognition algorithm is the first of its kind and aims to kick-start the field of action recognition of flu-like symptoms from videos. It will be challenging but necessary in future developments to consider more complex real-life scenario of detecting these actions simultaneously from multiple persons in possibly crowded environments.

Rapid and broad detection of H5 hemagglutinin by an immunochromatographic kit using novel monoclonal antibody against highly pathogenic avian influenza virus belonging to the genetic clade 2.3.4.4

PubMed Central

Nguyen, Lam Thanh; Nakaishi, Kazunari; Motojima, Keiko; Ohkawara, Ayako; Minato, Erina; Maruyama, Junki; Hiono, Takahiro; Matsuno, Keita; Okamatsu, Masatoshi; Kimura, Takashi; Takada, Ayato; Kida, Hiroshi; Sakoda, Yoshihiro

2017-01-01

Highly pathogenic avian influenza viruses (HPAIVs) of H5 subtype have persistently caused outbreaks in domestic poultry and wild birds worldwide and sporadically infected humans. Rapid and accurate diagnosis is one of the key strategies for the control of H5 HPAIVs. However, the sensitivity of the diagnosis of H5 HPAIVs has gradually reduced due to extensive antigenic variation during their evolution. Particularly, the previously developed immunochromatographic diagnosis kit for H5 viruses, Linjudge Flu A/H5, exhibits reduced detection of H5 HPAIVs isolated in recent years. In the present study, we established a new advanced H5 rapid immunochromatographic detection kit (New Linjudge Flu A/H5) by a combination of two anti-H5 hemagglutinin monoclonal antibodies, A64/1 previously applied in the Linjudge Flu A/H5 and A32/2, a novel monoclonal antibody generated from a clade 2.3.4.4 H5 HPAIV. The new kit broadly detected all classical and recent H5 influenza viruses and showed a higher specificity and sensitivity than the original Linjudge Flu A/H5 with recently circulating H5 HPAIVs. Furthermore, the applicability of the New Linjudge Flu A/H5 was demonstrated by detecting antigens from the swabs and tissue homogenates of naturally infected birds and experimentally infected chickens with H5N6 HPAIVs belonging to the genetic clade 2.3.4.4. Our study, therefore, can provide an effective point-of-care rapid antigen detection kit for the surveillance of H5 avian influenza viruses and as a prompt countermeasure against the current widespread of the clade 2.3.4.4 H5 HPAIVs in domestic and wild birds. PMID:28787440

Avalanche outbreaks emerging in cooperative contagions

NASA Astrophysics Data System (ADS)

Cai, Weiran; Chen, Li; Ghanbarnejad, Fakhteh; Grassberger, Peter

2015-11-01

The spreading of contagions can exhibit a percolation transition, which separates transitory prevalence from outbreaks that reach a finite fraction of the population. Such transitions are commonly believed to be continuous, but empirical studies have shown more violent spreading modes when the participating agents are not limited to one type. Striking examples include the co-epidemic of the Spanish flu and pneumonia that occurred in 1918 (refs , ), and, more recently, the concurrent prevalence of HIV/AIDS and a host of diseases. It remains unclear to what extent an outbreak in the presence of interacting pathogens differs from that due to an ordinary single-agent process. Here we study a mechanistic model for understanding contagion processes involving inter-agent cooperation. Our stochastic simulations reveal the possible emergence of a massive avalanche-like outbreak right at the threshold, which is manifested as a discontinuous phase transition. Such an abrupt change arises only if the underlying network topology supports a bottleneck for cascaded mutual infections. Surprisingly, all these discontinuous transitions are accompanied by non-trivial critical behaviours, presenting a rare case of hybrid transition. The findings may imply the origin of catastrophic occurrences in many realistic systems, from co-epidemics to financial contagions.

Strategies to increase influenza vaccination rates: outcomes of a nationwide cross-sectional survey of UK general practice

PubMed Central

Teare, M Dawn; Dexter, Matthew; Siriwardena, A Niroshan; Read, Robert C

2012-01-01

Objective To identify practice strategies associated with higher flu vaccination rates in primary care. Design Logistic regression analysis of data from a cross-sectional online questionnaire. Setting 795 general practices across England. Participants 569 practice managers, 335 nursing staff and 107 general practitioners. Primary outcome measures Flu vaccination rates achieved by each practice in different groups of at-risk patients. Results 7 independent factors associated with higher vaccine uptake were identified. Having a lead staff member for planning the flu campaign and producing a written report of practice performance predicted an 8% higher vaccination rate for at-risk patients aged <65 years (OR 1.37, 95% CI 1.10 to 1.71). These strategies, plus sending a personal invitation to all eligible patients and only stopping vaccination when Quality and Outcomes Framework targets are reached, predicted a 7% higher vaccination rate (OR 1.45, 95% CI 1.10 to 1.92) in patients aged ≥65 years. Using a lead member of staff for identifying eligible patients, with either a modified manufacturer's or in-house search programme for interrogating the practice IT system, independently predicted a 4% higher vaccination rate in patients aged ≥65 years (OR 1.22, 95% CI 1.06 to 1.41/OR 1.20, 95% CI 1.03 to 1.40). The provision of flu vaccine by midwives was associated with a 4% higher vaccination rate in pregnant women (OR 1.19, 95% CI 1.02 to 1.40). Conclusions Clear leadership, effective communication about performance and methods used to identify and contact eligible patients were independently associated with significantly higher rates of flu vaccination. Financial targets appear to incentivise practices to work harder to maximise seasonal influenza vaccine uptake. The strategies identified here could help primary care providers to substantially increase their seasonal flu vaccination rates towards or even above the Chief Medical Officer's targets. PMID:22581793

Outbreak of Chlamydia pneumoniae infection in former injection-drug users.

PubMed

Blasi, F; Boschini, A; Cosentini, R; Legnani, D; Smacchia, C; Ghira, C; Allegra, L

1994-03-01

In a retrospective analysis of lower respiratory tract infections in an ex-injection-drug users community, we found an outbreak (April to July 1991) of Chlamydia pneumoniae infection. The epidemic occurred in a group of 26 community members (23 men and 3 women, mean age, 28.9--3 years) living and working together, who underwent acute and convalescent serologic tests for Mycoplasma pneumoniae, Legionella pneumophila, cytomegalovirus, adenovirus, Coxiella burnetii, and Chlamydia pneumoniae. All subjects were submitted to chest radiograph, while sputum and blood cultures were performed in symptomatic patients. Antibodies to C pneumoniae were determined by a microimmunofluorescence test. Among all subjects studied (13 HIV-1 positive and 13 HIV-1 negative), 11 (8 HIV-positive and 3 HIV-negative) developed pneumonia, 2 (1 HIV-positive and 1 HIV-negative) developed pharyngitis, and 2 (1 HIV- positive and 1 HIV-negative) developed flu-like syndromes sustained by C pneumoniae; in 4 subjects (2 HIV-positive and 2 HIV-negative) suffering from flu-like syndrome, no causal agents were found. Seven subjects (one HIV-positive and six HIV- negative) remained asymptomatic without any evidence of infection. The prevalence of antibodies to C pneumoniae in HIV-1-positive subjects observed in a sample of community members was significantly higher than in HIV-1-negative subjects. C pneumoniae seems to be involved in respiratory tract infections in HIV-1-infected subjects. Our data suggest that C pneumoniae should be included in the diagnostic approach of respiratory infections in HIV-infected subjects.

Early and Real-Time Detection of Seasonal Influenza Onset

PubMed Central

Marques-Pita, Manuel

2017-01-01

Every year, influenza epidemics affect millions of people and place a strong burden on health care services. A timely knowledge of the onset of the epidemic could allow these services to prepare for the peak. We present a method that can reliably identify and signal the influenza outbreak. By combining official Influenza-Like Illness (ILI) incidence rates, searches for ILI-related terms on Google, and an on-call triage phone service, Saúde 24, we were able to identify the beginning of the flu season in 8 European countries, anticipating current official alerts by several weeks. This work shows that it is possible to detect and consistently anticipate the onset of the flu season, in real-time, regardless of the amplitude of the epidemic, with obvious advantages for health care authorities. We also show that the method is not limited to one country, specific region or language, and that it provides a simple and reliable signal that can be used in early detection of other seasonal diseases. PMID:28158192

MapMyFlu: visualizing spatio-temporal relationships between related influenza sequences

PubMed Central

Nolte, Nicholas; Kurzawa, Nils; Eils, Roland; Herrmann, Carl

2015-01-01

Understanding the molecular dynamics of viral spreading is crucial for anticipating the epidemiological implications of disease outbreaks. In the case of influenza, reassortments or point mutations affect the adaption to new hosts or resistance to anti-viral drugs and can determine whether a new strain will result in a pandemic infection or a less severe progression. To this end, tools integrating molecular information with epidemiological parameters are important to understand how molecular characteristics reflect in the infection dynamics. We present a new web tool, MapMyFlu, which allows to spatially and temporally display influenza viruses related to a query sequence on a Google Map based on BLAST results against the NCBI Influenza Database. Temporal and geographical trends appear clearly and may help in reconstructing the evolutionary history of a particular sequence. The tool is accessible through a web server, hence without the need for local installation. The website has an intuitive design and provides an easy-to-use service, and is available at http://mapmyflu.ipmb.uni-heidelberg.de PMID:25940623

Onset of a pandemic: characterizing the initial phase of the swine flu (H1N1) epidemic in Israel

PubMed Central

2011-01-01

Background The swine influenza H1N1 first identified in Mexico, spread rapidly across the globe and is considered the fastest moving pandemic in history. The early phase of an outbreak, in which data is relatively scarce, presents scientific challenges on key issues such as: scale, severity and immunity which are fundamental for establishing sound and rapid policy schemes. Our analysis of an Israeli dataset aims at understanding the spatio-temporal dynamics of H1N1 in its initial phase. Methods We constructed and analyzed a unique dataset from Israel on all confirmed cases (between April 26 to July 7, 2009), representing most swine flu cases in this period. We estimated and characterized fundamental epidemiological features of the pandemic in Israel (e.g. effective reproductive number, age-class distribution, at-risk social groups, infections between sexes, and spatial dynamics). Contact data collected during this stage was used to estimate the generation time distribution of the pandemic. Results We found a low effective reproductive number (Re = 1.06), an age-class distribution of infected individuals (skewed towards ages 18-25), at-risk social groups (soldiers and ultra Orthodox Jews), and significant differences in infections between sexes (skewed towards males). In terms of spatial dynamics, the pandemic spread from the central coastal plain of Israel to other regions, with higher infection rates in more densely populated sub-districts with higher income households. Conclusions Analysis of high quality data holds much promise in reducing uncertainty regarding fundamental aspects of the initial phase of an outbreak (e.g. the effective reproductive number Re, age-class distribution, at-risk social groups). The formulation for determining the effective reproductive number Re used here has many advantages for studying the initial phase of the outbreak since it neither assumes exponential growth of infectives and is independent of the reporting rate. The finding of a low Re (close to unity threshold), combined with identification of social groups with high transmission rates would have enabled the containment of swine flu during the summer in Israel. Our unique use of contact data provided new insights into the differential dynamics of influenza in different ages and sexes, and should be promoted in future epidemiological studies. Thus our work highlights the importance of conducting a comprehensive study of the initial stage of a pandemic in real time. PMID:21492430

Linear instabilities near the DIII-D edge simulated in fluid models

NASA Astrophysics Data System (ADS)

Bass, Eric; Holland, Christopher

2017-10-01

The linear instability spectrum is reported near the DIII-D edge (within the separatrix) for L-mode and H-mode shots using the new eigenvalue solver FluTES (Fluid Toroidal Eigenvalue Solver). FluTES circumvents difficulties with convergence to clean linear eigenmodes (required for diagnosis of nonlinear simulations in codes such as BOUT++) often encountered with fluid initial-value solvers. FluTES is well-verified in analytic cases and against a BOUT++/ELITE benchmark toroidal case. We report results for both a 3-field, one-fluid model (the well-known ``elm-pb'' model) and a 5-field, two-fluid model. For the peeling-ballooning-dominated H-mode, the two solutions are qualitatively the same. In the driftwave-dominated L-mode edge, only the two-fluid solution gives robust instabilities which occur primarily at n > 50 . FluTES is optimized for this regime (near-flutelike limit, toroidally spectral). Cross-separatrix, coupled fluid and drift instabilities may play a role in explaining the gyrokinetic L-mode edge transport shortfall. Extension of FluTES into the open-field-line region is underway. Prepared by UCSD under Contract Number DE-FG02-06ER54871.

Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study

PubMed Central

Kim, Theresa W; Alford, Daniel P; Cabral, Howard; Saitz, Richard; Samet, Jeffrey H

2011-01-01

Objective To compare cancer screening and flu vaccination among persons with and without unhealthy substance use. Design The authors analysed data from 4804 women eligible for mammograms, 4414 eligible for Papanicolou (Pap) smears, 7008 persons eligible for colorectal cancer (CRC) screening and 7017 persons eligible for flu vaccination. All patients were screened for unhealthy substance use. The main outcome was completion of cancer screening and flu vaccination. Results Among the 9995 patients eligible for one or more of the preventive services of interest, 10% screened positive for unhealthy substance use. Compared with women without unhealthy substance use, women with unhealthy substance use received mammograms less frequently (75.4% vs 83.8%; p<0.0001), but Pap smears no less frequently (77.9% vs 78.1%). Persons with unhealthy substance use received CRC screening no less frequently (61.7% vs 63.4%), yet received flu vaccination less frequently (44.7% vs 50.4%; p=0.01). In multivariable analyses, women with unhealthy substance use were less likely to receive mammograms (adjusted odds ratio 0.68; 95% CI 0.52 to 0.89), and persons with unhealthy substance use were less likely to receive flu vaccination (adjusted odds ratio 0.81; 95% CI 0.67 to 0.97). Conclusions Unhealthy substance use is a risk factor for not receiving all appropriate preventive health services. PMID:22021737

Controlling Pandemic Flu: The Value of International Air Travel Restrictions

PubMed Central

Epstein, Joshua M.; Goedecke, D. Michael; Yu, Feng; Morris, Robert J.; Wagener, Diane K.; Bobashev, Georgiy V.

2007-01-01

Background Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration. Methods and Findings A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT) to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product. Conclusions International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions can be substantial while their costs are minimal, dismissal of travel restrictions as an aid in dealing with a global pandemic seems premature. PMID:17476323

From containment to community: Trigger points from the London pandemic (H1N1) 2009 influenza incident response.

PubMed

Balasegaram, S; Glasswell, A; Cleary, V; Turbitt, D; McCloskey, B

2011-02-01

In the UK, during the first wave of pandemic (H1N1) 2009 influenza, a national 'containment' strategy was employed from 25 April to 2 July 2009, with case finding, treatment of cases, contact tracing and prophylaxis of close contacts. The aim of the strategy was to delay the introduction and spread of pandemic flu in the UK, provide a better understanding of the course of the novel disease, and thereby allow more time for the development of treatment and vaccination options. Descriptive study of the management of the containment phase of pandemic (H1N1) 2009 influenza. Analysis of data reported to the London Flu Response Centre (LFRC). The average number of telephone calls and faxes per day from health professionals before 15 June 2009 was 188, but this started to rise from 363 on 12 June, to 674 on 15 June, and peaked on 22 June at 2206 calls. The number of cases confirmed [by pandemic (H1N1) 2009 influenza specific H1 and N1 polymerase chain reaction] in London rose to a peak of 200 cases per day. There were widespread school outbreaks reporting large numbers of absences with influenza-like illnesses. Activity in the LFRC intensified to a point where London was declared a 'hot spot' for pandemic (H1N1) 2009 influenza on 19 June 2009 because of sustained community transmission. The local incident response was modified to the 'outbreak management phase' of the containment phase. The sharp rise in the number of telephone calls and the rise in school outbreaks appeared to be trigger points for community transmission. These indicators should inform decisions on modifying public health strategy in pandemic situations. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Influenza Pandemic: Continued Focus on the Nation's Planning and Preparedness Efforts Remains Essential. Testimony before the Ad Hoc Subcommittee on State, Local, and Private Sector Preparedness and Integration, Senate Committee on Homeland Security and Governmental Affairs. GAO-09-760T

ERIC Educational Resources Information Center

Steinhardt, Bernice

2009-01-01

As the recent outbreak of the H1N1 (swine flu) virus underscores, an influenza pandemic remains a real threat to our nation and to the world. Over the past 3 years, the US Government Accountability Office (GAO) has conducted a body of work to help the nation better prepare for a possible pandemic. In a February 2009 report, GAO synthesized the…

Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

PubMed

Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

2014-09-01

Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data statistically improve the performance of predicting ILI-related ED visits in Douglas County, and this result can be generalized to other communities. Timely and accurate estimates of ED volume during the influenza season, as well as during pandemic outbreaks, can help hospitals plan their ED resources accordingly and lower their costs by optimizing supplies and staffing and can improve service quality by decreasing ED wait times and overcrowding. Copyright © 2014 Elsevier Inc. All rights reserved.

Antibody Responses in Humans Infected with Newly Emerging Strains of West Nile Virus in Europe

PubMed Central

Chabierski, Stefan; Makert, Gustavo R.; Kerzhner, Alexandra; Barzon, Luisa; Fiebig, Petra; Liebert, Uwe G.; Papa, Anna; Richner, Justin M.; Niedrig, Matthias; Diamond, Michael S.; Palù, Giorgio; Ulbert, Sebastian

2013-01-01

Infection with West Nile Virus (WNV) affects an increasing number of countries worldwide. Although most human infections result in no or mild flu-like symptoms, the elderly and those with a weakened immune system are at higher risk for developing severe neurological disease. Since its introduction into North America in 1999, WNV has spread across the continental United States and caused annual outbreaks with a total of 36,000 documented clinical cases and ∼1,500 deaths. In recent years, outbreaks of neuroinvasive disease also have been reported in Europe. The WNV strains isolated during these outbreaks differ from those in North America, as sequencing has revealed that distinct phylogenetic lineages of WNV concurrently circulate in Europe, which has potential implications for the development of vaccines, therapeutics, and diagnostic tests. Here, we studied the human antibody response to European WNV strains responsible for outbreaks in Italy and Greece in 2010, caused by lineage 1 and 2 strains, respectively. The WNV structural proteins were expressed as a series of overlapping fragments fused to a carrier-protein, and binding of IgG in sera from infected persons was analyzed. The results demonstrate that, although the humoral immune response to WNV in humans is heterogeneous, several dominant peptides are recognized. PMID:23776680

Antibody responses in humans infected with newly emerging strains of West Nile Virus in Europe.

PubMed

Chabierski, Stefan; Makert, Gustavo R; Kerzhner, Alexandra; Barzon, Luisa; Fiebig, Petra; Liebert, Uwe G; Papa, Anna; Richner, Justin M; Niedrig, Matthias; Diamond, Michael S; Palù, Giorgio; Ulbert, Sebastian

2013-01-01

Infection with West Nile Virus (WNV) affects an increasing number of countries worldwide. Although most human infections result in no or mild flu-like symptoms, the elderly and those with a weakened immune system are at higher risk for developing severe neurological disease. Since its introduction into North America in 1999, WNV has spread across the continental United States and caused annual outbreaks with a total of 36,000 documented clinical cases and ∼1,500 deaths. In recent years, outbreaks of neuroinvasive disease also have been reported in Europe. The WNV strains isolated during these outbreaks differ from those in North America, as sequencing has revealed that distinct phylogenetic lineages of WNV concurrently circulate in Europe, which has potential implications for the development of vaccines, therapeutics, and diagnostic tests. Here, we studied the human antibody response to European WNV strains responsible for outbreaks in Italy and Greece in 2010, caused by lineage 1 and 2 strains, respectively. The WNV structural proteins were expressed as a series of overlapping fragments fused to a carrier-protein, and binding of IgG in sera from infected persons was analyzed. The results demonstrate that, although the humoral immune response to WNV in humans is heterogeneous, several dominant peptides are recognized.

Massively multiplexed microbial identification using resequencing DNA microarrays for outbreak investigation

NASA Astrophysics Data System (ADS)

Leski, T. A.; Ansumana, R.; Jimmy, D. H.; Bangura, U.; Malanoski, A. P.; Lin, B.; Stenger, D. A.

2011-06-01

Multiplexed microbial diagnostic assays are a promising method for detection and identification of pathogens causing syndromes characterized by nonspecific symptoms in which traditional differential diagnosis is difficult. Also such assays can play an important role in outbreak investigations and environmental screening for intentional or accidental release of biothreat agents, which requires simultaneous testing for hundreds of potential pathogens. The resequencing pathogen microarray (RPM) is an emerging technological platform, relying on a combination of massively multiplex PCR and high-density DNA microarrays for rapid detection and high-resolution identification of hundreds of infectious agents simultaneously. The RPM diagnostic system was deployed in Sierra Leone, West Africa in collaboration with Njala University and Mercy Hospital Research Laboratory located in Bo. We used the RPM-Flu microarray designed for broad-range detection of human respiratory pathogens, to investigate a suspected outbreak of avian influenza in a number of poultry farms in which significant mortality of chickens was observed. The microarray results were additionally confirmed by influenza specific real-time PCR. The results of the study excluded the possibility that the outbreak was caused by influenza, but implicated Klebsiella pneumoniae as a possible pathogen. The outcome of this feasibility study confirms that application of broad-spectrum detection platforms for outbreak investigation in low-resource locations is possible and allows for rapid discovery of the responsible agents, even in cases when different agents are suspected. This strategy enables quick and cost effective detection of low probability events such as outbreak of a rare disease or intentional release of a biothreat agent.

Living with avian FLU--Persistence of the H5N1 highly pathogenic avian influenza virus in Egypt.

PubMed

Njabo, Kevin Yana; Zanontian, Linda; Sheta, Basma N; Samy, Ahmed; Galal, Shereen; Schoenberg, Frederic Paik; Smith, Thomas B

2016-05-01

H5N1 highly pathogenic avian influenza virus (HPAIV) continues to cause mortality in poultry and threaten human health at a panzootic scale in Egypt since it was reported in 2006. While the early focus has been in Asia, recent evidence suggests that Egypt is an emerging epicenter for the disease. Despite control measures, epizootic transmission of the disease continues. Here, we investigate the persistence of HPAIV across wild passerine birds and domestic poultry between 2009 and 2012 and the potential risk for continuous viral transmission in Egypt. We use a new weighted cross J-function to investigate the degree and spatial temporal nature of the clustering between sightings of infected birds of different types, and the risk of infection associated with direct contact with infected birds. While we found no infection in wild birds, outbreaks occurred year round between 2009 and 2012, with a positive interaction between chickens and ducks. The disease was more present in the years 2010 and 2011 coinciding with the political unrest in the country. Egypt thus continues to experience endemic outbreaks of avian influenza HPAIV in poultry and an increased potential risk of infection to other species including humans. With the current trends, the elimination of the HPAIV infection is highly unlikely without a complete revamp of current policies. The application of spatial statistics techniques to these types of data may help us to understand the characteristics of the disease and may subsequently allow practitioners to explore possible preventive solutions. Copyright © 2016 Elsevier B.V. All rights reserved.

Bringing influenza vaccines into the 21st century

PubMed Central

Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

2014-01-01

The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and ‘universal’ flu vaccines, offer a promise of a dramatically improved influenza vaccine system. PMID:24378716

Bringing influenza vaccines into the 21st century.

PubMed

Settembre, Ethan C; Dormitzer, Philip R; Rappuoli, Rino

2014-01-01

The recent H7N9 influenza outbreak in China highlights the need for influenza vaccine production systems that are robust and can quickly generate substantial quantities of vaccines that target new strains for pandemic and seasonal immunization. Although the influenza vaccine system, a public-private partnership, has been effective in providing vaccines, there are areas for improvement. Technological advances such as mammalian cell culture production and synthetic vaccine seeds provide a means to increase the speed and accuracy of targeting new influenza strains with mass-produced vaccines by dispensing with the need for egg isolation, adaptation, and reassortment of vaccine viruses. New influenza potency assays that no longer require the time-consuming step of generating sheep antisera could further speed vaccine release. Adjuvants that increase the breadth of the elicited immune response and allow dose sparing provide an additional means to increase the number of available vaccine doses. Together these technologies can improve the influenza vaccination system in the near term. In the longer term, disruptive technologies, such as RNA-based flu vaccines and 'universal' flu vaccines, offer a promise of a dramatically improved influenza vaccine system.

Quantitative evaluation of infection control models in the prevention of nosocomial transmission of SARS virus to healthcare workers: implication to nosocomial viral infection control for healthcare workers.

PubMed

Yen, Muh-Yong; Lu, Yun-Ching; Huang, Pi-Hsiang; Chen, Chen-Ming; Chen, Yee-Chun; Lin, Yusen E

2010-07-01

Healthcare workers (HCWs) are at high risk of acquiring emerging infections while caring for patients, as has been shown in the recent SARS and swine flu epidemics. Using SARS as an example, we determined the effectiveness of infection control measures (ICMs) by logistic regression and structural equation modelling (SEM), a quantitative methodology that can test a hypothetical model and validates causal relationships among ICMs. Logistic regression showed that installing hand wash stations in the emergency room (p = 0.012, odds ratio = 1.07) was the only ICM significantly associated with the protection of HCWs from acquiring the SARS virus. The structural equation modelling results showed that the most important contributing factor (highest proportion of effectiveness) was installation of a fever screening station outside the emergency department (51%). Other measures included traffic control in the emergency department (19%), availability of an outbreak standard operation protocol (12%), mandatory temperature screening (9%), establishing a hand washing setup at each hospital checkpoint (3%), adding simplified isolation rooms (3%), and a standardized patient transfer protocol (3%). Installation of fever screening stations outside of the hospital and implementing traffic control in the emergency department contributed to 70% of the effectiveness in the prevention of SARS transmission. Our approach can be applied to the evaluation of control measures for other epidemic infectious diseases, including swine flu and avian flu.

Kondogogu gum-Zn+2-pectinate emulgel matrices reinforced with mesoporous silica for intragastric furbiprofen delivery.

PubMed

Bera, Hriday; Nadimpalli, Jhansirani; Kumar, Sanoj; Vengala, Pavani

2017-11-01

Flurbiprofen (FLU), a non-steroidal anti-inflammatory drug, exhibits limited clinical response due to its poor physicochemical properties. This study aimed at developing reliable drug carriers for intrgastric FLU delivery with a view to improve biopharmaceutical characteristics of drug and modulate its release in a controlled manner. In this context, FLU-loaded kondogogu gum (KG)-Zn +2 -low methoxyl (LM) pectinate emulgel matrices reinforced with calcium silicate (CS) were accomplished by ionotropic gelation technique employing zinc acetate as cross-linker and characterized for their in vitro performances. All the formulations demonstrated excellent drug encapsulation efficiency (DEE, 46-87%) and sustained drug release behavior (Q 7h , 70-91%). These quality attributes were remarkably influenced by polymer-blend (LM pectin:KG) ratios, low-density oil types and CS inclusion. The drug release profile of the FLU-loaded optimized matrices (F-7) was best fitted in Korsmeyer-Peppas model with Fickian diffusion driven mechanism. It also conferred excellent in vitro gastroretention capabilities. Moreover, the drug-excipient compatibility, alteration of crystallinity and thermal behavior of drug and surface morphology of matrices were evidenced with the results of FTIR, XRD, DSC and SEM analyses, respectively. Thus, the newly developed matrices are appropriate for sustained intragastric FLU delivery and simultaneous zinc supplementation for effective inflammation and arthritis management. Copyright © 2017 Elsevier B.V. All rights reserved.

Bird flu, influenza and 1918: the case for mutant Avian tuberculosis.

PubMed

Broxmeyer, Lawrence

2006-01-01

Influenza is Italian for "influence", Latin: influentia. It used to be thought that the disease was caused by a bad influence from the heavens. Influenza was called a virus long, long before it was proven to be one. In 2005, an article in the New England Journal of Medicine estimated that a recurrence of the 1918 influenza epidemic could kill between 180 million and 360 million people worldwide. A large part of the current bird-flu hysteria is fostered by a distrust among the lay and scientific community regarding the actual state of our knowledge regarding the bird flu or H5N1 and the killer "Influenza" Pandemic of 1918 that it is compared to. And this distrust is not completely unfounded. Traditionally, "flu" does not kill. Experts, including Peter Palese of the Mount School of Medicine in Manhattan, remind us that even in 1992, millions in China already had antibodies to H5N1, meaning that they had contracted it and that their immune system had little trouble fending it off. Dr. Andrew Noymer and Michel Garenne, UC Berkely demographers, reported in 2000 convincing statistics showing that undetected tuberculosis may have been the real killer in the 1918 flu epidemic. Aware of recent attempts to isolate the "Influenza virus" on human cadavers and their specimens, Noymer and Garenne summed that: "Frustratingly, these findings have not answered the question why the 1918 virus was so virulent, nor do they offer an explanation for the unusual age profile of deaths". Bird flu would certainly be diagnosed in the hospital today as Acute Respiratory Distress Syndrome (ARDS). Roger and others favor suspecting tuberculosis in all cases of acute respiratory failure of unknown origin. By 1918, it could be said, in so far as tuberculosis was concerned, that the world was a supersaturated sponge ready to ignite and that among its most vulnerable parts was the very Midwest where the 1918 unknown pandemic began. It is theorized that the lethal pig epidemic that began in Kansas just prior to the first human outbreaks was a disease of avian and human tuberculosis genetically combined through mycobacteriophage interchange, with the pig, susceptible to both, as its involuntary living culture medium. What are the implications of mistaking a virus such as Influenza A for what mycobacterial disease is actually causing? They would be disastrous, with useless treatment and preventative stockpiles. The obvious need for further investigation is presently imminent and pressing.

Swine flu. Mexico's handling of A/H1N1 in comparative perspective.

PubMed

Ear, Sophal

2012-01-01

Emerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. Despite the scale of this threat, there are inherent limitations in preventing and controlling EIDs, including the scope of current disease surveillance efforts. All of this leads to the following questions in the context of Mexico's recent swine flu experience: What were the cultural, political, and economic challenges to Influenza A/H1N1 virus response in Mexico? By way of comparison, what can we learn from the U.S. experience in 1976 with A/New Jersey/76 (Hsw1N1), later referred to as H1N1? This article explores the comparative political economy of Mexico's handling of influenza virus A/H1N1 outbreak in 2009. Research provides notable observations-based on the strengths and weaknesses of each country's response--that can be used as a starting point of discussion for the design of effective EIDs surveillance programs in developing and middle-income countries. In the U.S., the speed and efficiency of the 1976 U.S. mobilization against H1N1 was laudable. Although the U.S. response to the outbreak is seldom praised, the unity of the scientific and political communities demonstrated the national ability to respond to the situation. Mexico's strongest characteristics were its transparency, as well as the cooperation the country exhibited with other nations, particularly the U.S. and Canada. While Mexico showed savvy in its effective management of public and media relations, as the article details, political, economic, and cultural problems persisted.

Cross-Border Cholera Outbreaks in Sub-Saharan Africa, the Mystery behind the Silent Illness: What Needs to Be Done?

PubMed Central

Mwesawina, Maurice; Baluku, Yosia; Kanyanda, Setiala S. E.; Orach, Christopher Garimoi

2016-01-01

Introduction Cross-border cholera outbreaks are a major public health problem in Sub-Saharan Africa contributing to the high annual reported cholera cases and deaths. These outbreaks affect all categories of people and are challenging to prevent and control. This article describes lessons learnt during the cross-border cholera outbreak control in Eastern and Southern Africa sub-regions using the case of Uganda-DRC and Malawi-Mozambique borders and makes recommendations for future outbreak prevention and control. Materials and Methods We reviewed weekly surveillance data, outbreak response reports and documented experiences on the management of the most recent cross-border cholera outbreaks in Eastern and Southern Africa sub-regions, namely in Uganda and Malawi respectively. Uganda-Democratic Republic of Congo and Malawi-Mozambique borders were selected because the countries sharing these borders reported high cholera disease burden to WHO. Results A total of 603 cross-border cholera cases with 5 deaths were recorded in Malawi and Uganda in 2015. Uganda recorded 118 cases with 2 deaths and CFR of 1.7%. The under-fives and school going children were the most affected age groups contributing 24.2% and 36.4% of all patients seen along Malawi-Mozambique and Uganda-DRC borders, respectively. These outbreaks lasted for over 3 months and spread to new areas leading to 60 cases with 3 deaths, CRF of 5%, and 102 cases 0 deaths in Malawi and Uganda, respectively. Factors contributing to these outbreaks were: poor sanitation and hygiene, use of contaminated water, floods and rampant cross-border movements. The outbreak control efforts mainly involved unilateral measures implemented by only one of the affected countries. Conclusions Cross-border cholera outbreaks contribute to the high annual reported cholera burden in Sub-Saharan Africa yet they remain silent, marginalized and poorly identified by cholera actors (governments and international agencies). The under-fives and the school going children were the most affected age groups. To successfully prevent and control these outbreaks, guidelines and strategies should be reviewed to assign clear roles and responsibilities to cholera actors on collaboration, prevention, detection, monitoring and control of these epidemics. PMID:27258124

Fluoxetine-induced toxicity results in human placental glutathione S-transferase-π (GST-π) dysfunction.

PubMed

Dalmizrak, Ozlem; Kulaksiz-Erkmen, Gulnihal; Ozer, Nazmi

2016-10-01

The antidepressant drug fluoxetine (FLU) is considered in the group of selective serotonine re-uptake inhibitors. Its distribution in brain and binding to human brain glutathione S-transferase-π (GST-π) have been shown. FLU can cross blood brain barrier and placenta, accumulate in fetus and may cause congenital malformations. To elucidate the interaction of placental GST-π with FLU. First, concentration-dependent inhibition of human placental GST-π was evaluated by using different FLU concentrations and then 0.3125, 0.625, 1.25, 2.5 and 5 mM FLU concentrations were chosen and tested while keeping GSH concentration constant and 1-chloro-2,4-dinitrobenzene (CDNB) concentration varied and vice versa. The data were evaluated with different kinetic models and Statistica 9.00 for Windows. The Vm, at variable [CDNB] (142 ± 16 U/mg protein) was 3 times higher than the Vm obtained at variable [GSH] (49 ± 4 U/mg protein). On the other hand, the Km for CDNB was ∼10 times higher than the Km for GSH (1.99 ± 0.36 mM versus 0.21 ± 0.06 mM). The IC50 value for FLU was 8.6 mM. Both at constant [CDNB] and variable [GSH] and at constant [GSH] and variable [CDNB] the inhibition types were competitive with the Ki values of 5.62 ± 4.37 and 8.09 ± 1.27 mM, respectively. Although the Ki values obtained for FLU in vitro are high, due to their uneven distribution, long elimination time and inhibitory behavior on detoxification systems, it may cause defects in adults but these effects may be much more severe in fetus and result in congenital malformations.

The effect of gamma-irradiation conditions on the immunogenicity of whole-inactivated Influenza A virus vaccine.

PubMed

David, Shannon C; Lau, Josyane; Singleton, Eve V; Babb, Rachelle; Davies, Justin; Hirst, Timothy R; McColl, Shaun R; Paton, James C; Alsharifi, Mohammed

2017-02-15

Gamma-irradiation, particularly an irradiation dose of 50kGy, has been utilised widely to sterilise highly pathogenic agents such as Ebola, Marburg Virus, and Avian Influenza H5N1. We have reported previously that intranasal vaccination with a gamma-irradiated Influenza A virus vaccine (γ-Flu) results in cross-protective immunity. Considering the possible inclusion of highly pathogenic Influenza strains in future clinical development of γ-Flu, an irradiation dose of 50kGy may be used to enhance vaccine safety beyond the internationally accepted Sterility Assurance Level (SAL). Thus, we investigated the effect of irradiation conditions, including high irradiation doses, on the immunogenicity of γ-Flu. Our data confirm that irradiation at low temperatures (using dry-ice) is associated with reduced damage to viral structure compared with irradiation at room temperature. In addition, a single intranasal vaccination with γ-Flu irradiated on dry-ice with either 25 or 50kGy induced seroconversion and provided complete protection against lethal Influenza A challenge. Considering that low temperature is expected to reduce the protein damage associated with exposure to high irradiation doses, we titrated the vaccine dose to verify the efficacy of 50kGy γ-Flu. Our data demonstrate that exposure to 50kGy on dry-ice is associated with limited effect on vaccine immunogenicity, apparent only when using very low vaccine doses. Overall, our data highlight the immunogenicity of influenza virus irradiated at 50kGy for induction of high titre antibody and cytotoxic T-cell responses. This suggests these conditions are suitable for development of γ-Flu vaccines based on highly pathogenic Influenza A viruses. Copyright © 2017 Elsevier Ltd. All rights reserved.

Analysing Twitter and web queries for flu trend prediction.

PubMed

Santos, José Carlos; Matos, Sérgio

2014-05-07

Social media platforms encourage people to share diverse aspects of their daily life. Among these, shared health related information might be used to infer health status and incidence rates for specific conditions or symptoms. In this work, we present an infodemiology study that evaluates the use of Twitter messages and search engine query logs to estimate and predict the incidence rate of influenza like illness in Portugal. Based on a manually classified dataset of 2704 tweets from Portugal, we selected a set of 650 textual features to train a Naïve Bayes classifier to identify tweets mentioning flu or flu-like illness or symptoms. We obtained a precision of 0.78 and an F-measure of 0.83, based on cross validation over the complete annotated set. Furthermore, we trained a multiple linear regression model to estimate the health-monitoring data from the Influenzanet project, using as predictors the relative frequencies obtained from the tweet classification results and from query logs, and achieved a correlation ratio of 0.89 (p<0.001). These classification and regression models were also applied to estimate the flu incidence in the following flu season, achieving a correlation of 0.72. Previous studies addressing the estimation of disease incidence based on user-generated content have mostly focused on the english language. Our results further validate those studies and show that by changing the initial steps of data preprocessing and feature extraction and selection, the proposed approaches can be adapted to other languages. Additionally, we investigated whether the predictive model created can be applied to data from the subsequent flu season. In this case, although the prediction result was good, an initial phase to adapt the regression model could be necessary to achieve more robust results.

Students' Reasoning and Decision Making about a Socioscientific Issue: A Cross-Context Comparison

ERIC Educational Resources Information Center

Lee, Yeung Chung; Grace, Marcus

2012-01-01

It has been argued that decision making about socioscientific issue (SSIs) necessitates informal reasoning, which involves multiperspective thinking and moral judgment. This study extends the scope of the literature concerning students' reasoning on SSIs to a cross-contextual study by comparing decisions made on avian flu by 12-13-year-old Chinese…

Critical behavior in a stochastic model of vector mediated epidemics

NASA Astrophysics Data System (ADS)

Alfinito, E.; Beccaria, M.; Macorini, G.

2016-06-01

The extreme vulnerability of humans to new and old pathogens is constantly highlighted by unbound outbreaks of epidemics. This vulnerability is both direct, producing illness in humans (dengue, malaria), and also indirect, affecting its supplies (bird and swine flu, Pierce disease, and olive quick decline syndrome). In most cases, the pathogens responsible for an illness spread through vectors. In general, disease evolution may be an uncontrollable propagation or a transient outbreak with limited diffusion. This depends on the physiological parameters of hosts and vectors (susceptibility to the illness, virulence, chronicity of the disease, lifetime of the vectors, etc.). In this perspective and with these motivations, we analyzed a stochastic lattice model able to capture the critical behavior of such epidemics over a limited time horizon and with a finite amount of resources. The model exhibits a critical line of transition that separates spreading and non-spreading phases. The critical line is studied with new analytical methods and direct simulations. Critical exponents are found to be the same as those of dynamical percolation.

Critical behavior in a stochastic model of vector mediated epidemics.

PubMed

Alfinito, E; Beccaria, M; Macorini, G

2016-06-06

The extreme vulnerability of humans to new and old pathogens is constantly highlighted by unbound outbreaks of epidemics. This vulnerability is both direct, producing illness in humans (dengue, malaria), and also indirect, affecting its supplies (bird and swine flu, Pierce disease, and olive quick decline syndrome). In most cases, the pathogens responsible for an illness spread through vectors. In general, disease evolution may be an uncontrollable propagation or a transient outbreak with limited diffusion. This depends on the physiological parameters of hosts and vectors (susceptibility to the illness, virulence, chronicity of the disease, lifetime of the vectors, etc.). In this perspective and with these motivations, we analyzed a stochastic lattice model able to capture the critical behavior of such epidemics over a limited time horizon and with a finite amount of resources. The model exhibits a critical line of transition that separates spreading and non-spreading phases. The critical line is studied with new analytical methods and direct simulations. Critical exponents are found to be the same as those of dynamical percolation.

The macroeconomic impact of pandemic influenza: estimates from models of the United Kingdom, France, Belgium and The Netherlands.

PubMed

Keogh-Brown, Marcus Richard; Smith, Richard D; Edmunds, John W; Beutels, Philippe

2010-12-01

The 2003 outbreak of severe acute respiratory syndrome (SARS) showed that infectious disease outbreaks can have notable macroeconomic impacts. The current H1N1 and potential H5N1 flu pandemics could have a much greater impact. Using a multi-sector single country computable general equilibrium model of the United Kingdom, France, Belgium and The Netherlands, together with disease scenarios of varying severity, we examine the potential economic cost of a modern pandemic. Policies of school closure, vaccination and antivirals, together with prophylactic absence from work are evaluated and their cost impacts are estimated. Results suggest GDP losses from the disease of approximately 0.5-2% but school closure and prophylactic absenteeism more than triples these effects. Increasing school closures from 4 weeks at the peak to entire pandemic closure almost doubles the economic cost, but antivirals and vaccinations seem worthwhile. Careful planning is therefore important to ensure expensive policies to mitigate the pandemic are effective in minimising illness and deaths.

What's new with the flu? Reflections regarding the management and prevention of influenza from the 2nd New Zealand Influenza Symposium, November 2015.

PubMed

Charania, Nadia A; Mansoor, Osman D; Murfitt, Diana; Turner, Nikki M

2016-09-09

Influenza is a common respiratory viral infection. Seasonal outbreaks of influenza cause substantial morbidity and mortality that burdens healthcare services every year. The influenza virus constantly evolves by antigenic drift and occasionally by antigenic shift, making this disease particularly challenging to manage and prevent. As influenza viruses cause seasonal outbreaks and also have the ability to cause pandemics leading to widespread social and economic losses, focused discussions on improving management and prevention efforts is warranted. The Immunisation Advisory Centre (IMAC) hosted the 2nd New Zealand Influenza Symposium (NZiS) in November 2015. International and national participants discussed current issues in influenza management and prevention. Experts in the field presented data from recent studies and discussed the ecology of influenza viruses, epidemiology of influenza, methods of prevention and minimisation, and experiences from the 2015 seasonal influenza immunisation campaign. The symposium concluded that although much progress in this field has been made, many areas for future research remain.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wanitchang, Asawin; Narkpuk, Jaraspim; Jaru-ampornpan, Peera

Given that co-infection of cells with equivalent titers of influenza A and B viruses (FluA and FluB) has been shown to result in suppression of FluA growth, it is possible that FluB-specific proteins might hinder FluA polymerase activity and replication. We addressed this possibility by individually determining the effect of each gene of FluB on the FluA polymerase assay and found that the nucleoprotein of FluB (NP{sub FluB}) inhibits polymerase activity of FluA in a dose-dependent manner. Mutational analyses of NP{sub FluB} suggest that functional NP{sub FluB} is necessary for this inhibition. Slower growth of FluA was also observed inmore » MDCK cells stably expressing NP{sub FluB}. Further analysis of NP{sub FluB} indicated that it does not affect nuclear import of NP{sub FluA}. Taken together, these findings suggest a novel role of NP{sub FluB} in inhibiting replication of FluA, providing more insights into the mechanism of interference between FluA and FluB and the lack of reassortants between them.« less

Adjuvant effects of invariant NKT cell ligand potentiates the innate and adaptive immunity to an inactivated H1N1 swine influenza virus vaccine in pigs.

PubMed

Dwivedi, Varun; Manickam, Cordelia; Dhakal, Santosh; Binjawadagi, Basavaraj; Ouyang, Kang; Hiremath, Jagadish; Khatri, Mahesh; Hague, Jacquelyn Gervay; Lee, Chang Won; Renukaradhya, Gourapura J

2016-04-15

Pigs are considered as the source of some of the emerging human flu viruses. Inactivated swine influenza virus (SwIV) vaccine has been in use in the US swine herds, but it failed to control the flu outbreaks. The main reason has been attributed to lack of induction of strong local mucosal immunity in the respiratory tract. Invariant natural killer T (iNKT) cell is a unique T cell subset, and activation of iNKT cell using its ligand α-Galactosylceramide (α-GalCer) has been shown to potentiate the cross-protective immunity to inactivated influenza virus vaccine candidates in mice. Recently, we discovered iNKT cell in pig and demonstrated its activation using α-GalCer. In this study, we evaluated the efficacy of an inactivated H1N1 SwIV coadministered with α-GalCer intranasally against a homologous viral challenge. Our results demonstrated the potent adjuvant effects of α-GalCer in potentiating both innate and adaptive immune responses to SwIV Ags in the lungs of pigs, which resulted in reduction in the lung viral load by 3 logs compared to without adjuvant. Immunologically, in the lungs of pigs vaccinated with α-GalCer an increased virus specific IgA response, IFN-α secretion and NK cell-cytotoxicity was observed. In addition, iNKT cell-stimulation enhanced the secretion of Th1 cytokines (IFN-γ and IL-12) and reduced the production of immunosuppressive cytokines (IL-10 and TGF-β) in the lungs of pigs⋅ In conclusion, we demonstrated for the first time iNKT cell adjuvant effects in pigs to SwIV Ags through augmenting the innate and adaptive immune responses in the respiratory tract. Copyright © 2016 Elsevier B.V. All rights reserved.

Biodegradable nanoparticle delivery of inactivated swine influenza virus vaccine provides heterologous cell-mediated immune response in pigs.

PubMed

Dhakal, Santosh; Hiremath, Jagadish; Bondra, Kathryn; Lakshmanappa, Yashavanth S; Shyu, Duan-Liang; Ouyang, Kang; Kang, Kyung-Il; Binjawadagi, Basavaraj; Goodman, Jonathan; Tabynov, Kairat; Krakowka, Steven; Narasimhan, Balaji; Lee, Chang Won; Renukaradhya, Gourapura J

2017-02-10

Swine influenza virus (SwIV) is one of the important zoonotic pathogens. Current flu vaccines have failed to provide cross-protection against evolving viruses in the field. Poly(lactic-co-glycolic acid) (PLGA) is a biodegradable FDA approved polymer and widely used in drug and vaccine delivery. In this study, inactivated SwIV H1N2 antigens (KAg) encapsulated in PLGA nanoparticles (PLGA-KAg) were prepared, which were spherical in shape with 200 to 300nm diameter, and induced maturation of antigen presenting cells in vitro. Pigs vaccinated twice with PLGA-KAg via intranasal route showed increased antigen specific lymphocyte proliferation and enhanced the frequency of T-helper/memory and cytotoxic T cells (CTLs) in peripheral blood mononuclear cells (PBMCs). In PLGA-KAg vaccinated and heterologous SwIV H1N1 challenged pigs, clinical flu symptoms were absent, while the control pigs had fever for four days. Grossly and microscopically, reduced lung pathology and viral antigenic mass in the lung sections with clearance of infectious challenge virus in most of the PLGA-KAg vaccinated pig lung airways were observed. Immunologically, PLGA-KAg vaccine irrespective of not significantly boosting the mucosal antibody response, it augmented the frequency of IFN-γ secreting total T cells, T-helper and CTLs against both H1N2 and H1N1 SwIV. In summary, inactivated influenza virus delivered through PLGA-NPs reduced the clinical disease and induced cross-protective cell-mediated immune response in a pig model. Our data confirmed the utility of a pig model for intranasal particulate flu vaccine delivery platform to control flu in humans. Copyright © 2017 Elsevier B.V. All rights reserved.

Between Securitisation and Neglect: Managing Ebola at the Borders of Global Health

PubMed Central

Honigsbaum, Mark

2017-01-01

In 2014 the World Health Organization (WHO) was widely criticised for failing to anticipate that an outbreak of Ebola in a remote forested region of south-eastern Guinea would trigger a public health emergency of international concern (pheic). In explaining the WHO’s failure, critics have pointed to structural restraints on the United Nations organisation and a leadership ‘vacuum’ in Geneva, among other factors. This paper takes a different approach. Drawing on internal WHO documents and interviews with key actors in the epidemic response, I argue that the WHO’s failure is better understood as a consequence of Ebola’s shifting medical identity and of triage systems for managing emerging infectious disease (EID) risks. Focusing on the discursive and non-discursive practices that produced Ebola as a ‘problem’ for global health security, I argue that by 2014 Ebola was no longer regarded as a paradigmatic EID and potential biothreat so much as a neglected tropical disease. The result was to relegate Ebola to the fringes of biosecurity concerns just at the moment when the virus was crossing international borders in West Africa and triggering large urban outbreaks for the first time. Ebola’s fluctuating medical identity also helps explain the prominence of fear and rumours during the epidemic and social resistance to Ebola control measures. Contrasting the WHO’s delay over declaring a pheic in 2014, with its rapid declaration of pheics in relation to H1N1 swine flu in 2009 and polio in 2014, I conclude that such ‘missed alarms’ may be an inescapable consequence of pandemic preparedness systems that seek to rationalise responses to the emergence of new diseases. PMID:28260567

A Fast Test to Diagnose Flu

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hazi, A U

People with flu-like symptoms who seek treatment at a medical clinic or hospital often must wait several hours before being examined, possibly exposing many people to an infectious virus. If a patient appears to need more than the routine fluids-and-rest prescription, effective diagnosis requires tests that must be sent to a laboratory. Hours or days may pass before results are available to the doctor, who in the meantime must make an educated guess about the patient's illness. The lengthy diagnostic process places a heavy burden on medical laboratories and can result in improper use of antibiotics or a costly hospitalmore » stay. A faster testing method may soon be available. An assay developed by a team of Livermore scientists can diagnose influenza and other respiratory viruses in about two hours once a sample has been taken. Unlike other systems that operate this quickly, the new device, called FluIDx (and pronounced ''fluidics''), can differentiate five types of respiratory viruses, including influenza. FluIDx can analyze samples at the point of patient care--in hospital emergency departments and clinics--allowing medical providers to quickly determine how best to treat a patient, saving time and potentially thousands of dollars per patient. The FluIDx project, which is led by Livermore chemist Mary McBride of the Physics and Advanced Technologies Directorate, received funding from the National Institute of Allergy and Infectious Diseases and the Laboratory Directed Research and Development (LDRD) Program. To test the system and make it as useful as possible, the team worked closely with the Emergency Department staff at the University of California (UC) at Davis Medical Center in Sacramento. Flu kills more than 35,000 people every year in the US. The 2003 outbreak of severe acute respiratory syndrome and the ongoing concern about a possible bird flu pandemic show the need for a fast, reliable test that can differentiate seasonal flu from a potentially pandemic influenza. Such a test should also discriminate influenza from pathogens that cause illnesses with flu-like symptoms. When a precise diagnosis is required to treat an adult patient with serious respiratory symptoms, sample cells are usually obtained with a nasal or throat swab and analyzed with one of several laboratory methods. The gold standard test is viral culturing, a highly sensitive method that can identify the specific strain of virus. However, viral culturing is a labor-intensive process and requires 3-10 days to produce results, too long for early intervention. Enzyme and optical immunoassays offer results in 30 minutes, but these methods are less sensitive than viral culturing so they can produce false positives or negatives. They also cannot distinguish the type of virus found. Direct immunofluorescence antibody (DFA) staining is as sensitive as viral culturing. It also can detect multiple respiratory pathogens simultaneously by a process known as multiplexing. However, DFA staining requires expensive equipment, a skilled microscopist, and samples with enough target cells for testing. In addition, the results are ultimately subjective. Another method, called reverse transcriptase-polymerase chain reaction assay, offers sensitivity and specificity comparable to viral culturing and DFA staining. It also produces results in two hours and can rapidly test a large number of samples. The drawback with these tests, however, is that they must be performed in a laboratory. None of them can be used where they are needed most: in the clinic or emergency department where patients are being treated. Livermore's FluIDx diagnostic system, with its instrumentation and multiplexed assays, is designed specifically for point-of-care diagnosis. The fast, easy-to-use system is based on the Autonomous Pathogen Detection System, a homeland security technology developed by LLNL. This R&D 100 Award-winning technology constantly monitors the air to detect airborne bioterrorism agents, such as anthrax. FluIDx is an integrated system designed to perform highly multiplexed polymerase chain reaction (PCR) nucleic-acid-based assays in real time. The FluIDx system processes a sample, analyzes the data, reports the results, and decontaminates itself before another sample is taken. The device currently uses 16 assays--12 for individual nucleic-acid targets and 4 for internal controls. The assays can simultaneously detect influenza A and B, parainfluenza (Types 1 and 3), respiratory syncytial virus, and adenovirus (Groups B, C, and E).« less

Pandemic policy and planning considerations for universities: findings from a tabletop exercise.

PubMed

Beaton, Randal; Stergachis, Andy; Thompson, Jack; Osaki, Carl; Johnson, Clark; Charvat, Steven J; Marsden-Haug, Nicola

2007-12-01

The potential for a novel influenza virus to cause a pandemic represents a significant threat to global health. Planning for pandemic flu, as compared to planning for other types of hazards, presents some unique challenges to businesses, communities, and education institutions. To identify and address the challenges that may be faced by major metropolitan universities during a flu pandemic, a tabletop exercise was developed, offered, and evaluated. Its purpose was to assess existing University of Washington (UW) plans and policies for responding to an influenza pandemic. On May 31, 2006, more than 50 participants, including UW administrators and unit leaders and a number of key external partners, participated in a tabletop exercise designed to simulate all phases of an influenza pandemic. This exercise revealed existing gaps in university pandemic influenza plans and policies, including issues related to isolation and quarantine, continuity of operations, disaster mental health services, integration of volunteers into a disaster response, tracking travel of university students and personnel, communication problems, and ways to meet the needs of resident and foreign students and faculty during an outbreak. Policy and planning recommendations are offered that address each of these challenges faced by UW as well as other major research universities and colleges.

Flu Widget

MedlinePlus

... 0" width="300" title="Flu I.Q. Widget" style="overflow: hidden;"> Flu ... 0" width="280" title="CDC Flu Vaccine Finder" style="overflow: hidden;"> FluView Widget < ...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, Braeton J.; Starks, Shirley J.; Loose, Verne W.

Pandemic influenza has become a serious global health concern; in response, governments around the world have allocated increasing funds to containment of public health threats from this disease. Pandemic influenza is also recognized to have serious economic implications, causing illness and absence that reduces worker productivity and economic output and, through mortality, robs nations of their most valuable assets - human resources. This paper reports two studies that investigate both the short- and long-term economic implications of a pandemic flu outbreak. Policy makers can use the growing number of economic impact estimates to decide how much to spend to combatmore » the pandemic influenza outbreaks. Experts recognize that pandemic influenza has serious global economic implications. The illness causes absenteeism, reduced worker productivity, and therefore reduced economic output. This, combined with the associated mortality rate, robs nations of valuable human resources. Policy makers can use economic impact estimates to decide how much to spend to combat the pandemic influenza outbreaks. In this paper economists examine two studies which investigate both the short- and long-term economic implications of a pandemic influenza outbreak. Resulting policy implications are also discussed. The research uses the Regional Economic Modeling, Inc. (REMI) Policy Insight + Model. This model provides a dynamic, regional, North America Industrial Classification System (NAICS) industry-structured framework for forecasting. It is supported by a population dynamics model that is well-adapted to investigating macro-economic implications of pandemic influenza, including possible demand side effects. The studies reported in this paper exercise all of these capabilities.« less

Environmental sampling coupled with real-time PCR and genotyping to investigate the source of a Q fever outbreak in a work setting.

PubMed

Hurtado, A; Alonso, E; Aspiritxaga, I; López Etxaniz, I; Ocabo, B; Barandika, J F; Fernández-Ortiz DE Murúa, J I; Urbaneja, F; Álvarez-Alonso, R; Jado, I; García-Pérez, A L

2017-07-01

A Q fever outbreak was declared in February 2016 in a company that manufactures hoists and chains and therefore with no apparent occupational-associated risk. Coxiella burnetii infection was diagnosed by serology in eight of the 29 workers of the company; seven of them had fever or flu-like signs and five had pneumonia, one requiring hospitalisation. A further case of C. burnetii pneumonia was diagnosed in a local resident. Real-time PCR (RTi-PCR) showed a widespread distribution of C. burnetii DNA in dust samples collected from the plant facilities, thus confirming the exposure of workers to the infection inside the factory. Epidemiological investigations identified a goat flock with high C. burnetii seroprevalence and active shedding which was owned and managed by one of the workers of the company as possible source of infection. Genotyping by multispacer sequence typing (MST) and a 10-loci single-nucleotide polymorphism (SNP) discrimination using RTi-PCR identified the same genotype (MST18 and SNP type 8, respectively) in the farm and the factory. These results confirmed the link between the goat farm and the outbreak and allowed the identification of the source of infection. The circumstances and possible vehicles for the bacteria entering the factory are discussed.

Epidemics: Lessons from the past and current patterns of response

NASA Astrophysics Data System (ADS)

Martin, Paul

2008-09-01

Hippocrates gave the term 'epidemic' its medical meaning. From antiquity to modern times, the meaning of the word epidemic has continued to evolve. Over the centuries, researchers have reached an understanding of the varying aspects of epidemics and have tried to combat them. The role played by travel, trade, and human exchanges in the propagation of epidemic infectious diseases has been understood. In 1948, the World Health Organization was created and given the task of advancing ways of combating epidemics. An early warning system to combat epidemics has been implemented by the WHO. The Global Outbreak Alert and Response Network (GOARN) is collaboration between existing institutions and networks that pool their human and technical resources to fight outbreaks. Avian influenza constitutes currently the most deadly epidemic threat, with fears that it could rapidly reach pandemic proportions and put several thousands of lives in jeopardy. Thanks to the WHO's support, most of the world's countries have mobilised and implemented an 'Action Plan for Pandemic Influenza'. As a result, most outbreaks of the H5N1 avian flu virus have so far been speedily contained. Cases of dengue virus introduction in countries possessing every circumstance required for its epidemic spread provide another example pertinent to the prevention of epidemics caused by vector-borne pathogens.

Social Network Sensors for Early Detection of Contagious Outbreaks

PubMed Central

Christakis, Nicholas A.; Fowler, James H.

2010-01-01

Current methods for the detection of contagious outbreaks give contemporaneous information about the course of an epidemic at best. It is known that individuals near the center of a social network are likely to be infected sooner during the course of an outbreak, on average, than those at the periphery. Unfortunately, mapping a whole network to identify central individuals who might be monitored for infection is typically very difficult. We propose an alternative strategy that does not require ascertainment of global network structure, namely, simply monitoring the friends of randomly selected individuals. Such individuals are known to be more central. To evaluate whether such a friend group could indeed provide early detection, we studied a flu outbreak at Harvard College in late 2009. We followed 744 students who were either members of a group of randomly chosen individuals or a group of their friends. Based on clinical diagnoses, the progression of the epidemic in the friend group occurred 13.9 days (95% C.I. 9.9–16.6) in advance of the randomly chosen group (i.e., the population as a whole). The friend group also showed a significant lead time (p<0.05) on day 16 of the epidemic, a full 46 days before the peak in daily incidence in the population as a whole. This sensor method could provide significant additional time to react to epidemics in small or large populations under surveillance. The amount of lead time will depend on features of the outbreak and the network at hand. The method could in principle be generalized to other biological, psychological, informational, or behavioral contagions that spread in networks. PMID:20856792

Paradoxical risk perception and behaviours related to Avian Flu outbreak and education campaign, Laos.

PubMed

Barennes, Hubert; Harimanana, Aina N; Lorvongseng, Somchay; Ongkhammy, Somvay; Chu, Cindy

2010-10-12

In Laos, small backyard poultry systems predominate (90%). The first lethal human cases of highly pathogenic avian influenza (HPAI) occurred in 2007. Few studies have addressed the impact of outbreaks and education campaigns on a smallholder producer system. We evaluated awareness and behaviours related to educational campaigns and the 2007 HPAI outbreaks. During a national 2-stage cross-sectional randomised survey we interviewed 1098 households using a pre-tested questionnaire in five provinces representative of the Southern to Northern strata of Laos. We used multivariate analysis (Stata, version 8; Stata Corporation, College Station, TX, USA) to analyse factors affecting recollection of HPAI educational messages, awareness of HPAI, and behaviour change. Of the 1098 participants, 303 (27.6%) received training on HPAI. The level of awareness was similar to that in 2006. The urban population considered risk to be decreased, yet unsafe behaviours persisted or increased. This contrasted with an increase in awareness and safe behaviour practices in rural areas. Reported behaviour changes in rural areas included higher rates of cessation of poultry consumption and dead poultry burial when compared to 2006. No participants reported poultry deaths to the authorities. Overall, 70% could recall an educational message but the content and accuracy differed widely depending on training exposure. Washing hands and other hygiene advice, messages given during the HPAI educational campaign, were not recalled. Trained persons were able to recall only one message while untrained participants recalled a broader range of messages. Factors associated with an awareness of a threat of AI in Laos were: having received HPAI training, literacy level, access to TV, recent information, living in rural areas. We report a paradoxical relationship between unsafe behaviours and risk perception in urban areas, as well as exposure to HPAI training and message misinterpretation. Future educational campaigns need to be tailored to specific target populations and farming styles, for example, small holder farms as compared to commercial farms. Special attention must be given to varying risk perceptions and the risk of misinterpretation of key messages, economic hardship, and real life consequences of reporting.

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics.

PubMed

Conesa, David; López-Quílez, Antonio; Martínez-Beneito, Miguel Angel; Miralles, María Teresa; Verdejo, Francisco

2009-07-29

The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software. In this paper, we introduce FluDetWeb, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (R and WinBUGS), a web server environment for Java code (Tomcat) and a software module created by us (Rdp) responsible for managing internal tasks; the software package MySQL has been used to construct the database management system. The implementation is available on-line from: http://www.geeitema.org/meviepi/fludetweb/. The ease of use of FluDetWeb and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods.

FluDetWeb: an interactive web-based system for the early detection of the onset of influenza epidemics

PubMed Central

2009-01-01

Background The early identification of influenza outbreaks has became a priority in public health practice. A large variety of statistical algorithms for the automated monitoring of influenza surveillance have been proposed, but most of them require not only a lot of computational effort but also operation of sometimes not-so-friendly software. Results In this paper, we introduce FluDetWeb, an implementation of a prospective influenza surveillance methodology based on a client-server architecture with a thin (web-based) client application design. Users can introduce and edit their own data consisting of a series of weekly influenza incidence rates. The system returns the probability of being in an epidemic phase (via e-mail if desired). When the probability is greater than 0.5, it also returns the probability of an increase in the incidence rate during the following week. The system also provides two complementary graphs. This system has been implemented using statistical free-software (ℝ and WinBUGS), a web server environment for Java code (Tomcat) and a software module created by us (Rdp) responsible for managing internal tasks; the software package MySQL has been used to construct the database management system. The implementation is available on-line from: http://www.geeitema.org/meviepi/fludetweb/. Conclusion The ease of use of FluDetWeb and its on-line availability can make it a valuable tool for public health practitioners who want to obtain information about the probability that their system is in an epidemic phase. Moreover, the architecture described can also be useful for developers of systems based on computationally intensive methods. PMID:19640304

Avian influenza H9N2 virus isolated from air samples in LPMs in Jiangxi, China.

PubMed

Zeng, Xiaoxu; Liu, Mingbin; Zhang, Heng; Wu, Jingwen; Zhao, Xiang; Chen, Wenbing; Yang, Lei; He, Fenglan; Fan, Guoyin; Wang, Dayan; Chen, Haiying; Shu, Yuelong

2017-07-24

Recently, avian influenza virus has caused repeated worldwide outbreaks in humans. Live Poultry Markets (LPMs) play an important role in the circulation and reassortment of novel Avian Influenza Virus (AIVs). Aerosol transmission is one of the most important pathways for influenza virus to spread among poultry, from poultry to mammals, and among mammals. In this study, air samples were collected from LPMs in Nanchang city between April 2014 and March 2015 to investigate possible aerosol transmission of AIVs. Air samples were detected for Flu A by Real-Time Reverse Transcription-Polymerase Chain Reaction (RRT-PCR). If samples were positive for Flu A, they were inoculated into 9- to 10-day-old specific-pathogen-free embryonated eggs. If the result was positive, the whole genome of the virus was sequenced by MiSeq. Phylogenetic trees of all 8 segments were constructed using MEGA 6.05 software. To investigate the possible aerosol transmission of AIVs, 807 air samples were collected from LPMs in Nanchang city between April 2014 and March 2015. Based on RRT-PCR results, 275 samples (34.1%) were Flu A positive, and one virus was successfully isolated with embryonated eggs. The virus shared high nucleotide homology with H9N2 AIVs from South China. Our study provides further evidence that the air in LPMs can be contaminated by influenza viruses and their nucleic acids, and this should be considered when choosing and evaluating disinfection strategies in LPMs, such as regular air disinfection. Aerosolized viruses such as the H9N2 virus detected in this study can increase the risk of human infection when people are exposed in LPMs.

Avian flu pandemic - flight of the healthcare worker?

PubMed

Shabanowitz, Robert B; Reardon, Judith E

2009-12-01

One of the ethical issues identified in response to a possible pandemic is healthcare workers' duty to provide care during a communicable disease outbreak. Healthcare employees may be subject to a variety of work obligations under such conditions. Questions of duty to treat remain controversial, and debate continues as to the ethical articulation of a duty to treat. This study aimed to investigate opinions from healthcare workers themselves on the perceived duty to treat, and how they might respond to a severe avian flu pandemic. Using system-wide e-mail, we surveyed employees at our rural tertiary/quaternary care health system regarding their knowledge of our institution's pandemic planning policy and their willingness to work in the event of a virulent avian pandemic. Results (N=908) show that employees felt a responsibility for"duty to care." Over 60% disagreed that it was ethical to abandon the workplace during a pandemic. However, opinions also stated that employees wanted autonomy to decide whether or not to work (65%). When asked about volunteering, 79% would agree to volunteer, given some incentives and protective options, the most salient being protective equipment (with relative training for use) and infectious disease training. Our research demonstrated that the healthcare workers a tour institution voiced an earnest willingness to work in the event of an avian flu pandemic, if provided with the necessary input, protections and tools, and education. The use of an electronic methodology for dissemination of surveys allowed the low-cost solicitation of information from a vast proportion of the workforce with ease, providing the institutional ethics committee with the empirical data needed to articulate more meaningful,thoughtful, and robust suggestions for ethical pandemic planning.

ORBiT: Oak Ridge Bio-surveillance Toolkit for Public Health Dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramanathan, Arvind; Pullum, Laura L; Hobson, Tanner C

With novel emerging infectious diseases being reported across different parts of the world, there is a need to build effective bio-surveillance systems that can track, monitor and report such events in a timely manner. Apart from monitoring for emerging disease outbreaks, it is also important to identify susceptible geographic regions and populations where these diseases may have a significant impact. The digitization of health related information through electronic health records (EHR) and electronic healthcare claim reimbursements (eHCR) and the continued growth of self-reported health information through social media provides both tremendous opportunities and challenges in developing novel public health surveillancemore » tools. In this paper, we present an overview of Oak Ridge Bio-surveillance Toolkit (ORBiT), which we have developed specifically to address data analytic challenges in the realm of public health surveillance. In particular, ORBiT provides an extensible environment to pull together diverse, large-scale datasets and analyze them to identify spatial and temporal patterns for various bio-surveillance related tasks. We demonstrate the utility of ORBiT in automatically extracting a small number of spatial and temporal patterns during the 2009-2010 pandemic H1N1 flu season using eHCR data. These patterns provide quantitative insights into the dynamics of how the pandemic flu spread across different parts of the country. We discovered that the eHCR data exhibits multi-scale patterns from which we could identify a small number of states in the United States (US) that act as bridge regions contributing to one or more specific influenza spread patterns. Similar to previous studies, the patterns show that the south-eastern regions of the US were widely affected by the H1N1 flu pandemic. Several of these south-eastern states act as bridge regions, which connect the north-east and central US in terms of flu occurrences. These quantitative insights show how the eHCR data combined with novel analytical techniques can provide important information to decision makers when an epidemic spreads throughout the country. Taken together ORBiT provides a scalable and extensible platform for public health surveillance.« less

Comparison of in vitro bioactivation of flutamide and its cyano analogue: evidence for reductive activation by human NADPH:cytochrome P450 reductase.

PubMed

Wen, Bo; Coe, Kevin J; Rademacher, Peter; Fitch, William L; Monshouwer, Mario; Nelson, Sidney D

2008-12-01

Flutamide (FLU), a nonsteroidal antiandrogen drug widely used in the treatment of prostate cancer, has been associated with idiosyncratic hepatotoxicity in patients. It is proposed that bioactivation of FLU and subsequent binding of reactive metabolite(s) to cellular proteins play a causative role. A toxicogenomic study comparing FLU and its nitro to cyano analogue (CYA) showed that the nitroaromatic group of FLU enhanced cytotoxicity to hepatocytes, indicating that reduction of the nitroaromatic group may represent a potential route of FLU-induced hepatotoxicity [Coe et al. (2007) Chem. Res. Toxicol. 20, 1277-1290]. In the current study, we compared in vitro bioactivation of FLU and CYA in human liver microsomes and cryopreserved human hepatocytes. A nitroreduction metabolite FLU-6 was formed in liver microsomal incubations of FLU under atmospheric oxygen levels and, to a greater extent, under anaerobic conditions. Seven glutathione (GSH) adducts of FLU, FLU-G1-7, were tentatively identified in human liver microsomal incubations using liquid chromatography-tandem mass spectrometry (LC/ MS/MS), while CYA formed only four corresponding GSH adducts, CYA-G1-4, under the same conditions. Of particular interest was the formation of FLU-G5-7 from FLU, where the nitroaromatic group of FLU was reduced to an amino group. A tentative pathway is that upon nitroreduction, the para-diamines undergo cytochrome P450 (P450)-catalyzed two-electron oxidations to form corresponding para-diimine intermediates that react with GSH to form GSH adducts FLU-G5-7, respectively. The identities of FLU-G5-7 were further confirmed by LC/MS/MS analyses of microsomal incubations of a synthesized standard FLU-6. In an attempt to identify enzymes involved in the nitroreduction of FLU, NADPH:cytochrome P450 reductase (CPR) was shown to reduce FLU to FLU-6 under both aerobic and anaerobic conditions. Furthermore, the formation of FLU-G5-7 was completely blocked by the addition of a reversible CPR inhibitor, alpha-lipoic acid, to the incubations of FLU under aerobic conditions. In summary, these results clearly demonstrate that nitroreduction of FLU by CPR contributes to bioactivation and potentially to hepatotoxicity of FLU.

The health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) during an annual influenza epidemic and influenza pandemic in China.

PubMed

Caldwell, Ronald; Roberts, Craig S; An, Zhijie; Chen, Chieh-I; Wang, Bruce

2015-07-24

China has experienced several severe outbreaks of influenza over the past century: 1918, 1957, 1968, and 2009. Influenza itself can be deadly; however, the increase in mortality during an influenza outbreak is also attributable to secondary bacterial infections, specifically pneumococcal disease. Given the history of pandemic outbreaks and the associated morbidity and mortality, we investigated the cost-effectiveness of a PCV7 vaccination program in China from the context of typical and pandemic influenza seasons. A decision-analytic model was employed to evaluate the impact of a 7-valent pneumococcal vaccine (PCV7) infant vaccination program on the incidence, mortality, and cost associated with pneumococcal disease during a typical influenza season (15% flu incidence) and influenza pandemic (30% flu incidence) in China. The model incorporated Chinese data where available and included both direct and indirect (herd) effects on the unvaccinated population, assuming a point in time following the initial introduction of the vaccine where the impact of the indirect effects has reached a steady state, approximately seven years following the implementation of the vaccine program. Pneumococcal disease incidence, mortality, and costs were evaluated over a one year time horizon. Healthcare costs were calculated using a payer perspective and included vaccination program costs and direct medical expenditures from pneumococcal disease. The model predicted that routine PCV7 vaccination of infants in China would prevent 5,053,453 cases of pneumococcal disease and 76,714 deaths in a single year during a normal influenza season.The estimated incremental-cost-effectiveness ratios were ¥12,281 (US$1,900) per life-year saved and ¥13,737 (US$2,125) per quality-adjusted-life-year gained. During an influenza pandemic, the model estimated that routine vaccination with PCV7 would prevent 8,469,506 cases of pneumococcal disease and 707,526 deaths, and would be cost-saving. Routine vaccination with PCV7 in China would be a cost-effective strategy at limiting the negative impact of influenza during a typical influenza season. During an influenza pandemic, the benefit of PCV7 in preventing excess pneumococcal morbidity and mortality renders a PCV7 vaccination program cost-saving.

Critical behavior in a stochastic model of vector mediated epidemics

PubMed Central

Alfinito, E.; Beccaria, M.; Macorini, G.

2016-01-01

The extreme vulnerability of humans to new and old pathogens is constantly highlighted by unbound outbreaks of epidemics. This vulnerability is both direct, producing illness in humans (dengue, malaria), and also indirect, affecting its supplies (bird and swine flu, Pierce disease, and olive quick decline syndrome). In most cases, the pathogens responsible for an illness spread through vectors. In general, disease evolution may be an uncontrollable propagation or a transient outbreak with limited diffusion. This depends on the physiological parameters of hosts and vectors (susceptibility to the illness, virulence, chronicity of the disease, lifetime of the vectors, etc.). In this perspective and with these motivations, we analyzed a stochastic lattice model able to capture the critical behavior of such epidemics over a limited time horizon and with a finite amount of resources. The model exhibits a critical line of transition that separates spreading and non-spreading phases. The critical line is studied with new analytical methods and direct simulations. Critical exponents are found to be the same as those of dynamical percolation. PMID:27264105

Resequencing Pathogen Microarray (RPM) for prospective detection and identification of emergent pathogen strains and variants

NASA Astrophysics Data System (ADS)

Tibbetts, Clark; Lichanska, Agnieszka M.; Borsuk, Lisa A.; Weslowski, Brian; Morris, Leah M.; Lorence, Matthew C.; Schafer, Klaus O.; Campos, Joseph; Sene, Mohamadou; Myers, Christopher A.; Faix, Dennis; Blair, Patrick J.; Brown, Jason; Metzgar, David

2010-04-01

High-density resequencing microarrays support simultaneous detection and identification of multiple viral and bacterial pathogens. Because detection and identification using RPM is based upon multiple specimen-specific target pathogen gene sequences generated in the individual test, the test results enable both a differential diagnostic analysis and epidemiological tracking of detected pathogen strains and variants from one specimen to the next. The RPM assay enables detection and identification of pathogen sequences that share as little as 80% sequence similarity to prototype target gene sequences represented as detector tiles on the array. This capability enables the RPM to detect and identify previously unknown strains and variants of a detected pathogen, as in sentinel cases associated with an infectious disease outbreak. We illustrate this capability using assay results from testing influenza A virus vaccines configured with strains that were first defined years after the design of the RPM microarray. Results are also presented from RPM-Flu testing of three specimens independently confirmed to the positive for the 2009 Novel H1N1 outbreak strain of influenza virus.

Comparison of in Vitro Bioactivation of Flutamide and Its Cyano Analogue: Evidence for Reductive Activation by Human NADPH:Cytochrome P450 Reductase

PubMed Central

Wen, Bo; Coe, Kevin J.; Rademacher, Peter; Fitch, William L.; Monshouwer, Mario; Nelson, Sidney D.

2009-01-01

Flutamide (FLU), a nonsteroidal antiandrogen drug widely used in the treatment of prostate cancer, has been associated with idiosyncratic hepatotoxicity in patients. It is proposed that bioactivation of FLU and subsequent binding of reactive metabolite(s) to cellular proteins play a causative role. A toxicogenomic study comparing FLU and its nitro to cyano analogue (CYA) showed that the nitroaromatic group of FLU enhanced cytotoxicity to hepatocytes, indicating that reduction of the nitroaromatic group may represent a potential route of FLU-induced hepatotoxicity [Coe et al. (2007) Chem. Res. Toxicol. 20, 1277–1290]. In the current study, we compared in vitro bioactivation of FLU and CYA in human liver microsomes and cryopreserved human hepatocytes. A nitroreduction metabolite FLU-6 was formed in liver microsomal incubations of FLU under atmospheric oxygen levels and, to a greater extent, under anaerobic conditions. Seven glutathione (GSH) adducts of FLU, FLU-G1–7, were tentatively identified in human liver microsomal incubations using liquid chromatography–tandem mass spectrometry (LC/MS/MS), while CYA formed only four corresponding GSH adducts, CYA-G1–4, under the same conditions. Of particular interest was the formation of FLU-G5–7 from FLU, where the nitroaromatic group of FLU was reduced to an amino group. A tentative pathway is that upon nitroreduction, the para-diamines undergo cytochrome P450 (P450)-catalyzed two-electron oxidations to form corresponding para-diimine intermediates that react with GSH to form GSH adducts FLU-G5–7, respectively. The identities of FLU-G5–7 were further confirmed by LC/MS/MS analyses of microsomal incubations of a synthesized standard FLU-6. In an attempt to identify enzymes involved in the nitroreduction of FLU, NADPH:cytochrome P450 reductase (CPR) was shown to reduce FLU to FLU-6 under both aerobic and anaerobic conditions. Furthermore, the formation of FLU-G5–7 was completely blocked by the addition of a reversible CPR inhibitor, α-lipoic acid, to the incubations of FLU under aerobic conditions. In summary, these results clearly demonstrate that nitroreduction of FLU by CPR contributes to bioactivation and potentially to hepatotoxicity of FLU. PMID:19548358

Design and performance of the CDC real-time reverse transcriptase PCR swine flu panel for detection of 2009 A (H1N1) pandemic influenza virus.

PubMed

Shu, Bo; Wu, Kai-Hui; Emery, Shannon; Villanueva, Julie; Johnson, Roy; Guthrie, Erica; Berman, LaShondra; Warnes, Christine; Barnes, Nathelia; Klimov, Alexander; Lindstrom, Stephen

2011-07-01

Swine influenza viruses (SIV) have been shown to sporadically infect humans and are infrequently identified by the Influenza Division of the Centers for Disease Control and Prevention (CDC) after being received as unsubtypeable influenza A virus samples. Real-time reverse transcriptase PCR (rRT-PCR) procedures for detection and characterization of North American lineage (N. Am) SIV were developed and implemented at CDC for rapid identification of specimens from cases of suspected infections with SIV. These procedures were utilized in April 2009 for detection of human cases of 2009 A (H1N1) pandemic (pdm) influenza virus infection. Based on genetic sequence data derived from the first two viruses investigated, the previously developed rRT-PCR procedures were optimized to create the CDC rRT-PCR Swine Flu Panel for detection of the 2009 A (H1N1) pdm influenza virus. The analytical sensitivity of the CDC rRT-PCR Swine Flu Panel was shown to be 5 copies of RNA per reaction and 10(-1.3 - -0.7) 50% infectious doses (ID(50)) per reaction for cultured viruses. Cross-reactivity was not observed when testing human clinical specimens or cultured viruses that were positive for human seasonal A (H1N1, H3N2) and B influenza viruses. The CDC rRT-PCR Swine Flu Panel was distributed to public health laboratories in the United States and internationally from April 2009 until June 2010. The CDC rRT-PCR Swine Flu Panel served as an effective tool for timely and specific detection of 2009 A (H1N1) pdm influenza viruses and facilitated subsequent public health response implementation.

Design and Performance of the CDC Real-Time Reverse Transcriptase PCR Swine Flu Panel for Detection of 2009 A (H1N1) Pandemic Influenza Virus▿†‡

PubMed Central

Shu, Bo; Wu, Kai-Hui; Emery, Shannon; Villanueva, Julie; Johnson, Roy; Guthrie, Erica; Berman, LaShondra; Warnes, Christine; Barnes, Nathelia; Klimov, Alexander; Lindstrom, Stephen

2011-01-01

Swine influenza viruses (SIV) have been shown to sporadically infect humans and are infrequently identified by the Influenza Division of the Centers for Disease Control and Prevention (CDC) after being received as unsubtypeable influenza A virus samples. Real-time reverse transcriptase PCR (rRT-PCR) procedures for detection and characterization of North American lineage (N. Am) SIV were developed and implemented at CDC for rapid identification of specimens from cases of suspected infections with SIV. These procedures were utilized in April 2009 for detection of human cases of 2009 A (H1N1) pandemic (pdm) influenza virus infection. Based on genetic sequence data derived from the first two viruses investigated, the previously developed rRT-PCR procedures were optimized to create the CDC rRT-PCR Swine Flu Panel for detection of the 2009 A (H1N1) pdm influenza virus. The analytical sensitivity of the CDC rRT-PCR Swine Flu Panel was shown to be 5 copies of RNA per reaction and 10−1.3∼−0.7 50% infectious doses (ID50) per reaction for cultured viruses. Cross-reactivity was not observed when testing human clinical specimens or cultured viruses that were positive for human seasonal A (H1N1, H3N2) and B influenza viruses. The CDC rRT-PCR Swine Flu Panel was distributed to public health laboratories in the United States and internationally from April 2009 until June 2010. The CDC rRT-PCR Swine Flu Panel served as an effective tool for timely and specific detection of 2009 A (H1N1) pdm influenza viruses and facilitated subsequent public health response implementation. PMID:21593260

Twitter Influenza Surveillance: Quantifying Seasonal Misdiagnosis Patterns and their Impact on Surveillance Estimates.

PubMed

Mowery, Jared

2016-01-01

Influenza (flu) surveillance using Twitter data can potentially save lives and increase efficiency by providing governments and healthcare organizations with greater situational awareness. However, research is needed to determine the impact of Twitter users' misdiagnoses on surveillance estimates. This study establishes the importance of Twitter users' misdiagnoses by showing that Twitter flu surveillance in the United States failed during the 2011-2012 flu season, estimates the extent of misdiagnoses, and tests several methods for reducing the adverse effects of misdiagnoses. Metrics representing flu prevalence, seasonal misdiagnosis patterns, diagnosis uncertainty, flu symptoms, and noise were produced using Twitter data in conjunction with OpenSextant for geo-inferencing, and a maximum entropy classifier for identifying tweets related to illness. These metrics were tested for correlations with World Health Organization (WHO) positive specimen counts of flu from 2011 to 2014. Twitter flu surveillance erroneously indicated a typical flu season during 2011-2012, even though the flu season peaked three months late, and erroneously indicated plateaus of flu tweets before the 2012-2013 and 2013-2014 flu seasons. Enhancements based on estimates of misdiagnoses removed the erroneous plateaus and increased the Pearson correlation coefficients by .04 and .23, but failed to correct the 2011-2012 flu season estimate. A rough estimate indicates that approximately 40% of flu tweets reflected misdiagnoses. Further research into factors affecting Twitter users' misdiagnoses, in conjunction with data from additional atypical flu seasons, is needed to enable Twitter flu surveillance systems to produce reliable estimates during atypical flu seasons.

Difference in immune response in vaccinated and unvaccinated Swedish individuals after the 2009 influenza pandemic

PubMed Central

2014-01-01

Background Previous exposures to flu and subsequent immune responses may impact on 2009/2010 pandemic flu vaccine responses and clinical symptoms upon infection with the 2009 pandemic H1N1 influenza strain. Qualitative and quantitative differences in humoral and cellular immune responses associated with the flu vaccination in 2009/2010 (pandemic H1N1 vaccine) and natural infection have not yet been described in detail. We designed a longitudinal study to examine influenza- (flu-) specific immune responses and the association between pre-existing flu responses, symptoms of influenza-like illness (ILI), impact of pandemic flu infection, and pandemic flu vaccination in a cohort of 2,040 individuals in Sweden in 2009–2010. Methods Cellular flu-specific immune responses were assessed by whole-blood antigen stimulation assay, and humoral responses by a single radial hemolysis test. Results Previous seasonal flu vaccination was associated with significantly lower flu-specific IFN-γ responses (using a whole-blood assay) at study entry. Pandemic flu vaccination induced long-lived T-cell responses (measured by IFN-γ production) to influenza A strains, influenza B strains, and the matrix (M1) antigen. In contrast, individuals with pandemic flu infection (PCR positive) exhibited increased flu-specific T-cell responses shortly after onset of ILI symptoms but the immune response decreased after the flu season (spring 2010). We identified non-pandemic-flu vaccinated participants without ILI symptoms who showed an IFN-γ production profile similar to pandemic-flu infected participants, suggesting exposure without experiencing clinical symptoms. Conclusions Strong and long-lived flu-M1 specific immune responses, defined by IFN-γ production, in individuals after vaccination suggest that M1-responses may contribute to protective cellular immune responses. Silent flu infections appeared to be frequent in 2009/2010. The pandemic flu vaccine induced qualitatively and quantitatively different humoral and cellular immune responses as compared to infection with the 2009 H1N1 pandemic H1N1 influenza strain. PMID:24916787

Reflections on New York City's 1947 Smallpox Vaccination Program and Its 1976 Swine Influenza Immunization Program.

PubMed

Imperato, Pascal James

2015-06-01

In 1947, a smallpox outbreak occurred in New York City with a total of twelve cases and two deaths. In order to contain this outbreak, the New York City Department of Health launched a mass immunization campaign that over a period of some 60 days vaccinated 6.35 million people. This article examines in detail the epidemiology of this outbreak and the measures employed to contain it. In 1976, a swine influenza strain was isolated among a few recruits at a US Army training camp at Fort Dix, New Jersey. It was concluded at the time that this virus possibly represented a re-appearance of the 1918 influenza pandemic influenza strain. As a result, a mass national immunization program was launched by the federal government. From its inception, the program encountered a myriad of challenges ranging from doubts that it was even necessary to the development of Guillain-Barré paralysis among some vaccine recipients. This paper examines the planning for and implementation of the swine flu immunization program in New York City. It also compares it to the smallpox vaccination program of 1947. Despite equivalent financial and personnel resources, leadership and organizational skills, the 1976 program only immunized approximately a tenth of the number of New York City residents vaccinated in 1947. The reasons for these marked differences in outcomes are discussed in detail.

Bat Influenza (Flu)

MedlinePlus

... Influenza Types Seasonal Avian Swine Variant Pandemic Other Bat Influenza (Flu) Questions & Answers Language: English (US) Español ... How was bat flu discovered? References What is bat influenza (flu)? Bat flu refers to influenza A ...

Cancer, the Flu, and You

MedlinePlus

... Flu Publications Stay Informed Cancer Home Cancer, the Flu, and You What Cancer Patients, Survivors, and Caregivers ... Spanish) Recommend on Facebook Tweet Share Compartir Prevent Flu! Get a Flu Vaccine and Take Preventive Actions ...

Adaptation of the FLU-FOBT Program for a primary care clinic serving a low-income Chinese American community: new evidence of effectiveness.

PubMed

Potter, Michael B; Yu, Tina M; Gildengorin, Ginny; Yu, Albert Y; Chan, Kit; McPhee, Stephen J; Green, Lawrence W; Walsh, Judith M

2011-02-01

We sought to adapt and evaluate the FLU-FOBT Program for a primary care clinic serving a low-income Chinese American community. We compared colorectal cancer screening (CRCS) rate changes for patients who received flu shots versus those who did not receive flu shots during the FLU-FOBT Program. Analysis of data from the year prior to the intervention was used to validate the results. Rates of CRCS increased by 18.0 percentage points for flu shot recipients during the FLU-FOBT Program vs. 1.7 percentage points for flu shot non-recipients (p<.001 for change difference). In the year prior to the FLU-FOBT Program, flu shot recipients had only a 3.3 percentage point increase in the CRCS rate vs. a 1.9 percentage point decline for flu shot non-recipients (p=.08 for change difference). The FLU-FOBT Program as adapted was effective at increasing CRCS rates for primary care patients in this low-income Chinese American community.

Avoiding the Flu

MedlinePlus

... of this page please turn Javascript on. Feature: Flu Avoiding the Flu Past Issues / Fall 2009 Table of Contents Children ... help avoid getting and passing on the flu. Influenza (Seasonal) The flu is a contagious respiratory illness ...

Flu Vaccine Safety Information

MedlinePlus

... Types Seasonal Avian Swine Variant Pandemic Other Flu Vaccine Safety Information Questions & Answers Language: English (US) Español ... of flu vaccines monitored? Egg Allergy Are flu vaccines safe? Flu vaccines have good safety record. Hundreds ...

[Differentiation of influenza (Flu) type A, type B, and respiratory syncytial virus (RSV) by QuickNavi™-Flu+RSV].

PubMed

Kohiyama, Risa; Miyazawa, Takashi; Shibano, Nobuko; Inano, Koichi

2014-01-01

Because it is not easy to differentiate Influenza virus (Flu) from RS virus (RSV) just by clinical symptoms, to accurately diagnose those viruses in conjunction with patient's clinical symptoms, rapid diagnostic kits has been used separately for each of those viruses. In our new study, we have developed a new rapid diagnostic kit, QuickNavi™-Flu+RSV. The kit can detect Flu A, Flu B, and RSV antigens with a single sample collection and an assay. Total of 2,873 cases (including nasopharyngeal swabs and nasopharyngeal aspirates specimens) in 2010/2011 and 2011/2012 seasons were evaluated with QuickNavi™-Flu+RSV and a commercially available kit. Sensitivity, specificity, and accuracy of Flu type A, type B, and RSV were above 95% when compared to commercially available kits (QuickNavi™-Flu and QuickNavi™-RSV) and considered to be equivalent to the commercially available kits. In 2011/2012 season, RSV infections increased prior to Flu season and continued during the peak of the Flu season. The kit can contribute to accurate diagnosis of Flu and RSV infections since co-infection cases have also been reported during the 2011/2012 season. QuickNavi™-Flu+RSV is useful for differential diagnosis of respiratory infectious diseases since it can detect Flu type A, type B, and RSV virus antigens with a single sample collection.

Children, the Flu, and the Flu Vaccine

MedlinePlus

... Pandemic Other Children, the Flu, and the Flu Vaccine Language: English (US) Español Recommend on Facebook Tweet ... an additional B virus. What kinds of flu vaccines are available for children? Influenza vaccine options for ...

Simulation of Cross-border Impacts Resulting from Classical Swine Fever Epidemics within the Netherlands and Germany.

PubMed

Hop, G E; Mourits, M C M; Oude Lansink, A G J M; Saatkamp, H W

2016-02-01

The cross-border region of the Netherlands (NL) and the two German states of North Rhine Westphalia (NRW) and Lower Saxony (LS) is a large and highly integrated livestock production area. This region increasingly develops towards a single epidemiological area in which disease introduction is a shared veterinary and, consequently, economic risk. The objectives of this study were to examine classical swine fever (CSF) control strategies' veterinary and direct economic impacts for NL, NRW and LS given the current production structure and to analyse CSF's cross-border causes and impacts within the NL-NRW-LS region. The course of the epidemic was simulated by the use of InterSpread Plus, whereas economic analysis was restricted to calculating disease control costs and costs directly resulting from the control measures applied. Three veterinary control strategies were considered: a strategy based on the minimum EU requirements, a vaccination and a depopulation strategy based on NL and GER's contingency plans. Regardless of the veterinary control strategy, simulated outbreak sizes and durations for 2010 were much smaller than those simulated previously, using data from over 10 years ago. For example, worst-case outbreaks (50th percentile) in NL resulted in 30-40 infected farms and lasted for two to four and a half months; associated direct costs and direct consequential costs ranged from €24.7 to 28.6 million and €11.7 to 26.7 million, respectively. Both vaccination and depopulation strategies were efficient in controlling outbreaks, especially large outbreaks, whereas the EU minimum strategy was especially deficient in controlling worst-case outbreaks. Both vaccination and depopulation strategies resulted in low direct costs and direct consequential costs. The probability of cross-border disease spread was relatively low, and cross-border spread resulted in small, short outbreaks in neighbouring countries. Few opportunities for further cross-border harmonization and collaboration were identified, including the implementation of cross-border regions (free and diseased regions regardless of the border) in case of outbreaks within close proximity of the border, and more and quicker sharing of information across the border. It was expected, however, that collaboration to mitigate the market effects of an epidemic will create more opportunities to lower the impact of CSF outbreaks in a cross-border context. © 2014 Blackwell Verlag GmbH.

Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow.

PubMed

Garraud, O; Heshmati, F; Pozzetto, B; Lefrere, F; Girot, R; Saillol, A; Laperche, S

2016-02-01

Plasma therapy consists in bringing to a patient in need - in general suffering a severe, resistant to current therapy, and even lethal infection - plasma or specific, fractioned, antibodies, along with other immunoglobulins and possibly healing factors that can be obtained from immunized blood donors; donors (voluntary and benevolent) can be either actively immunized individuals or convalescent persons. Plasma therapy has been used since the Spanish flu in 1917-1918, and regularly then when viral epidemics threatened vulnerable populations, the last reported occurrence being the 2013-2015 Ebola virus outbreak in West Africa. The precise action mechanism of plasma therapy is not fully delineated as it may function beyond purified, neutralizing antibodies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Dummheit

PubMed Central

Evans, Robert G.

2015-01-01

Immunizing against influenza is tricky; against measles is not. Influenza comes in many constantly evolving strains, but one measles shot in childhood confers lifelong immunity. Unlike the flu, measles was wiped out. Its return represents an outbreak not of disease, but of stupidity. The matrix of stupidity is, however, reinforced by strong strands of malice, as when Andrew Wakefield's fraudulent 1998 paper linked the MMR vaccine to autism. The fraud was unmasked and the vaccine–autism link disproven, but the evil influence continues. Measles offers an illustration of Virchow's insights that medicine is a social science and that politics is medicine writ large. It is this “inconvenient truth” that is being suppressed by muzzling the Chief Public Health Officer (CPHO) and attacking public health for addressing “social determinants.” PMID:25947030

The rhetorical construction of the predatorial virus: a Burkian analysis of nonfiction accounts of the Ebola virus.

PubMed

Weldon, R A

2001-01-01

Over the past 5 years, a new subgenre of horror films, referred to as plague films, has turned our focus to the threat of a hemorrhagic viral pandemic, comparable to the Spanish Flu epidemic of 1916. Based on the Ebola viral outbreaks of 1976, various writers have presented their accounts under the guise of increasing interest and prevention strategies. Disregarding inappropriate health care practices as the cause of these epidemics, accountability is refocused onto the rhetorically constructed, predatory nature of the virus. By employing Burke's theory of dramatism and pentadic analysis, the author examines this rhetorical construction of Ebola as a predatorial virus and its implications for public perceptions of public health endeavors.

Nucleoprotein of influenza B virus binds to its type A counterpart and disrupts influenza A viral polymerase complex formation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jaru-ampornpan, Peera, E-mail: peera.jar@biotec.or.th; Narkpuk, Jaraspim; Wanitchang, Asawin

Highlights: •FluB nucleoprotein (BNP) can bind to FluA nucleoprotein (ANP). •BNP–ANP interaction inhibits FluA polymerase activity. •BNP binding prevents ANP from forming a functional FluA polymerase complex. •Nuclear localization of BNP is necessary for FluA polymerase inhibition. •Viral RNA is not required for the BNP–ANP interaction. -- Abstract: Upon co-infection with influenza B virus (FluB), influenza A virus (FluA) replication is substantially impaired. Previously, we have shown that the nucleoprotein of FluB (BNP) can inhibit FluA polymerase machinery, retarding the growth of FluA. However, the molecular mechanism underlying this inhibitory action awaited further investigation. Here, we provide evidence that BNPmore » hinders the proper formation of FluA polymerase complex by competitively binding to the nucleoprotein of FluA. To exert this inhibitory effect, BNP must be localized in the nucleus. The interaction does not require the presence of the viral RNA but needs an intact BNP RNA-binding motif. The results highlight the novel role of BNP as an anti-influenza A viral agent and provide insights into the mechanism of intertypic interference.« less

Get Your Flu Shot!| NIH MedlinePlus the Magazine

MedlinePlus

... of this page please turn Javascript on. Feature: Flu Shot Get Your Flu Shot! Past Issues / Winter 2011 Table of Contents ... failure, or lung disease "For the 2010–2011 flu season, the flu vaccine provides protection against the ...

Help Stop the Flu | NIH MedlinePlus the Magazine

MedlinePlus

... of this page please turn Javascript on. Feature: Flu Shot Help Stop the Flu Past Issues / Winter 2011 Table of Contents The ... vaccinated (for everyone six months or older). Find Flu Clinics Near You At www.flu.gov Use ...

Fighting the Flu with a Universal Vaccine | NIH MedlinePlus the Magazine

MedlinePlus

... Follow us Fighting the Flu with a Universal Vaccine Photo: iStock After a serious 2017–2018 flu ... have safely received seasonal flu vaccines. The universal vaccine should: Protect against multiple flu strains Be 75% ...

Canadian Acute Respiratory Illness and Flu Scale (CARIFS) for clinical detection of influenza in children.

PubMed

Fischer, Jason B; Prasad, Priya A; Coffin, Susan E; Alpern, Elizabeth R; Mistry, Rakesh D

2014-10-01

Validated clinical scales, such as the Canadian Acute Respiratory Illness and Flu Scale (CARIFS), have not been used to differentiate influenza (FLU) from other respiratory viruses. Secondary analysis of a prospective cohort presenting to the emergency department (ED) with an influenza-like infection from 2008 to 2010. Subjects were children aged 0 to 19 years who had a venipuncture and respiratory virus polymerase chain reaction. Demographics and CARIFS items were assessed during the ED visit; comparisons were made between FLU and non-FLU subjects. The 203 subjects had median age 30.5 months; 61.6% were male. Comorbid conditions (51.2%) were common. FLU was identified in 26.6%, and were older than non-FLU patients (69.7 vs 47.9 months, P = .02). Demographic, household factors, and mean CARIFS score did not differ between FLU (33.7), and non-FLU (32.0) (mean difference 1.6, 95% CI: -2.0 to 5.2) groups. CARIFS cannot discriminate between FLU and non-FLU infection in ED children with influenza-like infection. © The Author(s) 2014.

What You Can Do to Stop the Flu

MedlinePlus

... of this page please turn Javascript on. Feature: Flu What You Can Do to Stop the Flu Past Issues / Fall 2009 Table of Contents To ... Health and Human Services: http://flu.gov NIH Flu Research to Results Scientists at the National Institute ...

Diagnosing Flu

MedlinePlus

... your symptoms and their clinical judgment. Will my health care provider test me for flu if I have flu-like ... with flu symptoms are not tested because the test results usually do not change how you are treated. Your health care provider may diagnose you with flu based on ...

2009 H1N1 Flu Vaccine Facts

MedlinePlus

... turn Javascript on. Feature: Flu 2009 H1N1 Flu Vaccine Facts Past Issues / Fall 2009 Table of Contents ... H1N1 flu vaccine. 1 The 2009 H1N1 flu vaccine is safe and well tested. Clinical trials conducted ...

H1N1 influenza (Swine flu)

MedlinePlus

Swine flu; H1N1 type A influenza ... The H1N1 virus is now considered a regular flu virus. It is one of the three viruses included in the regular (seasonal) flu vaccine . You cannot get H1N1 flu virus from ...

Evaluation of the immunogenicity and safety of different doses and formulations of a broad spectrum influenza vaccine (FLU-v) developed by SEEK: study protocol for a single-center, randomized, double-blind and placebo-controlled clinical phase IIb trial.

PubMed

van Doorn, Eva; Pleguezuelos, Olga; Liu, Heng; Fernandez, Ana; Bannister, Robin; Stoloff, Gregory; Oftung, Fredrik; Norley, Stephen; Huckriede, Anke; Frijlink, Henderik W; Hak, Eelko

2017-04-04

Current influenza vaccines, based on antibodies against surface antigens, are unable to provide protection against newly emerging virus strains which differ from the vaccine strains. Therefore the population has to be re-vaccinated annually. It is thus important to develop vaccines which induce protective immunity to a broad spectrum of influenza viruses. This trial is designed to evaluate the immunogenicity and safety of FLU-v, a vaccine composed of four synthetic peptides with conserved epitopes from influenza A and B strains expected to elicit both cell mediated immunity (CMI) and humoral immunity providing protection against a broad spectrum of influenza viruses. In a single-center, randomized, double-blind and placebo-controlled phase IIb trial, 222 healthy volunteers aged 18-60 years will be randomized (2:2:1:1) to receive two injections of a suspension of 500 μg FLU-v in saline (arm 1), one dose of emulsified 500 μg FLU-v in Montanide ISA-51 and water for injection (WFI) followed by one saline dose (arm 2), two saline doses (arm 3), or one dose of Montanide ISA-51 and WFI emulsion followed by one saline dose (arm 4). All injections will be given subcutaneously. Primary endpoints are safety and FLU-v induced CMI, evaluated by cytokine production by antigen specific T cell populations (flow-cytometry and ELISA). Secondary outcomes are measurements of antibody responses (ELISA and multiplex), whereas exploratory outcomes include clinical efficacy and additional CMI assays (ELISpot) to show cross-reactivity. Broadly protective influenza vaccines able to provide protection against multiple strains of influenza are urgently needed. FLU-v is a promising vaccine which has shown to trigger the cell-mediated immune response. The dosages and formulations tested in this current trial are also estimated to induce antibody response. Therefore, both cellular and humoral immune responses will be evaluated. EudraCT number 2015-001932-38 ; retrospectively registered clinicaltrials.gov NCT02962908 (November 7th 2016).

Armed Forces Institute of Pathology Becomes CDC Registered Testing Site for Human Swine Influenza

DTIC Science & Technology

2010-01-01

naval officer and pathologist during his nearly three decades of military service. Adrien Ravizee, research associate, is pipetting cells used to...grow influenza virus to new flasks and plates, so the cells can be infected with influenza virus as Dr. Sue Cross, virologist, left and Dr...Izadjoo said. “The collection can be used for validating improved diagnostic swine flu assays.” Dr. Sue Cross, a virologist, used cell cultures

Time to Get Your Seasonal Flu Shot | NIH MedlinePlus the Magazine

MedlinePlus

... of this page please turn JavaScript on. Feature: Flu Season Time to Get Your Seasonal Flu Shot Past Issues / Fall 2014 Table of Contents ... protect/vaccine/index.htm Signs and Symptoms of Flu People who have the flu often feel some ...

Flu Facts

MedlinePlus

... Your doctor will probably recommend that you get one. Flu vaccines are available as a shot. The shot contains killed flu viruses and will ... CDC). This nasal mist did not help prevent cases of flu between 2013 and ... don't have reactions to a flu shot, although a few may notice a fever, sore ...

New Influenza A/H1N1 (“Swine Flu”): information needs of airport passengers and staff

PubMed Central

Dickmann, P.; Rubin, G. J.; Gaber, W.; Wessely, S.; Wicker, S.; Serve, H.; Gottschalk, R.

2010-01-01

Please cite this paper as: Dickmann et al. (2010) New Influenza A/H1N1 (“Swine Flu”): information needs of airport passengers and staff. . Influenza and Other Respiratory Viruses 5(1), 39–46. Background  Airports are the entrances of infectious diseases. Particularly at the beginning of an outbreak, information and communication play an important role to enable the early detection of signs or symptoms and to encourage passengers to adopt appropriate preventive behaviour to limit the spread of the disease. Objectives  To determine the adequacy of the information provided to airport passengers and staff in meeting their information needs in relation to their concerns. Methods  At the start of the influenza A/H1N1 epidemic (29–30 April 2009), qualitative semi‐structured interviews (N = 101) were conducted at Frankfurt International Airport with passengers who were either returning from or going to Mexico and with airport staff who had close contact with these passengers. Interviews focused on knowledge about swine flu, information needs and fear or concern about the outbreak. Results  The results showed that a desire for more information was associated with higher concern – the least concerned participants did not want any additional information, while the most concerned participants reported a range of information needs. Airport staff in contact with passengers travelling from the epicentre of the outbreak showed the highest levels of fear or concern, coupled with a desire to be adequately briefed by their employer. Conclusions  Our results suggest that information strategies should address not only the exposed or potentially exposed but also groups that feel at risk. Identifying what information these different passenger and staff groups wish to receive will be an important task in any future infectious disease outbreak. PMID:21138539

Dynamics of influenza A virus infections in permanently infected pig farms: evidence of recurrent infections, circulation of several swine influenza viruses and reassortment events.

PubMed

Rose, Nicolas; Hervé, Séverine; Eveno, Eric; Barbier, Nicolas; Eono, Florent; Dorenlor, Virginie; Andraud, Mathieu; Camsusou, Claire; Madec, François; Simon, Gaëlle

2013-09-04

Concomitant infections by different influenza A virus subtypes within pig farms increase the risk of new reassortant virus emergence. The aims of this study were to characterize the epidemiology of recurrent swine influenza virus infections and identify their main determinants. A follow-up study was carried out in 3 selected farms known to be affected by repeated influenza infections. Three batches of pigs were followed within each farm from birth to slaughter through a representative sample of 40 piglets per batch. Piglets were monitored individually on a monthly basis for serology and clinical parameters. When a flu outbreak occurred, daily virological and clinical investigations were carried out for two weeks. Influenza outbreaks, confirmed by influenza A virus detection, were reported at least once in each batch. These outbreaks occurred at a constant age within farms and were correlated with an increased frequency of sneezing and coughing fits. H1N1 and H1N2 viruses from European enzootic subtypes and reassortants between viruses from these lineages were consecutively and sometimes simultaneously identified depending on the batch, suggesting virus co-circulations at the farm, batch and sometimes individual levels. The estimated reproduction ratio R of influenza outbreaks ranged between 2.5 [1.9-2.9] and 6.9 [4.1-10.5] according to the age at infection-time and serological status of infected piglets. Duration of shedding was influenced by the age at infection time, the serological status of the dam and mingling practices. An impaired humoral response was identified in piglets infected at a time when they still presented maternally-derived antibodies.

Influenza (Flu)

MedlinePlus

Influenza (flu) Overview Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as stomach "flu" viruses ...

A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

PubMed Central

Rooney, Roisin M.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K.; Farber, Jeffrey M.; Benembarek, Peter K.

2004-01-01

OBJECTIVE: Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. METHODS: The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. CONCLUSIONS: Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work. PMID:15219800

A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

PubMed

Rooney, Roisin M; Cramer, Elaine H; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K; Farber, Jeffrey M; Benembarek, Peter K

2004-01-01

Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work.

Flu Symptoms & Complications

MedlinePlus

... Travelers Flu Activity & Surveillance CDC's WHO Collaborating Center Situation Update: Summary of Weekly FluView Overview of Influenza Surveillance in the United States Current United States Flu Activity Map Weekly U.S. Influenza ...

Flu Shot

MedlinePlus

... complications and sometimes even death. Getting the flu vaccine every year is the best way to lower ... flu and spreading it to others. The flu vaccine causes antibodies to develop in your body about ...

A pandemic influenza modeling and visualization tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maciejewski, Ross; Livengood, Philip; Rudolph, Stephen

2011-08-01

The National Strategy for Pandemic Influenza outlines a plan for community response to a potential pandemic. In this outline, state and local communities are charged with enhancing their preparedness. In order to help public health officials better understand these charges, we have developed a modeling and visualization toolkit (PanViz) for analyzing the effect of decision measures implemented during a simulated pandemic influenza scenario. Spread vectors based on the point of origin and distance traveled over time are calculated and the factors of age distribution and population density are taken into effect. Healthcare officials are able to explore the effects ofmore » the pandemic on the population through a spatiotemporal view, moving forward and backward through time and inserting decision points at various days to determine the impact. Linked statistical displays are also shown, providing county level summaries of data in terms of the number of sick, hospitalized and dead as a result of the outbreak. Currently, this tool has been deployed in Indiana State Department of Health planning and preparedness exercises, and as an educational tool for demonstrating the impact of social distancing strategies during the recent H1N1 (swine flu) outbreak.« less

Key Facts about Influenza (Flu) and Flu Vaccine

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... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Key Facts About Influenza (Flu) Language: English (US) Español Recommend on Facebook ...

Flu & You: Preventive Steps

MedlinePlus

... flu, and have respiratory symptoms without a fever. Digital Resources Prevent Flu! Get a Flu Vaccine and ... by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs Email Recommend ...

Chinese social media analysis for disease surveillance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cui, Xiaohui; Yang, Nanhai; Wang, Zhibo

Here, it is reported that there are hundreds of thou- sands of deaths caused by seasonal flu all around the world every year. More other diseases such as chickenpox, malaria, etc. are also serious threats to people’s physical and mental health. There are 250,000–500,000 deaths every year around the world. Therefore proper techniques for disease surveillance are highly demanded. Recently, social media analysis is regarded as an efficient way to achieve this goal, which is feasible since growing number of people have been posting their health information on social media such as blogs, personal websites, etc. Previous work on socialmore » media analysis mainly focused on English materials but hardly considered Chinese materials, which hinders the application of such technique to Chinese peo- ple. In this paper, we proposed a new method of Chinese social media analysis for disease surveillance. More specifically, we compared different kinds of methods in the process of classification and then proposed a new way to process Chinese text data. The Chinese Sina micro-blog data collected from September to December 2013 are used to validate the effectiveness of the proposed method. The results show that a high classification precision of 87.49 % in average has been obtained. Comparing with the data from the authority, Chinese National Influenza Center, we can predict the outbreak time of flu 5 days earlier.« less

Influenza (Flu) Vaccine (Inactivated or Recombinant): What You Need to Know

MedlinePlus

... flu vaccine. This risk has been estimated at 1 or 2 additional cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine. • Young children who get the flu shot along with pneumococcal vaccine (PCV13) and/or DTaP ...

Implementation of a rapid influenza A/B and RSV direct molecular assay improves emergency department oseltamivir use in paediatric patients.

PubMed

Mitchell, Stephanie L; Chang, Yeh-Chung; Feemster, Kristen; Cárdenas, Ana María

2018-03-01

Influenza A virus (FluA), influenza B virus (FluB) and respiratory syncytial virus (RSV) illnesses increase hospitalizations during seasonal epidemics. To determine the utility of the Simplexa FluA/B & RSV Direct Assay (Direct Flu/RSV) and its impact on oseltamivir use, we offered this assay to emergency department (ED) patients with influenza-like illness. Utilization of the Direct Flu/RSV provided a turnaround time (TAT) of 2 hours. Compared to the flu season prior to implementation of the Direct Flu/RSV, clinicians were more likely to prescribe 5 days of oseltamivir therapy for Direct Flu/RSV-positive patients in comparison to those with a negative test. Use of Direct Flu/RSV provides results rapidly, which leads to more appropriate use of oseltamivir. The ease of use of this assay and quick TAT allows for prompt decision-making, which is essential for patient care and effective disease control during the influenza season.

Avian influenza: the political economy of disease control in Cambodia.

PubMed

Ear, Sophal

2011-01-01

Abstract In the wake of avian flu outbreaks in 2004, Cambodia received $45 million in commitments from international donors to help combat the spread of animal and human influenza, particularly avian influenza (H5N1). How countries leverage foreign aid to address the specific needs of donors and the endemic needs of the nation is a complex and nuanced issue throughout the developing world. Cambodia is a particularly compelling study in pandemic preparedness and the management of avian influenza because of its multilayered network of competing local, national, and global needs, and because the level of aid in Cambodia represents approximately $2.65 million per human case-a disproportionately high number when compared with neighbors Vietnam and Indonesia. This paper examines how the Cambodian government has made use of animal and human influenza funds to protect (or fail to protect) its citizens and the global community. It asks how effective donor and government responses were to combating avian influenza in Cambodia, and what improvements could be made at the local and international level to help prepare for and respond to future outbreaks. Based on original interviews, a field survey of policy stakeholders, and detailed examination of Cambodia's health infrastructure and policies, the findings illustrate that while pandemic preparedness has shown improvements since 2004, new outbreaks and human fatalities accelerated in 2011, and more work needs to be done to align the specific goals of funders with the endemic needs of developing nations.

Treating Influenza (Flu)

MedlinePlus

Treating Influenza (Flu) Information for People at High Risk for Flu Complications Do you have Asthma, Diabetes, or Chronic Heart Disease? ... risk of serious illness if you get the flu. Asthma, diabetes and chronic heart disease were among ...

First Aid: Influenza (Flu)

MedlinePlus

... for Educators Search English Español First Aid: The Flu KidsHealth / For Parents / First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

Flu (Influenza): Information for Parents

MedlinePlus

... PARENTS | DISEASES and the VACCINES THAT PREVENT THEM | Flu (Influenza) and the Vaccine to Prevent It Last updated October 2017 The best way to protect against flu is by getting a flu vaccine. Doctors recommend ...

Key Facts about Seasonal Flu Vaccine

MedlinePlus

... flu illness resulting in doctor’s visits in a comparative study published in 2016. Flu vaccination is an ... illness milder if you do get sick. (For example a 2017 study showed that flu vaccination reduced ...

Thimerosal in Flu Vaccine

MedlinePlus

... Avian Swine Variant Pandemic Other Thimerosal in Flu Vaccine Questions & Answers Language: English (US) Español Recommend on ... or fungi from contaminating the vaccine. Do flu vaccines contain thimerosal? Flu vaccines in multi-dose vials ...

Factors Mediating Seasonal and Influenza A (H1N1) Vaccine Acceptance among Ethnically Diverse Populations in the Urban South

PubMed Central

Frew, Paula M.; Painter, Julia E.; Hixson, Brooke; Kulb, Carolyn; Moore, Kathryn; del Rio, Carlos; Esteves-Jaramillo, Alejandra; Omer, Saad B.

2012-01-01

Objective We examined the acceptability of the influenza A (H1N1) and seasonal vaccinations immediately following government manufacture approval to gauge potential product uptake in minority communities. We studied correlates of vaccine acceptance including attitudes, beliefs, perceptions, and influenza immunization experiences, and sought to identify communication approaches to increase influenza vaccine coverage in community settings. Methods Adults ≥ 18 years participated in a cross-sectional survey from September through December 2009. Venue-based sampling was used to recruit participants of racial and ethnic minorities. Results The sample (N=503) included mostly lower income (81.9%, n=412) participants and African Americans (79.3%, n=399). Respondents expressed greater acceptability of the H1N1 vaccination compared to seasonal flu immunization (t=2.86, p=0.005) although H1N1 vaccine acceptability was moderately low (38%, n=191). Factors associated with acceptance of the H1N1 vaccine included positive attitudes about immunizations [OR=0.23, CI (0.16, 0.33)], community perceptions of H1N1 [OR=2.15, CI (1.57, 2.95)], and having had a flu shot in the past 5 years [OR=2.50, CI (1.52, 4.10). The factors associated with acceptance of the seasonal flu vaccine included positive attitudes about immunization [OR=0.43, CI (0.32, 0.59)], community perceptions of H1N1 [OR=1.53, CI (1.16, 2.01)], and having had the flu shot in the past 5 years [OR=3.53, CI (2.16, 5.78)]. Participants were most likely to be influenced to take a flu shot by physicians [OR=1.94, CI (1.31, 2.86)]. Persons who obtained influenza vaccinations indicated that Facebook (χ2=11.7, p=.02) and Twitter (χ2=18.1, p=.001) could be useful vaccine communication channels and that churches (χ2=21.5, p<.001) and grocery stores (χ2=21.5, p<.001) would be effective “flu shot stops” in their communities. Conclusions In this population, positive vaccine attitudes and community perceptions, along with previous flu vaccination, were associated with H1N1 and seasonal influenza vaccine acceptance. Increased immunization coverage in this community may be achieved through physician communication to dispel vaccine conspiracy beliefs and discussion about vaccine protection via social media and in other community venues. PMID:22537991

Analysis of the Argonne distance tabletop exercise method.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanzman, E. A.; Nieves, L. A.; Decision and Information Sciences

2008-02-14

The purpose of this report is to summarize and evaluate the Argonne Distance Tabletop Exercise (DISTEX) method. DISTEX is intended to facilitate multi-organization, multi-objective tabletop emergency response exercises that permit players to participate from their own facility's incident command center. This report is based on experience during its first use during the FluNami 2007 exercise, which took place from September 19-October 17, 2007. FluNami 2007 exercised the response of local public health officials and hospitals to a hypothetical pandemic flu outbreak. The underlying purpose of the DISTEX method is to make tabletop exercising more effective and more convenient for playingmore » organizations. It combines elements of traditional tabletop exercising, such as scenario discussions and scenario injects, with distance learning technologies. This distance-learning approach also allows playing organizations to include a broader range of staff in the exercise. An average of 81.25 persons participated in each weekly webcast session from all playing organizations combined. The DISTEX method required development of several components. The exercise objectives were based on the U.S. Department of Homeland Security's Target Capabilities List. The ten playing organizations included four public health departments and six hospitals in the Chicago area. An extent-of-play agreement identified the objectives applicable to each organization. A scenario was developed to drive the exercise over its five-week life. Weekly problem-solving task sets were designed to address objectives that could not be addressed fully during webcast sessions, as well as to involve additional playing organization staff. Injects were developed to drive play between webcast sessions, and, in some cases, featured mock media stories based in part on player actions as identified from the problem-solving tasks. The weekly 90-minute webcast sessions were discussions among the playing organizations that were moderated by a highly-qualified public health physician, who reviewed key scenario developments and player actions, as well as solicited input from each playing organization. The exercise control structure included trusted agents who oversaw exercise planning, playing organization points of contact to ensure exercise coordination, and exercise controller/evaluators to initiate and oversee exercise play. A password-protected exercise website was designed for FluNami 2007 to serve as a compartmentalized central information source, and for transmitting exercise documents. During the course of FluNami 2007, feedback on its quality was collected from players and controller/evaluators. Player feedback was requested at the conclusion of each webcast, upon completion of each problem-solving task, and on October 17, 2007, after the final webcast session had ended. The overall average score given to FluNami 2008 by the responding players was 3.9 on a five-point scale. In addition, suggestions for improving the process were provided by Argonne controller/evaluators after the exercise concluded. A series of recommendations was developed based on feedback from the players and controller/evaluators. These included improvements to the exercise scope and objectives, the problem-solving tasks, the scenarios, exercise control, the webcast sessions, the exercise website, and the player feedback process.« less

How to be a good visitor during flu season

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... consumers How to be a good visitor during flu season 11/20/2017 Access a printer-friendly ... of infection prevention. This is especially true during flu season. According to the CDC, influenza (the flu) ...

Pregnant Women Need a Flu Shot

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Pregnant? You Need a Flu Shot! Information for pregnant women Because you are pregnant, CDC and your ob- ... more likely to get severely ill from flu. Pregnant women who get flu are at high risk of ...

Flu (Influenza) Test: MedlinePlus Lab Test Information

MedlinePlus

... https://medlineplus.gov/labtests/fluinfluenzatest.html Flu (Influenza) Test To use the sharing features on this page, please enable JavaScript. What is a Flu (Influenza) Test? Influenza, known as the flu , is a respiratory ...

FluReF, an automated flu virus reassortment finder based on phylogenetic trees.

PubMed

Yurovsky, Alisa; Moret, Bernard M E

2011-01-01

Reassortments are events in the evolution of the genome of influenza (flu), whereby segments of the genome are exchanged between different strains. As reassortments have been implicated in major human pandemics of the last century, their identification has become a health priority. While such identification can be done "by hand" on a small dataset, researchers and health authorities are building up enormous databases of genomic sequences for every flu strain, so that it is imperative to develop automated identification methods. However, current methods are limited to pairwise segment comparisons. We present FluReF, a fully automated flu virus reassortment finder. FluReF is inspired by the visual approach to reassortment identification and uses the reconstructed phylogenetic trees of the individual segments and of the full genome. We also present a simple flu evolution simulator, based on the current, source-sink, hypothesis for flu cycles. On synthetic datasets produced by our simulator, FluReF, tuned for a 0% false positive rate, yielded false negative rates of less than 10%. FluReF corroborated two new reassortments identified by visual analysis of 75 Human H3N2 New York flu strains from 2005-2008 and gave partial verification of reassortments found using another bioinformatics method. FluReF finds reassortments by a bottom-up search of the full-genome and segment-based phylogenetic trees for candidate clades--groups of one or more sampled viruses that are separated from the other variants from the same season. Candidate clades in each tree are tested to guarantee confidence values, using the lengths of key edges as well as other tree parameters; clades with reassortments must have validated incongruencies among segment trees. FluReF demonstrates robustness of prediction for geographically and temporally expanded datasets, and is not limited to finding reassortments with previously collected sequences. The complete source code is available from http://lcbb.epfl.ch/software.html.

Anti-influenza Hyperimmune Immunoglobulin Enhances Fc-functional Antibody Immunity during Human Influenza Infection.

PubMed

Vanderven, Hillary A; Wragg, Kathleen; Ana-Sosa-Batiz, Fernanda; Kristensen, Anne B; Jegaskanda, Sinthujan; Wheatley, Adam K; Wentworth, Deborah; Wines, Bruce D; Hogarth, P Mark; Rockman, Steve; Kent, Stephen J

2018-05-31

New treatments for severe influenza are needed. Passive transfer of influenza-specific hyperimmune pooled immunoglobulin (Flu-IVIG) boosts neutralising antibody responses to past strains in influenza-infected subjects. The effect of Flu-IVIG on antibodies with Fc-mediated functions, which may target diverse influenza strains, is unclear. We studied the capacity of Flu-IVIG, relative to standard IVIG, to bind to Fc receptors and mediate antibody-dependent cellular cytotoxicity in vitro. The effect of Flu-IVIG infusion, compared to placebo infusion, was examined in serial plasma samples from 24 subjects with confirmed influenza infection in the INSIGHT FLU005 pilot study. Flu-IVIG contains higher concentrations of Fc-functional antibodies than IVIG against a diverse range of influenza hemagglutinins. Following infusion of Flu-IVIG into influenza-infected subjects, a transient increase in Fc-functional antibodies was present for 1-3 days against infecting and non-infecting strains of influenza. Flu-IVIG contains antibodies with Fc-mediated functions against influenza virus and passive transfer of Flu-IVIG increases anti-influenza Fc-functional antibodies in the plasma of influenza-infected subjects. Enhancement of Fc-functional antibodies to a diverse range of influenza strains suggests that Flu-IVIG infusion could prove useful in the context of novel influenza virus infections, when there may be minimal or no neutralising antibodies in the Flu-IVIG preparation.

Achoo! Cold, Flu, or Something Else? | NIH MedlinePlus the Magazine

MedlinePlus

... Flu, or Something Else? Follow us Achoo! Cold, Flu, or Something Else? Photo: iStock Winter and early ... over-the-counter medicines to ease symptoms. Seasonal Flu Symptoms usually last one to two weeks. Include ...

Influenza (the Flu)

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... However, ask your doctor if your child needs one or two flu shots and how far apart they should be given. ... for Flu Season Please, Please Get a Flu Shot Stay Mindful, Be Smart: How One Adult with CF Combats Germs in Daily Life ...

Transcripts of genes encoding reproductive neuroendocrine hormones and androgen receptor in the brain and testis of goldfish exposed to vinclozolin, flutamide, testosterone, and their combinations.

PubMed

Golshan, Mahdi; Habibi, Hamid R; Alavi, Sayyed Mohammad Hadi

2016-08-01

Vinclozolin (VZ) is a pesticide that acts as an anti-androgen to impair reproduction in mammals. However, VZ-induced disruption of reproduction is largely unknown in fish. In the present study, we have established a combination exposure in which adult goldfish were exposed to VZ (30 and 100 μg/L), anti-androgen flutamide (Flu, 300 μg/L), and androgen testosterone (T, 1 μg/L) to better understand effects of VZ on reproductive endocrine system. mRNA levels of kisspeptin (kiss-1 and kiss-2) and its receptor (gpr54), salmon gonadotropin-releasing hormone (gnrh3) and androgen receptor (ar) in the mid-brain, and luteinizing hormone receptor (lhr) in the testis were analyzed and compared with those of control following 10 days of exposure. kiss-1 mRNA level was increased in goldfish exposed to 100 µg/L VZ and to Flu, while kiss-2 mRNA level was increased following exposure to Flu and to combinations of 30 µg/L VZ with Flu, 100 µg/L VZ with T, and Flu with T. gpr54 mRNA level was increased in goldfish exposed to Flu and to combination of 30 µg/L VZ with Flu and 100 µg/L VZ with T. gnrh3 mRNA level was increased in goldfish exposed to 100 µg/L VZ, to Flu, and to combinations of 30 µg/L VZ with Flu, 100 µg/L VZ with T, and Flu with T. The mid-brain ar mRNA level was increased in goldfish exposed to Flu and to combinations of 30 µg/L VZ with Flu, 100 µg/L VZ with T, and Flu with T. Testicular lhr mRNA level was increased in goldfish exposed to Flu and to combination of 30 µg/L VZ with Flu. These results suggest that VZ and Flu are capable of interfering with kisspeptin and GnRH systems to alter pituitary and testicular horonal functions in adult goldfish and the brain ar mediates VZ-induced disruption of androgen production.

Multistate outbreak of listeriosis caused by imported cheese and evidence of cross-contamination of other cheeses, USA, 2012.

PubMed

Heiman, K E; Garalde, V B; Gronostaj, M; Jackson, K A; Beam, S; Joseph, L; Saupe, A; Ricotta, E; Waechter, H; Wellman, A; Adams-Cameron, M; Ray, G; Fields, A; Chen, Y; Datta, A; Burall, L; Sabol, A; Kucerova, Z; Trees, E; Metz, M; Leblanc, P; Lance, S; Griffin, P M; Tauxe, R V; Silk, B J

2016-10-01

Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0-825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March-October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.

Implementation of Flu (Influenza) Vaccination into Armenian Armed Forces Pre-Emptive Vaccination Plan

DTIC Science & Technology

2016-12-01

Vinci, M., Zordan, M., & Serra, G. (2006). Cost - benefit analysis of influenza vaccination in a public healthcare unit. Therapeutics and Clinical...readiness, flu morbidity, flu vaccination, pre-emptive vaccination plan, cost - benefit analysis 15. NUMBER OF PAGES 83 16. PRICE CODE 17...expenditures pose a heavy burden on the government. A cost - benefit analysis of the flu vaccination would assess whether conducting flu vaccination is

How to Boost Flu Vaccination Rates among Employees in Your Program

ERIC Educational Resources Information Center

de Perio, Marie A.; Wiegand, Douglas M.; Evans, Stefanie M.; Niemeier, Maureen T.

2012-01-01

Flu viruses are typically spread by droplets, when people who are sick with flu cough, sneeze, or talk. Less often, a person may get flu from touching a surface or object that has the virus on it and then touching his own mouth, eyes, or nose. Flu can cause mild to severe illness and may even lead to death. Child care providers are at risk of…

Navy and Marine Corps Medical News. Issue 12

DTIC Science & Technology

2009-12-11

swine flu , but other flu viruses remain a possible threat. Arroyo advises Marines to get the seasonal flu shot as well and to practice proper...IEDs, and the Flu in Afghanistan By Lance Cpl. Walter Marino, Regimental Combat Team 7 HELMAND PROVINCE, Afghanistan— Aside from the...potentially deadly enemy – the flu . Nearly 400 Marines and sailors with Regimental Combat Team 7 at Camp Dwyer, Afghanistan, and many other

Comparison of Cepheid Xpert Flu/RSV XC and BioFire FilmArray for Detection of Influenza A, Influenza B, and Respiratory Syncytial Virus.

PubMed

Wahrenbrock, Mark G; Matushek, Scott; Boonlayangoor, Sue; Tesic, Vera; Beavis, Kathleen G; Charnot-Katsikas, Angella

2016-07-01

The Xpert Flu/RSV XC was compared to the FilmArray respiratory panel for detection of influenza (Flu) A, Flu B, and respiratory syncytial virus (RSV), using 128 nasopharyngeal swabs. Positive agreements were 100% for Flu A and RSV and 92.3% for Flu B. The Xpert may be useful in clinical situations when extensive testing is not required and may serve an important role in laboratories already performing broader respiratory panel testing. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Application of foodborne disease outbreak data in the development and maintenance of HACCP systems.

PubMed

Panisello, P J; Rooney, R; Quantick, P C; Stanwell-Smith, R

2000-09-10

Five-hundred and thirty general foodborne outbreaks of food poisoning reported in England and Wales between 1992 and 1996 were reviewed to study their application to the development and maintenance of HACCP systems. Retrospective investigations of foodborne disease outbreaks provided information on aetiological agents, food vehicles and factors that contributed to the outbreaks. Salmonella spp. and foods of animal origin (red meat, poultry and seafood) were most frequently associated with outbreaks during this period. Improper cooking, inadequate storage, cross-contamination and use of raw ingredients in the preparation of food were the most common factors contributing to outbreaks. Classification and cross tabulation of surveillance information relating to aetiological agents, food vehicles and contributory factors facilitates hazard analysis. In forming control measures and their corresponding critical limits, this approach focuses monitoring on those aspects that are critical to the safety of the product. Incorporation of epidemiological data in the documentation of HACCP systems provides assurance that the system is based on the best scientific information available.

Fluid Intelligence Allows Flexible Recruitment of the Parieto-Frontal Network in Analogical Reasoning

PubMed Central

Preusse, Franziska; Elke, van der Meer; Deshpande, Gopikrishna; Krueger, Frank; Wartenburger, Isabell

2011-01-01

Fluid intelligence is the ability to think flexibly and to understand abstract relations. People with high fluid intelligence (hi-fluIQ) perform better in analogical reasoning tasks than people with average fluid intelligence (ave-fluIQ). Although previous neuroimaging studies reported involvement of parietal and frontal brain regions in geometric analogical reasoning (which is a prototypical task for fluid intelligence), however, neuroimaging findings on geometric analogical reasoning in hi-fluIQ are sparse. Furthermore, evidence on the relation between brain activation and intelligence while solving cognitive tasks is contradictory. The present study was designed to elucidate the cerebral correlates of geometric analogical reasoning in a sample of hi-fluIQ and ave-fluIQ high school students. We employed a geometric analogical reasoning task with graded levels of task difficulty and confirmed the involvement of the parieto-frontal network in solving this task. In addition to characterizing the brain regions involved in geometric analogical reasoning in hi-fluIQ and ave-fluIQ, we found that blood oxygenation level dependency (BOLD) signal changes were greater for hi-fluIQ than for ave-fluIQ in parietal brain regions. However, ave-fluIQ showed greater BOLD signal changes in the anterior cingulate cortex and medial frontal gyrus than hi-fluIQ. Thus, we showed that a similar network of brain regions is involved in geometric analogical reasoning in both groups. Interestingly, the relation between brain activation and intelligence is not mono-directional, but rather, it is specific for each brain region. The negative brain activation–intelligence relationship in frontal brain regions in hi-fluIQ goes along with a better behavioral performance and reflects a lower demand for executive monitoring compared to ave-fluIQ individuals. In conclusion, our data indicate that flexibly modulating the extent of regional cerebral activity is characteristic for fluid intelligence. PMID:21415916

Geolocalization of Influenza Outbreak Within an Acute Care Population: A Layered-Surveillance Approach.

PubMed

Kannan, Vijay Christopher; Hodgson, Nicole; Lau, Andrew; Goodin, Kate; Dugas, Andrea Freyer; LoVecchio, Frank

2016-11-01

We seek to use a novel layered-surveillance approach to localize influenza clusters within an acute care population. The first layer of this system is a syndromic surveillance screen to guide rapid polymerase chain reaction testing. The second layer is geolocalization and cluster analysis of these patients. We posit that any identified clusters could represent at-risk populations who could serve as high-yield targets for preventive medical interventions. This was a prospective observational surveillance study. Patients were screened with a previously derived clinical decision guideline that has a 90% sensitivity and 30% specificity for influenza. Patients received points for the following signs and symptoms within the past 7 days: cough (2 points), headache (1 point), subjective fever (1 point), and documented fever at triage (temperature >38°C [100.4°F]) (1 point). Patients scoring 3 points or higher were indicated for influenza testing. Patients were tested with Xpert Flu (Cepheid, Sunnyvale, CA), a rapid polymerase chain reaction test. Positive results were mapped with ArcGIS (ESRI, Redlands, CA) and analyzed with kernel density estimation to create heat maps. There were 1,360 patients tested with Xpert Flu with retrievable addresses within the greater Phoenix metro area. One hundred sixty-seven (12%) of them tested positive for influenza A and 23 (2%) tested positive for influenza B. The influenza A virus exhibited a clear cluster pattern within this patient population. The densest cluster was located in an approximately 1-square-mile region southeast of our hospital. Our layered-surveillance approach was effective in localizing a cluster of influenza A outbreak. This region may house a high-yield target population for public health intervention. Further collaborative efforts will be made between our hospital and the Maricopa County Department of Public Health to perform a series of community vaccination events before the next influenza season. We hope these efforts will ultimately serve to reduce the burden of this disease on our patient population, and that this system will serve as a framework for future investigations locating at-risk populations. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Prospective comparison of RT-PCR/ESI-MS to Prodesse ProFlu Plus and Cepheid GenXpert for the detection of Influenza A and B viruses.

PubMed

Hardick, Justin; Dugas, Andrea; Goheen, Joshua; Rothman, Richard; Gaydos, Charlotte

2015-03-01

RT-PCR/ESI-MS has previously demonstrated the capability to detect and identify respiratory viral pathogens in nasopharyngeal swabs. This study expands on previous research by performing a prospective evaluation of RT-PCR/ESI-MS to detect and identify Influenza A and B viruses compared to Prodesse ProFlu Plus and combined ProFlu Plus and Cepheid Xpert Flu. ProFlu Plus was also used as a gold standard for comparison for respiratory syncytial virus detection. Using ProFlu Plus as a gold standard, RT-PCR/ESI-MS had sensitivity and specificity of 82.1% (23/28) and 100% (258/258), respectively, for Influenza A, 100% (16/16) and 99.6% (269/270), respectively for Influenza B, and 88.6% (39/44) and 99.6% (241/242) for any Influenza virus. Using matching results from ProFlu Plus and Xpert Flu as a gold standard, RT-PCR/ESI-MS had 85.2% (23/27) and 100% (259/259) sensitivity and specificity respectively for Influenza A, 100% (14/14) and 99.6% (270/272), respectively for Influenza B virus. Overall, RT-PCR/ESI-MS was not as sensitive as the combined gold standard of ProFlu Plus and Xpert Flu, although it has the capability of detecting other respiratory viruses. Copyright © 2015 Elsevier B.V. All rights reserved.

Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

ERIC Educational Resources Information Center

Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

2005-01-01

Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

Flu

MedlinePlus

... are very bad and self-treatment is not working. Prevention You can take steps to avoid catching or spreading the flu. The best step is to get a flu vaccine. If you have the flu: Stay in your apartment, dorm room, or home for at least 24 hours after your fever has gone. Wear a mask ...

Germs and Hygiene - Multiple Languages

MedlinePlus

... አማርኛ ) Expand Section Cleaning to Prevent the Flu - English PDF Cleaning to Prevent the Flu - Amarɨñña / አማርኛ ( ... Disease Control and Prevention Fight the Flu Poster - English PDF Fight the Flu Poster - Amarɨñña / አማርኛ (Amharic) ...

Influenza Vaccine, Inactivated or Recombinant

MedlinePlus

... flu vaccine. This risk has been estimated at 1 or 2 additional cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine. Young children who get the flu shot along with pneumococcal vaccine (PCV13) and/or DTaP ...

Applying lessons from behavioral economics to increase flu vaccination rates.

PubMed

Chen, Frederick; Stevens, Ryan

2017-12-01

Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The 2009 Influenza Pandemic: An Overview

DTIC Science & Technology

2009-11-16

section is drawn from CDC, “FluView,” http://www.cdc.gov/flu/weekly/. 36 See, for example, the figure by Sanofi Pasteur (a flu vaccine manufacturer), “A...general. On September 16, FDA announced that it had approved H1N1 pandemic flu vaccines made by four companies: Sanofi Pasteur Inc., CSL Limited...Pasteur for purchase and maintenance of vaccine against H5N1 avian flu. b. Includes funds for contracts with Medimmune and Sanofi Pasteur. c. Includes

Listeria monocytogenes cross-contamination of cheese: risk throughout the food supply chain.

PubMed

Sauders, B D; D'Amico, D J

2016-10-01

Listeria monocytogenes has been the most common microbial cause of cheese-related recalls in both the United States and Canada in recent years. Since L. monocytogenes is inactivated by pasteurization, the majority of these cases have been linked to environmental and cross-contamination of fresh-soft, soft-ripened, and semi-soft cheeses. Cross-contamination of foods with L. monocytogenes is a continuous risk throughout the food supply chain and presents unique challenges for subsequent illness and outbreak investigations. Reports on outbreaks of listeriosis attributed to cross-contamination downstream from primary processing help highlight the critical role of epidemiological investigation coupled with coordinated molecular subtyping and surveillance in the recognition and investigation of complex foodborne outbreaks. Despite their complexity, environmental sampling throughout the supply chain coupled with improved genotyping approaches and concomitant analysis of foodborne illness epidemiological exposure data are needed to help resolve these and similar cases more rapidly and with greater confidence.

Influence of ionization states of antigen on anti-fluorescein antibodies

NASA Astrophysics Data System (ADS)

Fukunishi, Hiroaki

2012-10-01

Ratios of anion and di-anion states of fluorescein (FLU(-1) and FLU(-2)) are 21.2% and 78.8%, respectively, in the neutral pH. We investigated the influence of ionization states of antigen on anti-fluorescein antibodies. For this purpose, steered molecular dynamics (SMD) simulations were performed. Potential of mean forces (PMF) based on Jarzynski equality showed that wild-type (4-4-20) more strongly binds to FLU(-1) than FLU(-2), whereas its femtomolar-affinity mutant (4M5.3) more strongly binds to FLU(-2) than FLU(-1). It was speculated that the environment or the process of in vivo antibody production had been different from those of the protein engineering.

Is It a Cold or the Flu (For Parents)?

MedlinePlus

... English Español Is It a Cold or the Flu? KidsHealth / For Parents / Is It a Cold or the Flu? Print en español ¿Es un resfriado o una ... cough, and high fever — could it be the flu that's been going around? Or just a common ...

Antiviral activity of maca (Lepidium meyenii) against human influenza virus.

PubMed

Del Valle Mendoza, Juana; Pumarola, Tomàs; Gonzales, Libertad Alzamora; Del Valle, Luis J

2014-09-01

To investigate antiviral activity of maca to reduce viral load in Madin-Darby canine kidney (MDCK) cells infected with influenza type A and B viruses (Flu-A and Flu-B, respectively). Maca were extracted with methanol (1:2, v/v). The cell viability and toxicity of the extracts were evaluated on MDCK cells using method MTT assay. Antiviral activity of compounds against Flu-A and Flu-B viruses was assayed using a test for determining the inhibition of the cytopathic effect on cell culture and multiplex RT-PCR. The methanol extract of maca showed low cytotoxicity and inhibited influenza-induced cytopathic effect significantly, while viral load was reduced via inhibition of viral growth in MDCK infected cells. Maca contains potent inhibitors of Flu-A and Flu-B with a selectivity index [cytotoxic concentration 50%/IC50] of 157.4 and 110.5, respectively. In vitro assays demonstrated that maca has antiviral activity not only against Flu-A (like most antiviral agents) but also Flu-B viruses, providing remarkable therapeutic benefits. Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Healthy Bodies, Toxic Medicines: College Students and the Rhetorics of Flu Vaccination

PubMed Central

Lawrence, Heidi Y.

2014-01-01

This article examines flu vaccination beliefs and practices produced during a survey of undergraduate students in Spring 2012 (IRB#10-732). This research uses the methods of rhetorical analysis — or the study of persuasive features and arguments used in language — to examine statements respondents made regarding flu and flu vaccine. In these responses, students generated unique categories of arguments about the perceived dangers of flu vaccination, including the assertion that vaccines cause disease (including illnesses and conditions other than flu), that vaccines are toxic medicines, and that vaccines carry unknown, population-wide risks that are inadequately acknowledged. This study provides insight into vaccination beliefs and rationales among a population at risk of flu (college students) and suggests that further study of this population may yield important keys to addressing flu vaccine concerns as expressed by college students. Rhetorical analysis also offers a useful set of methods to understanding vaccination beliefs and practices, adding to existing methods of study and analysis of vaccination practices and beliefs in medicine and public health. PMID:25506277

Effects of Anti- Versus Pro-Vaccine Narratives on Responses by Recipients Varying in Numeracy: A Cross-sectional Survey-Based Experiment.

PubMed

Bruine de Bruin, Wändi; Wallin, Annika; Parker, Andrew M; Strough, JoNell; Hanmer, Janel

2017-11-01

To inform their health decisions, patients may seek narratives describing other patients' evaluations of their treatment experiences. Narratives can provide anti-treatment or pro-treatment evaluative meaning that low-numerate patients may especially struggle to derive from statistical information. Here, we examined whether anti-vaccine (v. pro-vaccine) narratives had relatively stronger effects on the perceived informativeness and judged vaccination probabilities reported among recipients with lower (v. higher) numeracy. Participants ( n = 1,113) from a nationally representative US internet panel were randomly assigned to an anti-vaccine or pro-vaccine narrative, as presented by a patient discussing a personal experience, a physician discussing a patient's experience, or a physician discussing the experiences of 50 patients. Anti-vaccine narratives described flu experiences of patients who got the flu after getting vaccinated; pro-vaccine narratives described flu experiences of patients who got the flu after not getting vaccinated. Participants indicated their probability of getting vaccinated and rated the informativeness of the narratives. Participants with lower numeracy generally perceived narratives as more informative. By comparison, participants with higher numeracy rated especially anti-vaccine narratives as less informative. Anti-vaccine narratives reduced the judged vaccination probabilities as compared with pro-vaccine narratives, especially among participants with lower numeracy. Mediation analyses suggested that low-numerate individuals' vaccination probabilities were reduced by anti-vaccine narratives-and, to a lesser extent, boosted by pro-vaccine narratives-because they perceived narratives to be more informative. These findings were similar for narratives provided by patients and physicians. Patients with lower numeracy may rely more on narrative information when making their decisions. These findings have implications for the development of health communications and decision aids.

Clinical Characteristics of Influenza-Associated Pneumonia of Adults: Clinical Features and Factors Contributing to Severity and Mortality.

PubMed

Ishiguro, Takashi; Kagiyama, Naho; Uozumi, Ryuji; Odashima, Kyuto; Takaku, Yotaro; Kurashima, Kazuyoshi; Morita, Satoshi; Takayanagi, Noboru

2017-06-01

Background : Pneumonia is a major complication of influenza that contributes to mortality. Clinical characteristics and factors of influenza virus contributing to the severity and mortality of pneumonia have not been fully elucidated. Objective : The objective was to clarify clinical characteristics and factors contributing to the severity and mortality of influenza-associated pneumonia ( flu-p ). Methods : We retrospectively analyzed patients with flu-p . Results : From December 1999 to March 2016, 210 patients with a median age of 69 (range, 17 to 92) years with flu-p based on positive rapid antigen tests, increased antibody titers of paired sera, or positive results of reverse transcription polymerase chain reaction were admitted to our institution. A multivariate analysis found that advanced age (≥ 65 years), pneumonia subtypes (unclassified), diabetes mellitus, and acute kidney injury complicated with flu-p were independent factors associated with disease severity, whereas pneumonia subtypes (mixed viral and bacterial pneumonia and unclassified), healthcare-associated pneumonia, acute kidney injury complicated with flu-p , and severity on admission (severe) were independent factors associated with non-survival. Conclusion : The clinical characteristics of flu-p are varied, and the contribution of several factors to the severity and mortality of flu-p suggest their importance in either preventing flu-p or managing flu-p after it develops.

Clinical Characteristics of Influenza-Associated Pneumonia of Adults: Clinical Features and Factors Contributing to Severity and Mortality

PubMed Central

Ishiguro, Takashi; Kagiyama, Naho; Uozumi, Ryuji; Odashima, Kyuto; Takaku, Yotaro; Kurashima, Kazuyoshi; Morita, Satoshi; Takayanagi, Noboru

2017-01-01

Background: Pneumonia is a major complication of influenza that contributes to mortality. Clinical characteristics and factors of influenza virus contributing to the severity and mortality of pneumonia have not been fully elucidated. Objective: The objective was to clarify clinical characteristics and factors contributing to the severity and mortality of influenza-associated pneumonia (flu-p). Methods: We retrospectively analyzed patients with flu-p. Results: From December 1999 to March 2016, 210 patients with a median age of 69 (range, 17 to 92) years with flu-p based on positive rapid antigen tests, increased antibody titers of paired sera, or positive results of reverse transcription polymerase chain reaction were admitted to our institution. A multivariate analysis found that advanced age (≥ 65 years), pneumonia subtypes (unclassified), diabetes mellitus, and acute kidney injury complicated with flu-p were independent factors associated with disease severity, whereas pneumonia subtypes (mixed viral and bacterial pneumonia and unclassified), healthcare-associated pneumonia, acute kidney injury complicated with flu-p, and severity on admission (severe) were independent factors associated with non-survival. Conclusion: The clinical characteristics of flu-p are varied, and the contribution of several factors to the severity and mortality of flu-p suggest their importance in either preventing flu-p or managing flu-p after it develops. PMID:28656006

Knowledge and Perceptions of Influenza Vaccinations Among College Students in Vietnam and the United States.

PubMed

Kamimura, Akiko; Trinh, Ha N; Weaver, Shannon; Chernenko, Alla; Nourian, Maziar M; Assasnik, Nushean; Nguyen, Hanh

2017-07-01

Influenza is a significant worldwide public health issue. Knowledge and perceptions regarding the flu vaccination are associated with whether individuals obtain the vaccination. The purpose of this study was to examine how such perceptions were related to knowledge and self-efficacy regarding influenza and the flu vaccination in Vietnam and the US. College students (n=932) in Vietnam (n=495) and the US (n=437) completed a self-administered survey regarding knowledge and perceptions of influenza vaccinations in September and October 2016. Vietnamese participants reported significantly lower levels of awareness about flu risk, higher levels of negative attitudes toward flu vaccination, lower levels of knowledge about the flu and vaccination, and lower levels of self-efficacy than US participants. Higher levels of flu and flu vaccination knowledge and self-efficacy regarding general responsible health practices were associated with lower levels of negative perceptions of flu risk and attitudes toward vaccination. At the same time, self-efficacy regarding responsible health practices was associated with higher levels of awareness of flu risk and lower levels of negative attitudes toward vaccination. Self-efficacy regarding exercise was associated with lower levels of perceptions of flu risk and higher levels of negative attitudes toward vaccination. Vietnam could benefit from influenza education based on this comparison with the US. In both countries, knowledge and self-efficacy were found to be important factors influencing perceptions of influenza risk and vaccination.

Accurate estimation of influenza epidemics using Google search data via ARGO.

PubMed

Yang, Shihao; Santillana, Mauricio; Kou, S C

2015-11-24

Accurate real-time tracking of influenza outbreaks helps public health officials make timely and meaningful decisions that could save lives. We propose an influenza tracking model, ARGO (AutoRegression with GOogle search data), that uses publicly available online search data. In addition to having a rigorous statistical foundation, ARGO outperforms all previously available Google-search-based tracking models, including the latest version of Google Flu Trends, even though it uses only low-quality search data as input from publicly available Google Trends and Google Correlate websites. ARGO not only incorporates the seasonality in influenza epidemics but also captures changes in people's online search behavior over time. ARGO is also flexible, self-correcting, robust, and scalable, making it a potentially powerful tool that can be used for real-time tracking of other social events at multiple temporal and spatial resolutions.

Grid-based International Network for Flu observation (g-INFO).

PubMed

Doan, Trung-Tung; Bernard, Aurélien; Da-Costa, Ana Lucia; Bloch, Vincent; Le, Thanh-Hoa; Legre, Yannick; Maigne, Lydia; Salzemann, Jean; Sarramia, David; Nguyen, Hong-Quang; Breton, Vincent

2010-01-01

The 2009 H1N1 outbreak has demonstrated that continuing vigilance, planning, and strong public health research capability are essential defenses against emerging health threats. Molecular epidemiology of influenza virus strains provides scientists with clues about the temporal and geographic evolution of the virus. In the present paper, researchers from France and Vietnam are proposing a global surveillance network based on grid technology: the goal is to federate influenza data servers and deploy automatically molecular epidemiology studies. A first prototype based on AMGA and the WISDOM Production Environment extracts daily from NCBI influenza H1N1 sequence data which are processed through a phylogenetic analysis pipeline deployed on EGEE and AuverGrid e-infrastructures. The analysis results are displayed on a web portal (http://g-info.healthgrid.org) for epidemiologists to monitor H1N1 pandemics.

Preliminary Success in the Characterization and Management of a Sudden Breakout of a Novel H7N9 Influenza A Virus

PubMed Central

Wu, Yan-Ling; Shen, Li-Wen; Ding, Yan-Ping; Tanaka, Yoshimasa; Zhang, Wen

2014-01-01

Influenza has always been one of the major threats to human health. The Spanish influenza in 1918, the pandemic influenza A/H1N1 in 2009, and the avian influenza A/H5N1 have brought about great disasters or losses to mankind. More recently, a novel avian influenza A/H7N9 broke out in China and until December 2, 2013, it had caused 139 cases of infection, including 45 deaths. Its risk and pandemic potential attract worldwide attention. In this article, we summarize epidemiology, virology characteristics, clinical symptoms, diagnosis methods, clinical treatment and preventive measures about the avian influenza A/H7N9 virus infection to provide a reference for a possible next wave of flu outbreak. PMID:24520209

[Reemergence of measles in vaccinated patients: report of 6 cases and proposals for prevention].

PubMed

Agut-Busquet, Eugènia; Gené Tous, Emili; Navarro, Gemma; González, Araceli

2016-06-01

A 2014 measles outbreak in Catalonia affected 131 persons. We describe a series of 6 cases diagnosed in our emergency department. All the patients were under 31 years of age and complained of flu-like symptoms, including high fever and rash. Five had been properly vaccinated and one was a health care worker. A firm diagnosis of measles need not be made in the emergency department, but a high level of suspicion is important for ruling out complications, isolating the patient, and protecting health care staff at high risk for exposure. We found that 6% of the staff of our emergency department had a low level of immunity to measles. Given our findings, we suggest that preventive treatment is necessary when health care staff have been exposed to measles and their vaccination status is unknown.

Social Web mining and exploitation for serious applications: Technosocial Predictive Analytics and related technologies for public health, environmental and national security surveillance.

PubMed

Kamel Boulos, Maged N; Sanfilippo, Antonio P; Corley, Courtney D; Wheeler, Steve

2010-10-01

This paper explores Technosocial Predictive Analytics (TPA) and related methods for Web "data mining" where users' posts and queries are garnered from Social Web ("Web 2.0") tools such as blogs, micro-blogging and social networking sites to form coherent representations of real-time health events. The paper includes a brief introduction to commonly used Social Web tools such as mashups and aggregators, and maps their exponential growth as an open architecture of participation for the masses and an emerging way to gain insight about people's collective health status of whole populations. Several health related tool examples are described and demonstrated as practical means through which health professionals might create clear location specific pictures of epidemiological data such as flu outbreaks. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use.

PubMed

McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E

2012-02-01

Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.

Do People Taking Flu Vaccines Need Them the Most?

PubMed Central

Gu, Qian; Sood, Neeraj

2011-01-01

Background A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = −0.067, p<0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = −0.361, p<0.01). Conclusions There is a poor match between those who get flu vaccines and those who have a high risk of flu infection within both the high priority and general populations. Targeting vaccination to people with low socioeconomic status, people who are engaged in unhealthy behaviors, working people, and families with kids will likely improve effectiveness of flu vaccine policy. PMID:22164202

Comparative Study of the Effects of Fluconazole and Voriconazole on Candida glabrata, Candida parapsilosis and Candida rugosa Biofilms.

PubMed

Madhavan, Priya; Jamal, Farida; Pei, Chong Pei; Othman, Fauziah; Karunanidhi, Arunkumar; Ng, Kee Peng

2018-06-01

Infections by non-albicans Candida species are a life-threatening condition, and formation of biofilms can lead to treatment failure in a clinical setting. This study was aimed to demonstrate the in vitro antibiofilm activity of fluconazole (FLU) and voriconazole (VOR) against C. glabrata, C. parapsilosis and C. rugosa with diverse antifungal susceptibilities to FLU and VOR. The antibiofilm activities of FLU and VOR in the form of suspension as well as pre-coatings were assessed by XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] reduction assay. Morphological and intracellular changes exerted by the antifungal drugs on Candida cells were examined by scanning electron microscope (SEM) and transmission electron microscope (TEM). The results of the antibiofilm activities showed that FLU drug suspension was capable of killing C. parapsilosis and C. rugosa at minimum inhibitory concentrations (MICs) of 4× MIC FLU and 256× MIC FLU, respectively. While VOR MICs ranging from 2× to 32× were capable of killing the biofilms of all Candida spp tested. The antibiofilm activities of pre-coated FLU were able to kill the biofilms at ¼× MIC FLU and ½× MIC FLU for C. parapsilosis and C. rugosa strains, respectively. While pre-coated VOR was able to kill the biofilms, all three Candida sp at ½× MIC VOR. SEM and TEM examinations showed that FLU and VOR treatments exerted significant impact on Candida cell with various degrees of morphological changes. In conclusion, a fourfold reduction in MIC 50 of FLU and VOR towards ATCC strains of C. glabrata, C. rugosa and C. rugosa clinical strain was observed in this study.

Incidence of online health information search: a useful proxy for public health risk perception.

PubMed

Liang, Bo; Scammon, Debra L

2013-06-17

Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers' search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public's attitudes and behaviors. This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population's environment. Using an ecological perspective, we suggest that a population's general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Overall, the results provide evidence that the main effects of independent variables-the incidence of the flu (P<.001); social factors, including media attention (P<.001); private resources, including life quality (P<.001) and health lifestyles (P=.009); and public resources, such as hospital care utilization (P=.008) and public health funds (P=.02)-have significant effects on Web searches for queries related to the flu. After controlling for the number of reported disease cases and Internet access rate by state, we estimate the contribution of social factors to the public health risk perception levels by state (R(2)=23.37%). The interaction effects between flu incidence and social factors for our search terms did not add to the explanatory power of our regression models (R(2)<1%). Our study suggests a practical way to measure the public's health risk perception for certain diseases using online information search volume by state. The social environment influences public risk perception regardless of disease incidence. Thus, monitoring the social variables can be very helpful in being ready to respond to the public's behavior in dealing with public health threats.

Major incidents in rural areas: managing a pandemic A/H1N1/2009 cluster.

PubMed

Stark, Cameron; Garman, Elaine; McMenamin, Jim; McCormick, Duncan; Oates, Ken

2010-01-01

Pandemic Influenza (A/H1N1/2009) caused worldwide concern because of its potential to spread rapidly in human populations. In Scotland, Government policy had been to seek to contain the spread of the virus for as long as possible in order to allow time for service preparations, and for vaccine development and supply. The first major Scottish outbreak of pandemic A/H1N1/2009 was in the rural area of Cowal and Bute. After two initial cases were identified, contact tracing found a cluster of cases associated with a football supporters' bus. Within 3 weeks, 130 cases had been identified in the area. Rapid provision of treatment doses of anti-viral medication to cases and prophylactic treatment of asymptomatic close contacts, advice on self-isolation and, where required, interruption of transmission by temporary school closure, were successful in containing the outbreak. Pre-existing Major Incident and Pandemic Flu plans were used and adapted to the particular circumstances of the outbreak and the area. Supporting operational decision-making as close to the cases as possible allowed for speed and flexibility of response. Contact tracing and tracking of cases and results was performed by specialist public health staff who were geographically removed from the cases. This was possible because of effective use of existing telephone conferencing facilities, clarity of roles, and frequent communication among staff working on all areas of the response. Basing the work on established plans, staff experience of rural areas and rural service provision was successful.

Association of over-the-counter pharmaceutical sales with influenza-like-illnesses to patient volume in an urgent care setting.

PubMed

Liu, Timothy Y; Sanders, Jason L; Tsui, Fu-Chiang; Espino, Jeremy U; Dato, Virginia M; Suyama, Joe

2013-01-01

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round.

Presence of polycyclic aromatic hydrocarbons (PAHs) in apple in rural terrains from Mexico City.

PubMed

Salinas, Rutilio Ortiz; González, Gilberto Díaz; Bermudez, Beatriz Schettino; Tolentino, Rey Gutiérrez; Vega Y León, Salvador

2010-08-01

This paper describes PAH concentrations in apple crops that are growing in rural terrains in Mexico City. The concentrations of individual PAHs showed great variability, there being low and high molecular weight compounds in dry (high molecular weight for Tlahuac 7.06 microg/g and Milpa Alta 3.96 microg/g) and wet months (high molecular weight for Tlahuac 11.25 microg/g and Milpa Alta 12.05 microg/g). Some PAHs indicators and cross plot ratios Ant/(Ant + Phe) and Flu/(Flu + Pyr) define fossil fuels and vegetation combustion as the source of contamination over the cuticle of the apples. It is likely that deposition (dry and wet) is the principal source o f contamination over the apple surface. This study reveals the presence of PAHs in apples due to the high air contamination of Mexico City.

Prisons' preparedness for pandemic flu and the ethical issues.

PubMed

van't Hoff, G; Fedosejeva, R; Mihailescu, L

2009-06-01

In Europe at any given time there are about 1,8 million people imprisoned in penal institutions. About 1 million personnel are working in prisons. With prisons, from the start there are fundamental problems in many parts of Europe. Poor housing conditions in prisons and a high proportion of prisoners who already suffer from severe health problems mean the chance of an outbreak in prison during a pandemic must be quite high. We expect it can be up to 90%. In this article we explain what the characteristics are of the prison population from a health point of view. A high rate of detainees suffers from mental health disorders and/or addiction. A high prevalence of communicable and infectious diseases is the rule, not an exception. According to the European Prison Rules and many other international rules, statements and documents prison health care should be an integral part of the public health system of any country. However, it has to be accepted that the prison population is the least popular in society and in politics. In reality in many countries in Europe the situation in prison cannot meet the level strived for by the European Prison Rules. We compare preparedness on pandemic flu in The Netherlands, Latvia and Romania. We explore the problems and ethical issues that may arise if a pandemic breaks out. There are three ethical dilemmas that require consideration: equivalence of care and prisoners' right to health care; prisoners' interests verses society's interests; countries in need and calls for bilateral help.

Outbreak of pandemic influenza A/H1N1 2009 in Nepal.

PubMed

Adhikari, Bal Ram; Shakya, Geeta; Upadhyay, Bishnu Prasad; Prakash Kc, Khagendra; Shrestha, Sirjana Devi; Dhungana, Guna Raj

2011-03-23

The 2009 flu pandemic is a global outbreak of a new strain of H1N1 influenza virus. Pandemic influenza A (H1N1) 2009 has posed a serious public health challenge world-wide. Nepal has started Laboratory diagnosis of Pandemic influenza A/H1N1 from mid June 2009 though active screening of febrile travellers with respiratory symptoms was started from April 27, 2009. Out of 609 collected samples, 302 (49.6%) were Universal Influenza A positive. Among the influenza A positive samples, 172(28.3%) were positive for Pandemic influenza A/H1N1 and 130 (21.3%) were Seasonal influenza A. Most of the pandemic cases (53%) were found among young people with ≤ 20 years. Case Fatality Ratio for Pandemic influenza A/H1N1 in Nepal was 1.74%. Upon Molecular characterization, all the isolated pandemic influenza A/H1N1 2009 virus found in Nepal were antigenically and genetically related to the novel influenza A/CALIFORNIA/07/2009-LIKE (H1N1)v type. The Pandemic 2009 influenza virus found in Nepal were antigenically and genetically related to the novel A/CALIFORNIA/07/2009-LIKE (H1N1)v type.

[Epidemics and pandemics in general practice. What can we learn from the swine flu (H1N1) and EHEC outbreak?].

PubMed

Eisele, M; Hansen, H; Wagner, H-O; von Leitner, E; Pohontsch, N; Scherer, M

2014-06-01

As primary care givers with a coordinating function, general practitioners (GP) play a key role in dealing with epidemics and pandemics. As of yet, there are no studies in Germany describing the difficulties experienced by GPs in patient care during epidemics/pandemics. This study aimed at identifying the problem areas in GPs' patient care during the H1N1 and EHEC (enterohemorrhagic strain of Escherichia coli) outbreaks. With this information, recommendations for guaranteeing proper patient care during future epidemics/pandemics can be derived. In all, 12 qualitative, semi-structured, open guideline interviews with GPs in Hamburg and Lübeck were conducted, transcribed, and evaluated with qualitative content analysis. Five areas in ambulatory patient care were identified in which changes are needed from the primary care perspective: provision of information for GPs, workload, financing of epidemic-related measures, organization of the practices, care of those taken ill. The workload of GPs in particular can and should be reduced through successful, centralized information distribution during epidemics/pandemics. The GP's function as a coordinator should be supported and consolidated, in order to relieve the in-patient sector in cases of an epidemic/pandemic. Secured financing of epidemic-associated measures can help ensure patient care.

The Complex Relationship of Realspace Events and Messages in Cyberspace: Case Study of Influenza and Pertussis Using Tweets

PubMed Central

Nagel, Anna C; Spitzberg, Brian H; An, Li; Gawron, J Mark; Gupta, Dipak K; Yang, Jiue-An; Han, Su; Peddecord, K Michael; Lindsay, Suzanne; Sawyer, Mark H

2013-01-01

Background Surveillance plays a vital role in disease detection, but traditional methods of collecting patient data, reporting to health officials, and compiling reports are costly and time consuming. In recent years, syndromic surveillance tools have expanded and researchers are able to exploit the vast amount of data available in real time on the Internet at minimal cost. Many data sources for infoveillance exist, but this study focuses on status updates (tweets) from the Twitter microblogging website. Objective The aim of this study was to explore the interaction between cyberspace message activity, measured by keyword-specific tweets, and real world occurrences of influenza and pertussis. Tweets were aggregated by week and compared to weekly influenza-like illness (ILI) and weekly pertussis incidence. The potential effect of tweet type was analyzed by categorizing tweets into 4 categories: nonretweets, retweets, tweets with a URL Web address, and tweets without a URL Web address. Methods Tweets were collected within a 17-mile radius of 11 US cities chosen on the basis of population size and the availability of disease data. Influenza analysis involved all 11 cities. Pertussis analysis was based on the 2 cities nearest to the Washington State pertussis outbreak (Seattle, WA and Portland, OR). Tweet collection resulted in 161,821 flu, 6174 influenza, 160 pertussis, and 1167 whooping cough tweets. The correlation coefficients between tweets or subgroups of tweets and disease occurrence were calculated and trends were presented graphically. Results Correlations between weekly aggregated tweets and disease occurrence varied greatly, but were relatively strong in some areas. In general, correlation coefficients were stronger in the flu analysis compared to the pertussis analysis. Within each analysis, flu tweets were more strongly correlated with ILI rates than influenza tweets, and whooping cough tweets correlated more strongly with pertussis incidence than pertussis tweets. Nonretweets correlated more with disease occurrence than retweets, and tweets without a URL Web address correlated better with actual incidence than those with a URL Web address primarily for the flu tweets. Conclusions This study demonstrates that not only does keyword choice play an important role in how well tweets correlate with disease occurrence, but that the subgroup of tweets used for analysis is also important. This exploratory work shows potential in the use of tweets for infoveillance, but continued efforts are needed to further refine research methods in this field. PMID:24158773

A Study of 279 General Outbreaks of Gastrointestinal Infection in the North-East Region of England

PubMed Central

Tebbutt, Grahame M.; Wilson, Deborah; Holtby, Ian

2009-01-01

All outbreaks of infectious intestinal disease reported to the authorities were entered on a computer database with outbreak control teams being established to investigate larger or more significant incidents. The outbreak database and, when set up, the notes of outbreak team meetings were examined for the 279 outbreaks reported in a three-year period (2003–2005). Faeces specimens submitted as part of an outbreak were examined for microbial pathogens and the results cross-matched to the outbreak number. Almost half of the general outbreaks reported (137) occurred in long-term care facilities for the elderly, 51 outbreaks were recorded in hospitals and 31 occurred in the wider community. In 76 outbreaks no specimen was logged. A microbial cause was confirmed in about one-third of outbreaks, with noroviruses being the most common (19%). Salmonellas accounted for 12 of the 21 community outbreaks linked to social events and all were foodborne. Suggestions for improving notification and surveillance are discussed. PMID:19440398

Pregnant Women and Influenza (Flu)

MedlinePlus

... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Pregnant Women & Influenza (Flu) Language: English (US) Español Recommend on Facebook ...

Flublok Seasonal Influenza (Flu) Vaccination

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... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Flublok Seasonal Influenza (Flu) Vaccine Questions & Answers Language: English (US) Español ...

Flu Surveillance: Department of Health

Science.gov Websites

Worker Flu Vaccination Rates Programs Acute Infectious Disease Epidemiology, Center for Immunization Surviellance Healthcare Worker Flu Vaccination Rates Programs Acute Infectious Disease Epidemiology, Center for

The H1N1 pandemic: media frames, stigmatization and coping.

PubMed

McCauley, Michael; Minsky, Sara; Viswanath, Kasisomayajula

2013-12-03

Throughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak's alleged origin in Mexican pig farms. In this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors. Twelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups. Participants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions.

Seasonal Influenza Questions & Answers

MedlinePlus

... not a stomach or intestinal disease. Do other respiratory viruses circulate during the flu season? In addition to flu viruses, several other respiratory viruses also circulate during the flu season and ...

Fermilab Today

Science.gov Websites

greatest risk. The number of Fermilab flu shot clinics was subsequently reduced from three to one and contact x3092. For DOE Labs Flu Vaccines Go a Long Way Flu Shot A flu shot You may be wondering what though our vaccine will wind up protecting at risk employees from three DOE labs instead of just one. You

Children, the Flu and the Flu Vaccine. Fact Sheet

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2008

2008-01-01

Flu is more dangerous than the common cold for children. Each year, flu places a large burden on the health and well-being of children and families. Children commonly need medical care because of influenza, especially before they turn 5 years old. Each year an average of 20,000 children under the age of 5 are hospitalized because of influenza…

What You Should Know and Do This Flu Season If You Are 65 Years and Older

MedlinePlus

... Pandemic Other What You Should Know and Do this Flu Season If You Are 65 Years and Older Language: English (US) Español Recommend on ... for people 65 and older. Actions To Take This Flu Season: Get Your ... get a seasonal flu vaccine each year by the end of October if possible. However, ...

Flu vaccines and patient decision making: what we need to know.

PubMed

Mayo, Ann M; Cobler, Steffanie

2004-09-01

To describe and compare patient-perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who received flu vaccines and those who did not. Data collection included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight patients participated in the study. Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Top barriers included fear of side effects from the vaccine (35%) and fear of contracting the flu (30%). Motivators, barriers, and patient decisional conflict differed depending upon the patient's vaccination status. Given the potential negative consequences of contracting the flu, prevention is the best strategy. Prevention is contingent upon motivating patients to obtain an annual flu vaccine. Recommending flu vaccinations, offering vaccinations in convenient locations free of charge, and discussing perceived barriers with patients may increase vaccinations among high-risk patients. Helping to clarify the advantages and disadvantages from the patient's perspective may decrease decisional conflict and increase vaccination rates.

FluBreaks: early epidemic detection from Google flu trends.

PubMed

Pervaiz, Fahad; Pervaiz, Mansoor; Abdur Rehman, Nabeel; Saif, Umar

2012-10-04

The Google Flu Trends service was launched in 2008 to track changes in the volume of online search queries related to flu-like symptoms. Over the last few years, the trend data produced by this service has shown a consistent relationship with the actual number of flu reports collected by the US Centers for Disease Control and Prevention (CDC), often identifying increases in flu cases weeks in advance of CDC records. However, contrary to popular belief, Google Flu Trends is not an early epidemic detection system. Instead, it is designed as a baseline indicator of the trend, or changes, in the number of disease cases. To evaluate whether these trends can be used as a basis for an early warning system for epidemics. We present the first detailed algorithmic analysis of how Google Flu Trends can be used as a basis for building a fully automated system for early warning of epidemics in advance of methods used by the CDC. Based on our work, we present a novel early epidemic detection system, called FluBreaks (dritte.org/flubreaks), based on Google Flu Trends data. We compared the accuracy and practicality of three types of algorithms: normal distribution algorithms, Poisson distribution algorithms, and negative binomial distribution algorithms. We explored the relative merits of these methods, and related our findings to changes in Internet penetration and population size for the regions in Google Flu Trends providing data. Across our performance metrics of percentage true-positives (RTP), percentage false-positives (RFP), percentage overlap (OT), and percentage early alarms (EA), Poisson- and negative binomial-based algorithms performed better in all except RFP. Poisson-based algorithms had average values of 99%, 28%, 71%, and 76% for RTP, RFP, OT, and EA, respectively, whereas negative binomial-based algorithms had average values of 97.8%, 17.8%, 60%, and 55% for RTP, RFP, OT, and EA, respectively. Moreover, the EA was also affected by the region's population size. Regions with larger populations (regions 4 and 6) had higher values of EA than region 10 (which had the smallest population) for negative binomial- and Poisson-based algorithms. The difference was 12.5% and 13.5% on average in negative binomial- and Poisson-based algorithms, respectively. We present the first detailed comparative analysis of popular early epidemic detection algorithms on Google Flu Trends data. We note that realizing this opportunity requires moving beyond the cumulative sum and historical limits method-based normal distribution approaches, traditionally employed by the CDC, to negative binomial- and Poisson-based algorithms to deal with potentially noisy search query data from regions with varying population and Internet penetrations. Based on our work, we have developed FluBreaks, an early warning system for flu epidemics using Google Flu Trends.

An outbreak of Salmonella Typhimurium infections in Denmark, Norway and Sweden, 2008.

PubMed

Bruun, T; Sørensen, G; Forshell, L P; Jensen, T; Nygard, K; Kapperud, G; Lindstedt, B A; Berglund, T; Wingstrand, A; Petersen, R F; Müller, L; Kjelsø, C; Ivarsson, S; Hjertqvist, M; Löfdahl, S; Ethelberg, S

2009-03-12

In November-December 2008, Norway and Denmark independently identified outbreaks of Salmonella Typhimurium infections characterised in the multiple-locus variable number of tandem repeats analysis (MLVA) by a distinct profile. Outbreak investigations were initiated independently in the two countries. In Denmark, a total of 37 cases were identified, and multiple findings of the outbreak strain in pork and pigs within the same supply chain led to the identification of pork in various forms as the source. In Norway, ten cases were identified, and the outbreak investigation quickly indicated meat bought in Sweden as the probable source and the Swedish authorities were alerted. Investigations in Sweden identified four human cases and two isolates from minced meat with the distinct profile. Subsequent trace-back of the meat showed that it most likely originated from Denmark. Through international alert from Norway on 19 December, it became clear that the Danish and Norwegian outbreak strains were identical and, later on, that the source of the outbreaks in all three countries could be traced back to Danish pork. MLVA was instrumental in linking the outbreaks in the different countries and tracing the source. This outbreak illustrates that good international communication channels, early alerting mechanisms, inter-sectoral collaboration between public health and food safety authorities and harmonised molecular typing tools are important for effective identification and management of cross-border outbreaks. Differences in legal requirements for food safety in neighbouring countries may be a challenge in terms of communication with consumers in areas where cross-border shopping is common.

Flu Prevention and Treatment Tips

MedlinePlus

Flu Prevention and Treatment Tips Expert Information from Healthcare Professionals Who Specialize in the Care of Older Adults Influenza, or the “flu,” is a contagious respiratory illness. It can cause ...

Modeling emergency department visit patterns for infectious disease complaints: results and application to disease surveillance

PubMed Central

Brillman, Judith C; Burr, Tom; Forslund, David; Joyce, Edward; Picard, Rick; Umland, Edith

2005-01-01

Background Concern over bio-terrorism has led to recognition that traditional public health surveillance for specific conditions is unlikely to provide timely indication of some disease outbreaks, either naturally occurring or induced by a bioweapon. In non-traditional surveillance, the use of health care resources are monitored in "near real" time for the first signs of an outbreak, such as increases in emergency department (ED) visits for respiratory, gastrointestinal or neurological chief complaints (CC). Methods We collected ED CCs from 2/1/94 – 5/31/02 as a training set. A first-order model was developed for each of seven CC categories by accounting for long-term, day-of-week, and seasonal effects. We assessed predictive performance on subsequent data from 6/1/02 – 5/31/03, compared CC counts to predictions and confidence limits, and identified anomalies (simulated and real). Results Each CC category exhibited significant day-of-week differences. For most categories, counts peaked on Monday. There were seasonal cycles in both respiratory and undifferentiated infection complaints and the season-to-season variability in peak date was summarized using a hierarchical model. For example, the average peak date for respiratory complaints was January 22, with a season-to-season standard deviation of 12 days. This season-to-season variation makes it challenging to predict respiratory CCs so we focused our effort and discussion on prediction performance for this difficult category. Total ED visits increased over the study period by 4%, but respiratory complaints decreased by roughly 20%, illustrating that long-term averages in the data set need not reflect future behavior in data subsets. Conclusion We found that ED CCs provided timely indicators for outbreaks. Our approach led to successful identification of a respiratory outbreak one-to-two weeks in advance of reports from the state-wide sentinel flu surveillance and of a reported increase in positive laboratory test results. PMID:15743535

Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

PubMed

Lochner, Kimberly A; Wynne, Marc

2011-12-21

Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring no co-pay on the part of the beneficiary (Centers for Medicare and Medicaid Services, 2011), for the 2008 flu season, only 73% of non-institutionalized Medicare beneficiaries, aged 65 years and older, reported receiving one. This report presents the most recent data on flu vaccination rates among non-institutionalized elderly Medicare beneficiaries and their association with socio-demographic and personal health characteristics. The report also describes the places beneficiaries received their flu shot and, for those not getting vaccinated, the reasons reported for not doing so. Public Domain.

Defense.gov - Special Report - H1N1 Flu: Facing the H1N1 Flu

Science.gov Websites

Learned WASHINGTON, Nov. 6, 2009 - Senior medical officials who successfully slowed the spread of H1N1 flu Crucial To Fleet Readiness NORFOLK (NNS) -- Commands and medical clinics throughout U.S. Fleet Forces , Ghana. Story» Naval Medical Center Portsmouth Works to Immunize Against Flu PORTSMOUTH, Va., Dec. 15

The performance of Luminex ARIES® Flu A/B & RSV and Cepheid Xpert® Flu/RSV XC for the detection of influenza A, influenza B, and respiratory syncytial virus in prospective patient samples.

PubMed

McMullen, Phillip; Boonlayangoor, Sue; Charnot-Katsikas, Angella; Beavis, Kathleen G; Tesic, Vera

2017-10-01

The demand for rapid, accurate viral testing has increased the number of assays available for the detection of viral pathogens. One of the newest FDA cleared platforms is the Luminex ARIES ® Flu A/B & RSV, which is a fully automated, real-time PCR-based assay used for detection of influenza A, influenza B, and respiratory syncytial virus (RSV). We sought to compare the performance of Luminex ARIES ® Flu A/B & RSV assay to the Cepheid Xpert ® Flu/RSV XC assay for rapid Flu and RSV testing. A series of consecutive nasopharyngeal specimens received in the clinical microbiology laboratory during peak influenza season at a major academic center in Chicago, IL, were prospectively tested, using both the ARIES ® Flu A/B & RSV and Xpert ® Flu/RSV XC assays, side by side. Discrepant results were tested on the BioFire FilmArray ® Respiratory Panel for resolution. A total of 143 consecutive nasopharyngeal specimens, obtained from patients ranging from six months to ninety-three years in age were received between January 1st, 2017 and March 21st, 2017. There was 96.6% agreement between the two assays for detection influenza A, 100% agreement for detection influenza B and RSV, and 98.9% agreement for negative results. The Xpert ® Flu/RSV XC performed with an average turn-around time of approximately 60min, compared to the ARIES ® Flu A/B & RSV of approximately 120min. Both assays were equally easy to perform, with a similar amount of hands-on technologist time for each platform. Overall, these results indicate that both tests are comparable in terms of result agreement and technical ease-of-use. The Xpert ® Flu/RSV XC assay did produce results with less turn-around-time, approximately 60min quicker than the ARIES ® Flu A/B & RSV. Copyright © 2017 Elsevier B.V. All rights reserved.

A randomized controlled study to evaluate the immunogenicity of a trivalent inactivated seasonal influenza vaccine at two dosages in children 6 to 35 months of age

PubMed Central

Pavia-Ruz, Noris; Angel Rodriguez Weber, Miguel; Lau, Yu-Lung; Nelson, E Anthony S; Kerdpanich, Angkool; Huang, Li-Min; Silas, Peter; Qaqundah, Paul; Blatter, Mark; Jeanfreau, Robert; Lei, Paul; Jain, Varsha; El Idrissi, Mohamed; Feng, Yang; Innis, Bruce; Peeters, Mathieu; Devaster, Jeanne-Marie

2013-01-01

The trivalent inactivated influenza vaccine Fluarix™ is licensed in the US for adults and children from 3 years old. This randomized observer-blind study (NCT00764790) evaluated Fluarix™ at two doses; 0.25 ml (Flu-25) and 0.5 ml (Flu-50) in children aged 6–35 months. The primary objective was to demonstrate immunogenic non-inferiority vs. a control vaccine (Fluzone®; 0.25 ml). Children received Flu-25 (n = 1107), Flu-50 (n = 1106) or control vaccine (n = 1104) at Day 0 and for un-primed children, also on Day 28. Serum hemagglutination-inhibition titers were determined pre-vaccination and at Day 28 (primed) or Day 56 (un-primed). Non-inferiority was assessed by post-vaccination geometric mean titer (GMT) ratio, (upper 95% confidence interval [CI] ≤ 1.5) and difference in seroconversion rate (upper 95% CI ≤ 10%). Reactogenicity/safety was monitored. The immune response to Flu-50 met all regulatory criteria. Indicated by adjusted GMT ratios [with 95% CI], the criteria for non-inferiority of Flu-50 vs. control vaccine were reached for the B/Florida strain (1.13 [1.01–1.25]) but not for the A/Brisbane/H1N1 (1.74 [1.54–1.98]) or A/Uruguay/H3N2 (1.72 [1.57–1.89]) strains. In children aged 18–35 months similar immune responses were observed for Flu-50 and the control vaccine. Flu-50 induced a higher response than Flu-25 for all strains. Temperature (≥ 37.5°C) was reported in 6.2%, 6.4%, and 6.6% of the Flu-25, Flu-50, and control group, respectively. Reactogenicity/safety endpoints were within the same range for all vaccines. In children aged 6–35 months, immune responses with Flu-50 fulfilled regulatory criteria but did not meet the pre-defined criteria for non-inferiority vs. control. This appeared to be due to differences in immunogenicity in children aged < 18 months. PMID:23782962

College students and the flu

MedlinePlus

... a lot of social activities make a college student more likely to catch the flu. This article ... give you information about the flu and college students. This is not a substitute for medical advice ...

Influence of post-harvest treatments with fludioxonil and soy lecithin co-application in controlling blue and grey mould and fludioxonil residues in Coscia pears.

PubMed

Schirra, M; D'Aquino, S; Migheli, Q; Pirisi, F M; Angioni, A

2009-01-01

The residue levels of fludioxonil (FLU) were determined in Coscia pear following a 1-, 2- or 4-min dip in an aqueous mixture of FLU containing 300 or 100 mg l(-1) (active ingredient, a.i.) at 20 and 50 degrees C, respectively, with or without 2% soy lecithin. The efficacy of heat treatment with water and FLU mixtures was investigated on artificially inoculated pears for the control of post-harvest decay caused by blue (Penicillium expansum Link) and grey (Botrytis cinerea Pers. ex Fr.) mould. Treatment with 300 mg l(-1) FLU at 20 degrees C increased residues significantly when treatment time rose from 1 to 2 min; no further increase was recorded when dip time raised from 2 to 4 min. FLU residue rates were unaffected by treatment time when 300 mg l(-1) a.i. was applied in combination with lecithin at 20 degrees C. While treatment with 100 mg l(-1) a.i. at 50 degrees C for 1 and 2 min resulted in similar residue levels, significantly higher residues were detected when dip time increased from 1 to 4 min. Co-application of lecithin significantly decreased FLU residues with respect to fruit treated with FLU alone. Treatments with FLU at 20 or 50 degrees C effectively controlled decay over 10 days of incubation. While co-application of lecithin did not affect the efficacy of FLU at 300 mg l(-1)and 20 degrees C, treatment efficacy decreased when lecithin was applied in combination with 100 mg l(-1) FLU and 50 degrees C for 4 min and to a greater extent when dip time was 1-2 min.

Evaluation of the Cepheid Xpert Flu Assay for rapid identification and differentiation of influenza A, influenza A 2009 H1N1, and influenza B viruses.

PubMed

Novak-Weekley, S M; Marlowe, E M; Poulter, M; Dwyer, D; Speers, D; Rawlinson, W; Baleriola, C; Robinson, C C

2012-05-01

The Xpert Flu Assay cartridge is a next-generation nucleic acid amplification system that provides multiplexed PCR detection of the influenza A, influenza A 2009 H1N1, and influenza B viruses in approximately 70 min with minimal hands-on time. Six laboratories participated in a clinical trial comparing the results of the new Cepheid Xpert Flu Assay to those of culture or real-time PCR with archived and prospectively collected nasal aspirate-wash (NA-W) specimens and nasopharyngeal (NP) swabs from children and adults. Discrepant results were resolved by DNA sequence analysis. After discrepant-result analysis, the sensitivities of the Xpert Flu Assay for prospective NA-W specimens containing the influenza A, influenza A 2009 H1N1, and influenza B viruses compared to those of culture were 90.0%, 100%, and 100%, respectively, while the sensitivities of the assay for prospective NP swabs compared to those of culture were 100%, 100%, and 100%, respectively. The sensitivities of the Xpert Flu Assay for archived NA-W specimens compared to those of Gen-Probe ProFlu+ PCR for the influenza A, influenza A 2009 H1N1, and influenza B viruses were 99.4%, 98.4%, and 100%, respectively, while the sensitivities of the Xpert Flu Assay for archived NP swabs compared to those of ProFlu+ were 98.1%, 100%, and 93.8%, respectively. The sensitivities of the Xpert Flu Assay with archived NP specimens compared to those of culture for the three targets were 97.5%, 100%, and 93.8%, respectively. We conclude that the Cepheid Xpert Flu Assay is an accurate and rapid method that is suitable for on-demand testing for influenza viral infection.

Self-mating in the definitive host potentiates clonal outbreaks of the apicomplexan parasites Sarcocystis neurona and Toxoplasma gondii.

PubMed

Wendte, Jered M; Miller, Melissa A; Lambourn, Dyanna M; Magargal, Spencer L; Jessup, David A; Grigg, Michael E

2010-12-23

Tissue-encysting coccidia, including Toxoplasma gondii and Sarcocystis neurona, are heterogamous parasites with sexual and asexual life stages in definitive and intermediate hosts, respectively. During its sexual life stage, T. gondii reproduces either by genetic out-crossing or via clonal amplification of a single strain through self-mating. Out-crossing has been experimentally verified as a potent mechanism capable of producing offspring possessing a range of adaptive and virulence potentials. In contrast, selfing and other life history traits, such as asexual expansion of tissue-cysts by oral transmission among intermediate hosts, have been proposed to explain the genetic basis for the clonal population structure of T. gondii. In this study, we investigated the contributing roles self-mating and sexual recombination play in nature to maintain clonal population structures and produce or expand parasite clones capable of causing disease epidemics for two tissue encysting parasites. We applied high-resolution genotyping against strains isolated from a T. gondii waterborne outbreak that caused symptomatic disease in 155 immune-competent people in Brazil and a S. neurona outbreak that resulted in a mass mortality event in Southern sea otters. In both cases, a single, genetically distinct clone was found infecting outbreak-exposed individuals. Furthermore, the T. gondii outbreak clone was one of several apparently recombinant progeny recovered from the local environment. Since oocysts or sporocysts were the infectious form implicated in each outbreak, the expansion of the epidemic clone can be explained by self-mating. The results also show that out-crossing preceded selfing to produce the virulent T. gondii clone. For the tissue encysting coccidia, self-mating exists as a key adaptation potentiating the epidemic expansion and transmission of newly emerged parasite clones that can profoundly shape parasite population genetic structures or cause devastating disease outbreaks.

Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

PubMed

Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

2017-03-31

On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

Flu Vaccine Skin Patch Tested

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... Subscribe September 2017 Print this issue Health Capsule Flu Vaccine Skin Patch Tested En español Send us ... Each year, millions of people nationwide catch the flu. The best way to protect yourself is to ...

Parents of Kids with Infectious Diseases

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... news labs links & resources hpv overview why vaccinate posters buttons and banners videos someone you love flu ... such thing as stomach flu pregnancy and flu posters meningitis overview why vaccinate CDC and meningitis Stiletto ...

Avian Influenza (Bird Flu)

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I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

PubMed

2014-11-01

While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership.

Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew.

PubMed

Rizal, Rachel E; Mediratta, Rishi P; Xie, James; Kambhampati, Swetha; Hills-Evans, Kelsey; Montacute, Tamara; Zhang, Michael; Zaw, Catherine; He, Jimmy; Sanchez, Magali; Pischel, Lauren

2015-01-01

Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful servicelearning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program's outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians.

Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew

PubMed Central

Rizal, Rachel E; Mediratta, Rishi P; Xie, James; Kambhampati, Swetha; Hills-Evans, Kelsey; Montacute, Tamara; Zhang, Michael; Zaw, Catherine; He, Jimmy; Sanchez, Magali; Pischel, Lauren

2015-01-01

Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful servicelearning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students’ attitudes about population health, highlights the program’s outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians. PMID:26170731

A Content Analysis of Newspaper Coverage of the Seasonal Flu Vaccine in Ontario, Canada, October 2001 to March 2011.

PubMed

Meyer, Samantha B; Lu, Stephanie K; Hoffman-Goetz, Laurie; Smale, Bryan; MacDougall, Heather; Pearce, Alex R

2016-10-01

Seasonal flu vaccine uptake has fallen dramatically over the past decade in Ontario, Canada, despite promotional efforts by public health officials. Media can be particularly influential in shaping the public response to seasonal flu vaccine campaigns. We therefore sought to identify the nature of the relationship between risk messages about getting the seasonal flu vaccine in newspaper coverage and the uptake of the vaccine by Ontarians between 2001 and 2010. A content analysis was conducted to quantify risk messages in newspaper content for each year of analysis. The quantification allowed us to test the correlation between the frequency of risk messages and vaccination rates. During the time period 2001-2010, vaccination rates were positively and significantly related to the frequency of risk messages in newspaper coverage (r = .691, p < .05). The most commonly identified risk messages related to the flu vaccine being ineffective, the flu vaccine being poorly understood by science, and the flu vaccine causing harm. Newspaper coverage plays an important role in shaping public response to seasonal flu vaccine campaigns. Public health officials should work alongside media to ensure that the public are exposed to information necessary for making informed decisions regarding vaccination.

Novel flurbiprofen derivatives with improved brain delivery: synthesis, in vitro and in vivo evaluations.

PubMed

Zheng, Dan; Shuai, Xiao; Li, Yanping; Zhou, Peng; Gong, Tao; Sun, Xun; Zhang, Zhirong

2016-09-01

Tarenflurbil (R-flurbiprofen) was acknowledged as a promising candidate in Alzheimer's disease (AD) therapy. However, the Phase III study of tarenflurbil was extremely restricted by its poor delivery efficiency to the brain. To tackle this problem, the novel carriers for tarenflurbil, racemic flurbiprofen (FLU) derivatives (FLU-D1 and FLU-D2) modified by N,N-dimethylethanolamine-related structures were synthesized and characterized. These derivatives showed good safety level in vitro and they possessed much higher cellular uptake efficiency in brain endothelial cells than FLU did. More importantly, the uptake experiments suggested that they were internalized via active transport mechanisms. Biodistribution studies in rats also illustrated a remarkably enhanced accumulation of these derivatives in the brain. FLU-D2, the ester linkage form of these derivatives, achieved a higher brain-targeting efficiency. Its C max and AUC 0- t were enhanced by 12.09-fold and 4.61-fold, respectively compared with those of FLU. Additionally, it could be hydrolyzed by esterase in the brain to release the parent FLU, which might facilitate its therapeutic effect. These in vitro and in vivo results highlighted the improvement of the brain-targeted delivery of FLU by making use of N,N-dimethylethanolamine ligand, with which an active transport mechanism was involved.

Analysis of fluG mutations that affect light-dependent conidiation in Aspergillus nidulans.

PubMed Central

Yager, L N; Lee, H O; Nagle, D L; Zimmerman, J E

1998-01-01

Conidiation in Aspergillus nidulans is induced by exposure to red light but can also be induced by blue light in certain mutant strains. We have isolated a mutation in the fluG gene that abolishes responsiveness to red light but does not affect the response to blue light. It has been shown that the veA1 (velvet) mutation allows conidiation to occur in the absence of light. We have identified three other fluG mutations that suppress the veA1 phenotype; these double mutants do not conidiate in the dark. The mutations described here define two new phenotypic classes of fluG alleles that display abnormal responses to light. We have characterized these mutations with respect to their molecular identity and to their effect on fluG transcription. Although it has been shown that fluG is required for the synthesis of an extracellular factor that directs conidiation, we do not detect this factor under conditions that promote conidiation in the veA1 suppressors. Furthermore, extracellular rescue is not observed in fluG deletion strains containing the wild-type veA allele. We propose that a genetic interaction between fluG and veA influences the production of the extracellular signal and regulates the initiation of conidiation. PMID:9691036

Flu Vaccine Guidance for Patients with Immune Deficiency

MedlinePlus

... Vaccine Guidance for Patients with Immune Deficiency Share | Flu Vaccine Guidance for Patients with Immune Deficiency This ... is the best tool for prevention of the flu, should patients with immune deficiency be given the ...

Using Combined Diagnostic Test Results to Hindcast Trends of Infection from Cross-Sectional Data

PubMed Central

Rydevik, Gustaf; Innocent, Giles T.; Marion, Glenn; White, Piran C. L.; Billinis, Charalambos; Barrow, Paul; Mertens, Peter P. C.; Gavier-Widén, Dolores; Hutchings, Michael R.

2016-01-01

Infectious disease surveillance is key to limiting the consequences from infectious pathogens and maintaining animal and public health. Following the detection of a disease outbreak, a response in proportion to the severity of the outbreak is required. It is thus critical to obtain accurate information concerning the origin of the outbreak and its forward trajectory. However, there is often a lack of situational awareness that may lead to over- or under-reaction. There is a widening range of tests available for detecting pathogens, with typically different temporal characteristics, e.g. in terms of when peak test response occurs relative to time of exposure. We have developed a statistical framework that combines response level data from multiple diagnostic tests and is able to ‘hindcast’ (infer the historical trend of) an infectious disease epidemic. Assuming diagnostic test data from a cross-sectional sample of individuals infected with a pathogen during an outbreak, we use a Bayesian Markov Chain Monte Carlo (MCMC) approach to estimate time of exposure, and the overall epidemic trend in the population prior to the time of sampling. We evaluate the performance of this statistical framework on simulated data from epidemic trend curves and show that we can recover the parameter values of those trends. We also apply the framework to epidemic trend curves taken from two historical outbreaks: a bluetongue outbreak in cattle, and a whooping cough outbreak in humans. Together, these results show that hindcasting can estimate the time since infection for individuals and provide accurate estimates of epidemic trends, and can be used to distinguish whether an outbreak is increasing or past its peak. We conclude that if temporal characteristics of diagnostics are known, it is possible to recover epidemic trends of both human and animal pathogens from cross-sectional data collected at a single point in time. PMID:27384712

Accurate estimation of influenza epidemics using Google search data via ARGO

PubMed Central

Yang, Shihao; Santillana, Mauricio; Kou, S. C.

2015-01-01

Accurate real-time tracking of influenza outbreaks helps public health officials make timely and meaningful decisions that could save lives. We propose an influenza tracking model, ARGO (AutoRegression with GOogle search data), that uses publicly available online search data. In addition to having a rigorous statistical foundation, ARGO outperforms all previously available Google-search–based tracking models, including the latest version of Google Flu Trends, even though it uses only low-quality search data as input from publicly available Google Trends and Google Correlate websites. ARGO not only incorporates the seasonality in influenza epidemics but also captures changes in people’s online search behavior over time. ARGO is also flexible, self-correcting, robust, and scalable, making it a potentially powerful tool that can be used for real-time tracking of other social events at multiple temporal and spatial resolutions. PMID:26553980

A data-driven model for influenza transmission incorporating media effects.

PubMed

Mitchell, Lewis; Ross, Joshua V

2016-10-01

Numerous studies have attempted to model the effect of mass media on the transmission of diseases such as influenza; however, quantitative data on media engagement has until recently been difficult to obtain. With the recent explosion of 'big data' coming from online social media and the like, large volumes of data on a population's engagement with mass media during an epidemic are becoming available to researchers. In this study, we combine an online dataset comprising millions of shared messages relating to influenza with traditional surveillance data on flu activity to suggest a functional form for the relationship between the two. Using this data, we present a simple deterministic model for influenza dynamics incorporating media effects, and show that such a model helps explain the dynamics of historical influenza outbreaks. Furthermore, through model selection we show that the proposed media function fits historical data better than other media functions proposed in earlier studies.

Key strategies for reducing spread of avian influenza among commercial poultry holdings: lessons for transmission to humans

PubMed Central

Le Menach, Arnaud; Vergu, Elisabeta; Grais, Rebecca F; Smith, David L; Flahault, Antoine

2006-01-01

Recent avian flu epidemics (A/H5N1) in Southeast Asia and case reports from around the world have led to fears of a human pandemic. Control of these outbreaks in birds would probably lead to reduced transmission of the avian virus to humans. This study presents a mathematical model based on stochastic farm-to-farm transmission that incorporates flock size and spatial contacts to evaluate the impact of control strategies. Fit to data from the recent epidemic in the Netherlands, we evaluate the efficacy of control strategies and forecast avian influenza dynamics. Our results identify high-risk areas of spread by mapping of the farm level reproductive number. Results suggest that an immediate depopulation of infected flocks following an accurate and quick diagnosis would have a greater impact than simply depopulating surrounding flocks. Understanding the relative importance of different control measures is essential for response planning. PMID:16959637

Social Web mining and exploitation for serious applications: Technosocial Predictive Analytics and related technologies for public health, environmental and national security surveillance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamel Boulos, Maged; Sanfilippo, Antonio P.; Corley, Courtney D.

2010-03-17

This paper explores techno-social predictive analytics (TPA) and related methods for Web “data mining” where users’ posts and queries are garnered from Social Web (“Web 2.0”) tools such as blogs, microblogging and social networking sites to form coherent representations of real-time health events. The paper includes a brief introduction to commonly used Social Web tools such as mashups and aggregators, and maps their exponential growth as an open architecture of participation for the masses and an emerging way to gain insight about people’s collective health status of whole populations. Several health related tool examples are described and demonstrated as practicalmore » means through which health professionals might create clear location specific pictures of epidemiological data such as flu outbreaks.« less

H1N1, globalization and the epidemiology of inequality.

PubMed

Sparke, Matthew; Anguelov, Dimitar

2012-07-01

This paper examines the lessons learned from the 2009 H1N1 pandemic in relation to wider work on globalization and the epidemiology of inequality. The media attention and economic resources diverted to the threats posed by H1N1 were significant inequalities themselves when contrasted with weaker responses to more lethal threats posed by other diseases associated with global inequality. However, the multiple inequalities revealed by H1N1 itself in 2009 still provide important insights into the future of global health in the context of market-led globalization. These lessons relate to at least four main forms of inequality: (1) inequalities in blame for the outbreak in the media; (2) inequalities in risk management; (3) inequalities in access to medicines; and (4) inequalities encoded in the actual emergence of new flu viruses. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multistate outbreak of listeriosis associated with Jensen Farms cantaloupe--United States, August-September 2011.

PubMed

2011-10-07

Listeriosis is caused by Listeria monocytogenes, a gram-positive bacillus common in the environment and acquired by humans primarily through consumption of contaminated food. Infection causes a spectrum of illness, ranging from febrile gastroenteritis to invasive disease, including sepsis and meningoencephalitis. Invasive listeriosis occurs predominantly in older adults and persons with impaired immune systems. Listeriosis in pregnant women is typically a mild "flu-like" illness, but can result in fetal loss, premature labor, or neonatal infection. Listeriosis is treated with antibiotics. On September 2, 2011, the Colorado Department of Public Health and Environment (CDPHE) notified CDC of seven cases of listeriosis reported since August 28. On average, Colorado reports two cases of listeriosis annually in August. By September 6, all seven Colorado patients interviewed with the Listeria Initiative* questionnaire reported eating cantaloupe in the month before illness began, and three reported eating cantaloupe marketed as "Rocky Ford."

Mandatory influenza immunization for health care workers--an ethical discussion.

PubMed

Steckel, Cynthia M

2007-01-01

Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year. Vaccination of high-risk groups has been called the single most important influenza control measure by the Centers for Disease Control and Prevention. Studies show that vaccination can lead to decreases in flu-related illness and absenteeism among health care workers, as well as fewer acute care outbreaks and reduced patient mortality in long-term care settings. However, to date, voluntary programs have achieved only a 40% vaccination rate among health care workers, causing concern among government and infectious disease organizations. This article addresses the ethical justification for mandating influenza vaccination for health care workers. Health care workers' attitudes toward vaccination are presented, as well as historical and legal perspectives on compulsory measures. The ethical principles of effectiveness, beneficence, necessity, autonomy, justice, and transparency are discussed.

What You Should Know about Flu Antiviral Drugs

MedlinePlus

... Other What You Should Know About Flu Antiviral Drugs Language: English (US) Español Recommend on Facebook Tweet ... used to treat flu illness. What are antiviral drugs? Antiviral drugs are prescription medicines (pills, liquid, an ...

"Stomach Flu" (For Kids)

MedlinePlus

... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español "Stomach Flu" KidsHealth / For Kids / "Stomach Flu" Print Many people talk about the " ...

Situation Update: Summary of Weekly FluView

MedlinePlus

... Pandemic Other Situation Update: Summary of Weekly FluView Report Language: English (US) Español Recommend on Facebook Tweet ... Influenza Positive Tests Reported to CDC The FluView report published on May 25 marks the final full ...

Protecting Against the Flu: Advice for Caregivers of Children Less than 6 Months Old. Fact Sheet

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

Research has shown that children less than 5 years of age are at high risk of serious flu-related complications. It is estimated that more than 20,000 children less than 5 years old are hospitalized due to flu each year in the U.S. Many more have to go to a doctor, an urgent care center, or the emergency room because of flu. Complications from the…

Incidence of Online Health Information Search: A Useful Proxy for Public Health Risk Perception

PubMed Central

Scammon, Debra L

2013-01-01

Background Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers’ search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public’s attitudes and behaviors. Objective This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population’s environment. Using an ecological perspective, we suggest that a population’s general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. Methods We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Results Overall, the results provide evidence that the main effects of independent variables—the incidence of the flu (P<.001); social factors, including media attention (P<.001); private resources, including life quality (P<.001) and health lifestyles (P=.009); and public resources, such as hospital care utilization (P=.008) and public health funds (P=.02)—have significant effects on Web searches for queries related to the flu. After controlling for the number of reported disease cases and Internet access rate by state, we estimate the contribution of social factors to the public health risk perception levels by state (R2=23.37%). The interaction effects between flu incidence and social factors for our search terms did not add to the explanatory power of our regression models (R2<1%). Conclusions Our study suggests a practical way to measure the public’s health risk perception for certain diseases using online information search volume by state. The social environment influences public risk perception regardless of disease incidence. Thus, monitoring the social variables can be very helpful in being ready to respond to the public’s behavior in dealing with public health threats. PMID:23773974

Plasma pharmacokinetics and milk residues of flunixin and 5-hydroxy flunixin following different routes of administration in dairy cattle.

PubMed

Kissell, L W; Smith, G W; Leavens, T L; Baynes, R E; Wu, H; Riviere, J E

2012-12-01

The objective of this study was to determine if the plasma pharmacokinetics and milk elimination of flunixin (FLU) and 5-hydroxy flunixin (5OH) differ following intramuscular and subcutaneous injection of FLU compared with intravenous injection. Twelve lactating Holstein cows were used in a randomized crossover design study. Cows were organized into 2 groups based on milk production (<20 or >30 kg of milk/d). All cattle were administered 2 doses of 1.1mg of FLU/kg at 12-h intervals by intravenous, intramuscular, and subcutaneous injections. The washout period between routes of administration was 7d. Blood samples were collected from the jugular vein before FLU administration and at various time points up to 36 h after the first dose of FLU. Composite milk samples were collected before FLU administration and twice daily for 5d after the first dose of FLU. Samples were analyzed by ultra-HPLC with mass spectrometric detection. For FLU plasma samples, a difference in terminal half-life was observed among routes of administration. Harmonic mean terminal half-lives for FLU were 3.42, 4.48, and 5.39 h for intravenous, intramuscular, and subcutaneous injection, respectively. The mean bioavailability following intramuscular and subcutaneous dosing was 84.5 and 104.2%, respectively. The decrease in 5OH milk concentration versus time after last dose was analyzed with the nonlinear mixed effects modeling approach and indicated that both the route of administration and rate of milk production were significant covariates. The number of milk samples greater than the tolerance limit for each route of administration was also compared at each time point for statistical significance. Forty-eight hours after the first dose, 5OH milk concentrations were undetectable in all intravenously injected cows; however, one intramuscularly injected and one subcutaneously injected cow had measurable concentrations. These cows had 5OH concentrations above the tolerance limit at the 36-h withdrawal time. The high number of FLU residues identified in cull dairy cows by the United States Department of Agriculture Food Safety Inspection Service is likely related to administration of the drug by an unapproved route. Cattle that received FLU by the approved (intravenous) route consistently eliminated the drug before the approved withdrawal times; however, residues can persist beyond these approved times following intramuscular or subcutaneous administration. Cows producing less than 20 kg of milk/d had altered FLU milk clearance, which may also contribute to violative FLU residues. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Evaluation of the rapid influenza detection tests GOLD SIGN FLU and Quick Navi-Flu for the detection of influenza A and B virus antigens in adults during the influenza season.

PubMed

Akaishi, Yu; Matsumoto, Tetsuya; Harada, Yoshimi; Hirayama, Yoji

2016-11-01

As the characteristics and accuracy of rapid influenza detection tests (RIDTs) vary, the development of a high-performance RIDT has been eagerly anticipated. In this study, the new RIDT GOLD SIGN FLU and the existing RIDT Quick Navi-Flu were evaluated in terms of detecting the antigens of influenza viruses A and B in Japanese adults with influenza-like symptoms. The study was performed from December 2013 to March 2014. Among the 123 patients from whom nasopharyngeal swab specimens were collected, 59 tested positive by viral isolation as the gold standard method (influenza A, n=38; influenza B, n=21). For GOLD SIGN FLU, the sensitivities were 73.7% and 81.0%, and the specificities were 97.6% and 98.0% for influenza A and B, respectively. For Quick Navi-Flu, the sensitivities were 86.8% and 85.7%, and the specificities were 98.8% and 100% for influenza A and B, respectively. The time to the appearance of the line on the test strip was less than 3min for influenza A and less than 2min for influenza B with both RIDTs in more than 90% of cases. GOLD SIGN FLU was useful for diagnosing influenza A, and the result was readily available for influenza B particularly among adult patients. Quick Navi-Flu showed better sensitivities and specificities than GOLD SIGN FLU. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Colds and the flu - what to ask your doctor - adult

MedlinePlus

... to ask your doctor about colds and the flu - adult; Influenza - what to ask your doctor - adult; Upper respiratory ... what to ask your doctor - adult; H1N1 (Swine) flu - what to ask your doctor - adult

Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

MedlinePlus

... Protecting Against Influenza (Flu): Advice for Caregivers of Young Children Language: English (US) Español Recommend on Facebook ... on How to Prevent Flu for Caregivers of Young Children 1. Take Time to Get a Vaccine ...

Workplace availability, risk group and perceived barriers predictive of 2016-17 influenza vaccine uptake in the United States: A cross-sectional study.

PubMed

Luz, Paula M; Johnson, Riley E; Brown, Heidi E

2017-10-13

Seasonal influenza, though mostly self-limited in the healthy adult, may lead to severe disease and/or complications in subpopulations. Annual influenza vaccination is available in many countries with coverage goals rarely being met. We conducted a cross-sectional study of influenza vaccine uptake and explored socio-demographic, economic, and psychological factors that explained vaccine uptake. The survey was administered via Amazon Mechanical Turk (MTurk) to United States residents in January 2017, using the Qualtrics platform. Using principal axis factor analysis, we reduced the 25 items theory-based psychological determinants into the primary constructs they measure if/when internal consistency was sufficient (Cronbach's alpha >0.60). Logistic regression models were used to quantify the association of socio-demographic, economic, and psychological factors with reported vaccine behavior in the 2016-17 flu season. 1007 participants completed the survey, sex distribution was even, 67% had 25-44years of age, and 61% annual household income of $30-99 thousand United States dollars. About 25% had the flu shot offered at their workplace and 20% reported belonging to a group for whom the flu shot is recommended. Vaccine uptake was 31.5%. Eight predictors remained in the final adjusted model (R 2 =0.489), having the vaccine offered at the workplace, belonging to a group for whom the vaccine is recommended, and higher perceived barriers were the strongest predictors of vaccine uptake, increasing (and decreasing in the case of barriers) the odds by >3-fold. Additionally, higher household income, higher perceived susceptibility and higher perceived benefits also independently predicted vaccine uptake. We found evidence that perceived barriers significantly impaired vaccine uptake to the same extent that having the vaccine offered at the workplace or belonging to a group for whom the vaccine is recommended facilitated uptake. Ideally, a better understanding of drivers of vaccine hesitancy will result in improved interventions to increase vaccine uptake. Copyright © 2017 Elsevier Ltd. All rights reserved.

FluBlok, a recombinant hemagglutinin influenza vaccine.

PubMed

Cox, Manon M J; Patriarca, Peter A; Treanor, John

2008-11-01

FluBlok, a recombinant trivalent hemagglutinin (HA) vaccine produced in insect cell culture using the baculovirus expression system, provides an attractive alternative to the current egg-based trivalent inactivated influenza vaccine (TIV) manufacturing process. FluBlok contains three times more HA than TIV and does not contain egg-protein or preservatives. This review discusses the four main clinical studies that were used to support licensure of FluBlok under the 'Accelerated Approval' mechanism in the United States.

Accurate PCR Detection of Influenza A/B and Respiratory Syncytial Viruses by Use of Cepheid Xpert Flu+RSV Xpress Assay in Point-of-Care Settings: Comparison to Prodesse ProFlu.

PubMed

Cohen, Daniel M; Kline, Jennifer; May, Larissa S; Harnett, Glenn Eric; Gibson, Jane; Liang, Stephen Y; Rafique, Zubaid; Rodriguez, Carina A; McGann, Kevin M; Gaydos, Charlotte A; Mayne, Donna; Phillips, David; Cohen, Jason

2018-02-01

The Xpert Flu+RSV Xpress Assay is a fast, automated in vitro diagnostic test for qualitative detection and differentiation of influenza A and B viruses and respiratory syncytial virus (RSV) performed on the Cepheid GeneXpert Xpress System. The objective of this study was to establish performance characteristics of the Xpert Flu+RSV Xpress Assay compared to those of the Prodesse ProFlu+ real-time reverse transcription-PCR (RT-PCR) assay (ProFlu+) for the detection of influenza A and B viruses as well as RSV in a Clinical Laboratory Improvement Amendments (CLIA)-waived (CW) setting. Overall, the assay, using fresh and frozen nasopharyngeal (NP) swabs, demonstrated high concordance with results of the ProFlu+ assay in the combined CW and non-CW settings with positive percent agreements (PPA) (100%, 100%, and 97.1%) and negative percent agreements (NPA) (95.2%, 99.5%, and 99.6%) for influenza A and B viruses and RSV, respectively. In conclusion, this multicenter study using the Cepheid Xpert Flu+RSV Xpress Assay demonstrated high sensitivities and specificities for influenza A and B viruses and RSV in ∼60 min for use at the point-of-care in the CW setting. Copyright © 2018 American Society for Microbiology.

Prospective and Retrospective Evaluation of the Performance of the FDA-Approved Cepheid Xpert Flu/RSV XC Assay.

PubMed

Arbefeville, Sophie; Thonen-Kerr, Elizabeth; Ferrieri, Patricia

2017-11-08

Rapid and accurate detection of respiratory viruses is important in patient care and in guiding therapy and infection prevention policy. Rapid viral antigen assays are simple to perform and provide results within 15 to 30 minutes but are limited by their modest-to-moderate sensitivity. Molecular assays are more sensitive and specific but require more technical time and expertise and are more expensive. We verified the performance of the Xpert Flu/RSV XC assay prospectively, using patient respiratory samples from the 2014-2015 respiratory season, and, retrospectively, with frozen patient samples from the previous respiratory season. A total of 60 specimens were assayed on the Xpert Flu/RSV XC assay and by the GenMark Diagnostics eSensor Respiratory Viral Panel. The sensitivity of the Xpert Flu/RSV XC for Flu A was 100% (23/23), for Flu B, 80% (8/10), and for respiratory syncytial virus (RSV), 94.1% (16/17), compared to the reference assay (GenMark). The specificity was 100%. Eight specimens were positive for viruses other than Flu A/B or RSV, and this did not interfere with detection of targets in the Xpert assay. We demonstrated that the performance of the Xpert Flu/RSV XC was comparable to the more comprehensive molecular respiratory assay. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development, Characterization, and In Vitro Biological Performance of Fluconazole-Loaded Microemulsions for the Topical Treatment of Cutaneous Leishmaniasis

PubMed Central

Graminha, Márcia; Cerecetto, Hugo; González, Mercedes

2015-01-01

Cutaneous leishmaniasis (CL) is a resistant form of leishmaniasis that is caused by a parasite belonging to the genus Leishmania. FLU-loaded microemulsions (MEs) were developed by phase diagram for topical administration of fluconazole (FLU) as prominent alternative to combat CL. Three MEs called F1, F2, and F3 (F1—60% 50 M phosphate buffer at pH 7.4 (PB) as aqueous phase, 10% cholesterol (CHO) as oil phase, and 30% soy phosphatidylcholine/oil polyoxyl-60 hydrogenated castor oil/sodium oleate (3/8/6) (S) as surfactant; F2—50% PB, 10% CHO, and 40% S; F3—40% PB, 10% CHO, and 50 % S) were characterized by droplet size analysis, zeta potential analysis, X-ray diffraction, continuous flow, texture profile analysis, and in vitro bioadhesion. MEs presented pseudoplastic flow and thixotropy was dependent on surfactant concentration. Droplet size was not affected by FLU. FLU-loaded MEs improved the FLU safety profile that was evaluated using red cell haemolysis and in vitro cytotoxicity assays with J-774 mouse macrophages. FLU-unloaded MEs did not exhibit leishmanicidal activity that was performed using MTT colourimetric assays; however, FLU-loaded MEs exhibited activity. Therefore, these MEs have potential to modulate FLU action, being a promising platform for drug delivery systems to treat CL. PMID:25650054

A Synthetic Influenza Virus Vaccine Induces a Cellular Immune Response That Correlates with Reduction in Symptomatology and Virus Shedding in a Randomized Phase Ib Live-Virus Challenge in Humans

PubMed Central

Pleguezuelos, Olga; Robinson, Stuart; Fernández, Ana; Stoloff, Gregory A.; Mann, Alex; Gilbert, Anthony; Balaratnam, Ganesh; Wilkinson, Tom; Lambkin-Williams, Rob; Oxford, John

2015-01-01

Current influenza vaccines elicit primarily antibody-based immunity. They require yearly revaccination and cannot be manufactured until the identification of the circulating viral strain(s). These issues remain to be addressed. Here we report a phase Ib trial of a vaccine candidate (FLU-v) eliciting cellular immunity. Thirty-two males seronegative for the challenge virus by hemagglutination inhibition assay participated in this single-center, randomized, double-blind study. Volunteers received one dose of either the adjuvant alone (placebo, n = 16) or FLU-v (500 μg) and the adjuvant (n = 16), both in saline. Twenty-one days later, FLU-v (n = 15) and placebo (n = 13) volunteers were challenged with influenza virus A/Wisconsin/67/2005 (H3N2) and monitored for 7 days. Safety, tolerability, and cellular responses were assessed pre- and postvaccination. Virus shedding and clinical signs were assessed postchallenge. FLU-v was safe and well tolerated. No difference in the prevaccination FLU-v-specific gamma interferon (IFN-γ) response was seen between groups (average ± the standard error of the mean [SEM] for the placebo and FLU-v, respectively, 1.4-fold ± 0.2-fold and 1.6-fold ± 0.5-fold higher than the negative-control value). Nineteen days postvaccination, the FLU-v group, but not the placebo group, developed FLU-v-specific IFN-γ responses (8.2-fold ± 3.9-fold versus 1.3-fold ± 0.1-fold higher than the negative-control value [average ± SEM] for FLU-v versus the placebo [P = 0.0005]). FLU-v-specific cellular responses also correlated with reductions in both viral titers (P = 0.01) and symptom scores (P = 0.02) postchallenge. Increased cellular immunity specific to FLU-v correlates with reductions in both symptom scores and virus loads. (This study has been registered at ClinicalTrials.gov under registration no. NCT01226758 and at hra.nhs.uk under EudraCT no. 2009-014716-35.) PMID:25994549

A Synthetic Influenza Virus Vaccine Induces a Cellular Immune Response That Correlates with Reduction in Symptomatology and Virus Shedding in a Randomized Phase Ib Live-Virus Challenge in Humans.

PubMed

Pleguezuelos, Olga; Robinson, Stuart; Fernández, Ana; Stoloff, Gregory A; Mann, Alex; Gilbert, Anthony; Balaratnam, Ganesh; Wilkinson, Tom; Lambkin-Williams, Rob; Oxford, John; Caparrós-Wanderley, Wilson

2015-07-01

Current influenza vaccines elicit primarily antibody-based immunity. They require yearly revaccination and cannot be manufactured until the identification of the circulating viral strain(s). These issues remain to be addressed. Here we report a phase Ib trial of a vaccine candidate (FLU-v) eliciting cellular immunity. Thirty-two males seronegative for the challenge virus by hemagglutination inhibition assay participated in this single-center, randomized, double-blind study. Volunteers received one dose of either the adjuvant alone (placebo, n = 16) or FLU-v (500 μg) and the adjuvant (n = 16), both in saline. Twenty-one days later, FLU-v (n = 15) and placebo (n = 13) volunteers were challenged with influenza virus A/Wisconsin/67/2005 (H3N2) and monitored for 7 days. Safety, tolerability, and cellular responses were assessed pre- and postvaccination. Virus shedding and clinical signs were assessed postchallenge. FLU-v was safe and well tolerated. No difference in the prevaccination FLU-v-specific gamma interferon (IFN-γ) response was seen between groups (average ± the standard error of the mean [SEM] for the placebo and FLU-v, respectively, 1.4-fold ± 0.2-fold and 1.6-fold ± 0.5-fold higher than the negative-control value). Nineteen days postvaccination, the FLU-v group, but not the placebo group, developed FLU-v-specific IFN-γ responses (8.2-fold ± 3.9-fold versus 1.3-fold ± 0.1-fold higher than the negative-control value [average ± SEM] for FLU-v versus the placebo [P = 0.0005]). FLU-v-specific cellular responses also correlated with reductions in both viral titers (P = 0.01) and symptom scores (P = 0.02) postchallenge. Increased cellular immunity specific to FLU-v correlates with reductions in both symptom scores and virus loads. (This study has been registered at ClinicalTrials.gov under registration no. NCT01226758 and at hra.nhs.uk under EudraCT no. 2009-014716-35.). Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Colds and the flu - what to ask your doctor - child

MedlinePlus

... to ask your doctor about colds and the flu - child; Influenza - what to ask your doctor - child; Upper respiratory ... URI - what to ask your doctor - child; Swine flu (H1N1) - what to ask your doctor - child

Forecasting the 2013–2014 influenza season using Wikipedia

DOE PAGES

Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid; ...

2015-05-14

Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are appliedmore » to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.« less

Forecasting the 2013–2014 Influenza Season Using Wikipedia

PubMed Central

Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid; Generous, Nicholas; Hyman, James M.; Deshpande, Alina; Del Valle, Sara Y.

2015-01-01

Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed. PMID:25974758

EpiCaster: An Integrated Web Application For Situation Assessment and Forecasting of Global Epidemics

PubMed Central

Deodhar, Suruchi; Bisset, Keith; Chen, Jiangzhuo; Barrett, Chris; Wilson, Mandy; Marathe, Madhav

2016-01-01

Public health decision makers need access to high resolution situation assessment tools for understanding the extent of various epidemics in different regions of the world. In addition, they need insights into the future course of epidemics by way of forecasts. Such forecasts are essential for planning the allocation of limited resources and for implementing several policy-level and behavioral intervention strategies. The need for such forecasting systems became evident in the wake of the recent Ebola outbreak in West Africa. We have developed EpiCaster, an integrated Web application for situation assessment and forecasting of various epidemics, such as Flu and Ebola, that are prevalent in different regions of the world. Using EpiCaster, users can assess the magnitude and severity of different epidemics at highly resolved spatio-temporal levels. EpiCaster provides time-varying heat maps and graphical plots to view trends in the disease dynamics. EpiCaster also allows users to visualize data gathered through surveillance mechanisms, such as Google Flu Trends (GFT) and the World Health Organization (WHO). The forecasts provided by EpiCaster are generated using different epidemiological models, and the users can select the models through the interface to filter the corresponding forecasts. EpiCaster also allows the users to study epidemic propagation in the presence of a number of intervention strategies specific to certain diseases. Here we describe the modeling techniques, methodologies and computational infrastructure that EpiCaster relies on to support large-scale predictive analytics for situation assessment and forecasting of global epidemics. PMID:27796009

Forecasting the 2013-2014 influenza season using Wikipedia.

PubMed

Hickmann, Kyle S; Fairchild, Geoffrey; Priedhorsky, Reid; Generous, Nicholas; Hyman, James M; Deshpande, Alina; Del Valle, Sara Y

2015-05-01

Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.

Assessment of H1N1 questions and answers posted on the Web.

PubMed

Kim, Sujin; Pinkerton, Thomas; Ganesh, Nithya

2012-04-01

A novel strain of human influenza A (H1N1) posed a serious pandemic threat worldwide during 2009. The public's fear of pandemic flu often raises awareness and discussion of such events. The goal of this study was to characterize major topical matters of H1N1 questions and answers raised by the online question and answer community Yahoo! Answers during H1N1 outbreak. The study used Text Mining for SPSS Clementine (v.12; SPSS Inc., Chicago, IL) to extract the major concepts of the collected Yahoo! questions and answers. The original collections were retrieved using "H1N1" in search, keyword and then filtered for only "resolved questions" in the "health" category submitted within the past 2 years. The most frequently formed categories were as follows: general health (health, disease, medicine, investigation, evidence, problem), flu-specific terms (H1N1, swine, shot, fever, cold, infective, throat), and nonmedical issues (feel, North American, people, child, nations, government, states, help, doubt, emotion). The study found that URL data are fairly predictable: those providing answers are divided between ones dedicated to giving trustworthy information-from news organizations and the government, for instance-and those looking to espouse a more biased point of view. Critical evaluation of online sources should be taught to select the quality of information and improve health literacy. The challenges of pandemic prevention and control, therefore, demand both e-surveillance and better informed "Netizens." Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Quality of life and trust among young people with narcolepsy and their families, after the Pandemrix® vaccination: protocol for a case-control study.

PubMed

Blomberg, Karin; Carlsson, Agneta Anderzén; Hagberg, Lars; Jonsson, Östen; Leissner, Lena; Eriksson, Mats H

2017-08-23

The extensive vaccination programme against swine flu resulted in an increased incidence of narcolepsy among children and adolescents. There is a need to explore if these young persons' experiences have affected their trust in healthcare, their willingness to participate in future prevention programmes, and their contacts with the healthcare system. The overall aim is to identify factors important for the life-situation of children and adolescents with narcolepsy and their families, and factors that correlate with trust in healthcare. Data will be collected via questionnaires from all available children with narcolepsy following the vaccination and their families, as well as a control group of children with diabetes and their families. Longitudinal descriptive interviews will also be conducted with a selection of 20-25 children and their families. Techniques from media research will be used for Internet-based data collection and analysis of information relating to narcolepsy from social media. This project will use the situation of young persons with narcolepsy after the swine flu vaccination as a case to build a model that can be used in situations where trust in healthcare is essential. This model will be based on findings from the included studies on how trust is influenced by support, quality of life, burden of disease, impact on family, and use of social media. The model developed in this project will be beneficial in future situations where trust in healthcare is essential, such as new pandemic outbreaks but also for "everyday" adherence to health advice.

Forecasting the 2013–2014 influenza season using Wikipedia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid

Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are appliedmore » to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.« less

Comparison of Xpert Flu rapid nucleic acid testing with rapid antigen testing for the diagnosis of influenza A and B.

PubMed

DiMaio, Michael A; Sahoo, Malaya K; Waggoner, Jesse; Pinsky, Benjamin A

2012-12-01

Influenza infections are associated with thousands of hospital admissions and deaths each year. Rapid detection of influenza is important for prompt initiation of antiviral therapy and appropriate patient triage. In this study the Cepheid Xpert Flu assay was compared with two rapid antigen tests, BinaxNOW Influenza A & B and BD Directigen EZ Flu A+B, as well as direct fluorescent antibody testing for the rapid detection of influenza A and B. Using real-time, hydrolysis probe-based, reverse transcriptase PCR as the reference method, influenza A sensitivity was 97.3% for Xpert Flu, 95.9% for direct fluorescent antibody testing, 62.2% for BinaxNOW, and 71.6% for BD Directigen. Influenza B sensitivity was 100% for Xpert Flu and direct fluorescent antibody testing, 54.5% for BinaxNOW, and 48.5% for BD Directigen. Specificity for influenza A was 100% for Xpert Flu, BinaxNOW, and BD Directigen, and 99.2% for direct fluorescent antibody testing. All methods demonstrated 100% specificity for influenza B. These findings support the use of the Xpert Flu assay in settings requiring urgent diagnosis of influenza A and B. Copyright © 2012 Elsevier B.V. All rights reserved.

OHS Helps Protect Employees During Flu Season | Poster

Cancer.gov

Flu season is in full swing, bringing a host of symptoms like congestion, coughs, fever, chills, muscle aches, and fatigue. To help NCI at Frederick employees stay healthy this year, Occupational Health Services (OHS) is offering two types of flu vaccines for free.

Vaccine Effectiveness - How Well Does the Seasonal Flu Vaccine Work?

MedlinePlus

... to determine the benefits of flu vaccination are “observational studies.” “Observational studies” compare the occurrence of flu illness in ... randomized. The measurement of vaccine effects in an observational study is referred to as “effectiveness.” Top of ...

Prevention

MedlinePlus

... from the flu occur in older adults. All older adults should get a flu shot every fall, at the start of the flu season. Pneumonia There are two different types of pneumococcal vaccine that are recommended for adults 65 or older. They are called pneumococcal conjugate vaccine (PCV)13 ...

Public-Private Partnerships: Critical to Combatting the Next Pandemic Influenza in the State of Kansas

DTIC Science & Technology

2011-06-10

Influenza A (H5N1), also known as Avian Flu or Bird Flu because it primarily affects chickens , turkeys, guinea fowls, migratory waterfowl, and other avian...difficult to predict. The 1918 "Spanish Flu ," the deadliest pandemic in history, is estimated to have killed more than 50 million people worldwide...overlooks influenza. As Dorothy Pettit and Janice Bailie suggested in their book, A Cruel Wind: Pandemic Flu in America, the general population in

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

PubMed Central

Liu, Timothy Y.; Sanders, Jason L.; Tsui, Fu-Chiang; Espino, Jeremy U.; Dato, Virginia M.; Suyama, Joe

2013-01-01

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. PMID:23555647

Offering Annual Fecal Occult Blood Tests at Annual Flu Shot Clinics Increases Colorectal Cancer Screening Rates

PubMed Central

Potter, Michael B.; Phengrasamy, La; Hudes, Esther S.; McPhee, Stephen J.; Walsh, Judith M.E.

2009-01-01

PURPOSE We wanted to determine whether providing home fecal occult blood test (FOBT) kits to eligible patients during influenza inoculation (flu shot) clinics can contribute to higher colorectal cancer screening (CRCS) rates. METHODS The study was time randomized. On 8 dates of an annual flu shot clinic at the San Francisco General Hospital, patients were offered flu shots as usual (control group) and on 9 other dates, patients were offered both flu shots and FOBT kits (intervention group). RESULTS The study included 514 patients aged 50 to 79 years, with 246 in the control group and 268 in the intervention group. At the conclusion of flu season, FOBT screening rates increased by 4.4 percentage points from 52.9% at baseline to 57.3% (P = .07) in the control group, and increased by 29.8 percentage points from 54.5% to 84.3% (P <.001) in the intervention group, with the change among intervention participants 25.4 percentage points greater than among control participants (P value for change difference <.001). Among patients initially due for CRCS, 20.7% in the control group and 68.0% in the intervention group were up-to-date at the conclusion of the study (P <.001). In multivariate analyses, the odds ratio for becoming up-to-date with screening in the intervention group (vs the control group) was 11.3 (95% CI, 5.8–22.0). CONCLUSIONS Offering FOBT kits during flu shot clinics dramatically increased the CRCS rate for flu shot clinic attendees. Pairing home FOBT kits with annual flu shots may be a useful strategy to improve CRCS rates in other primary care or public health settings. PMID:19139445

Dose-Dependent Negative Effects of Prior Multiple Vaccinations against Influenza A and Influenza B among School Children: A Study of Kamigoto Island in Japan during the 2011/12, 2012/13 and 2013/14 Influenza Seasons.

PubMed

Saito, Nobuo; Komori, Kazuhiro; Suzuki, Motoi; Kishikawa, Takayuki; Yasaka, Takahiro; Ariyoshi, Koya

2018-03-08

We investigated the negative effects of prior multiple vaccinations on influenza vaccine effectiveness (VE) and analysed the association of VE with prior vaccine doses. Patients aged 9-18 years presenting with influenza-like illness at a community hospital on a Japanese remote island during the 2011/12, 2012/13 and 2013/14 seasons were tested for influenza using a rapid diagnostic test (RDT). A test-negative case-control study design was used to estimate the VEs of trivalent inactivated influenza vaccine (TIV). Histories of vaccination and medically-attended influenza (MA-flu) A and B during three previous seasons were collected from registry systems. VE was calculated using multi-level mixed-effects logistic regression models adjusted for the history of RDT-confirmed MA-flu. During three influenza seasons, 1668 influenza-like illness episodes were analysed, including 421 and 358 episodes of MA-fluA and MA-fluB, respectively. The adjusted VE yielded significant dose-dependent attenuations by prior vaccinations against both MA-fluA [0 doses during previous three seasons: 96% (95% CI: 69%-100%), 1 dose: 48% (-7% to 74%), 2 doses: 52% (11%-74%), 3 doses: 21% (-25% to 51%); P for trend <0.05] and MA-fluB [0 doses: 66% (-5% to 89%), 1 dose: 48% (-14% to 76%), 2 doses: 34% (-33% to 67%), 3 doses: -7% (-83% to 37%); P for trend <0.05]. After excluding episodes of MA-flu during prior three seasons, similar trends were observed. Repeated previous vaccinations over multiple seasons had significant dose-dependent negative impacts on VE against both MA-fluA and MA-fluB. Further studies to confirm this finding are necessary.

Human Survivors of Disease Outbreaks Caused by Ebola or Marburg Virus Exhibit Cross-Reactive and Long-Lived Antibody Responses.

PubMed

Natesan, Mohan; Jensen, Stig M; Keasey, Sarah L; Kamata, Teddy; Kuehne, Ana I; Stonier, Spencer W; Lutwama, Julius Julian; Lobel, Leslie; Dye, John M; Ulrich, Robert G

2016-08-01

A detailed understanding of serological immune responses to Ebola and Marburg virus infections will facilitate the development of effective diagnostic methods, therapeutics, and vaccines. We examined antibodies from Ebola or Marburg survivors 1 to 14 years after recovery from disease, by using a microarray that displayed recombinant nucleoprotein (NP), viral protein 40 (VP40), envelope glycoprotein (GP), and inactivated whole virions from six species of filoviruses. All three outbreak cohorts exhibited significant antibody responses to antigens from the original infecting species and a pattern of additional filoviruses that varied by outbreak. NP was the most cross-reactive antigen, while GP was the most specific. Antibodies from survivors of infections by Marburg marburgvirus (MARV) species were least cross-reactive, while those from survivors of infections by Sudan virus (SUDV) species exhibited the highest cross-reactivity. Based on results revealed by the protein microarray, persistent levels of antibodies to GP, NP, and VP40 were maintained for up to 14 years after infection, and survival of infection caused by one species imparted cross-reactive antibody responses to other filoviruses. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

[The military role in a flu pandemic].

PubMed

Molina Hazan, Vered; Balicer, Ran D; Groto, Itamar; Zarka, Salman; Ankol, Omer E; Bar-Zeev, Yael; Levine, Hagai; Ash, Nachman

2010-01-01

Pandemic influenza is a major challenge to emergency preparedness agencies and health systems throughout the world. It requires preparation for a situation of widespread morbidity due to flu and its complications which will lead to a huge burden on the health system in the community and in hospitals, and work absenteeism, also among health care personnel. This may require major involvement of the army in both preparedness and measures to be taken to tackle such an event. This article reviews the different roles armies could take in such a crisis, and presents the Israeli test case. Defense systems are characterized by a number of attributes that may be major advantages during pandemic influenza: crisis management capacities, ability to deal with varied tasks in sub-optimal conditions, logistic resources (fuel, food and water), widespread deployment in the country and sometimes in the world, and the ability to activate people in risky situations, even against their will. The army roles during pandemic outbreaks could include: taking national and regional command of the event, assigning workforce for essential civilian missions, use of logistic and military resources, maintaining public order and implementing public health measures such as isolation and quarantine. In addition, the army must continue its primary role of maintaining the security and guarding the borders of the state, especially in times of global geopolitical changes due to pandemic. Since March 2009, the influenza A/H1N1 2009 virus spread throughout the world, leading the WHO to declare a state of pandemic influenza. According to Israeli preparedness plans, the management of the event was supposed to pass to the defense system. However, due to the moderate severity of the illness, it was decided to leave the management of the event to the health system. In view of the necessity of maintaining military combat capabilities, and the possibility of outbreaks in combat units, which actually occurred, the Israel Defense Forces (IDF) policy for the pandemic was stricter than the policy of the Ministry of Health. Defense systems in Israel and the world should prepare, the sooner the better, for the possibility of a worse pandemic, in which the army may take a major role, especially since regular life in the country, in such a case, would be disturbed.

Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions

MedlinePlus

... contain: the trivalent flu shot (two A and one B viruses), and the quadrivalent flu shot (two A and two B viruses). Any of these can be used, without preference for one over the other. Children 6 months to 8 ...

Your baby and the flu

MedlinePlus

... a live, weakened virus instead of a dead one like the flu shot. It is approved for healthy children over 2 ... fever for a day or two after the shot. If more severe symptoms ... likely to get a severe case of the flu. It is hard to predict ...

Clinical accuracy of a PLEX-ID flu device for simultaneous detection and identification of influenza viruses A and B.

PubMed

Tang, Yi-Wei; Lowery, Kristin S; Valsamakis, Alexandra; Schaefer, Virginia C; Chappell, James D; White-Abell, Jill; Quinn, Criziel D; Li, Haijing; Washington, Cicely A; Cromwell, Jenna; Giamanco, Chantel M; Forman, Michael; Holden, Jeffery; Rothman, Richard E; Parker, Michelle L; Ortenberg, Elaine V; Zhang, Lei; Lin, Yea-Lin; Gaydos, Charlotte A

2013-01-01

Respiratory tract infections caused by influenza A and B viruses often present nonspecifically, and a rapid, high-throughput laboratory technique that can identify influenza viruses is clinically and epidemiologically desirable. The PLEX-ID Flu assay (Abbott Molecular Inc., Des Plaines, IL) incorporates multilocus PCR and electrospray ionization-mass spectrometry to detect and differentiate influenza A 2009 H1N1 (H1N1-p), seasonal H1N1 (H1N1-s), influenza A H3N2, and influenza B viruses in nasopharyngeal swab (NPS) specimens. The clinical performance characteristics of the PLEX-ID Flu assay in symptomatic patients were determined in this multicenter trial. A total of 2,617 prospectively and retrospectively collected NPS specimens from patients with influenza-like illness between February 2008 and 28 May 2010 were eligible for inclusion in the study. Each specimen was tested in parallel by the PLEX-ID Flu assay and by the Prodesse ProFLU+ assay (Prodesse Inc., Madison, WI), to detect influenza A and B viruses. Specimens testing positive for influenza A virus by ProFLU+ were subtyped as H1N1-p, H1N1-s, or H3N2 by using the ProFAST+ assay (Gen-Probe Prodesse Inc.). The reproducibility of the PLEX-ID Flu assay ranged from 98.3 to 100.0%, as determined by testing a nine-specimen panel at three clinical sites on each of 5 days. Positive percent agreements (PPAs) and negative percent agreements (NPAs) of the PLEX-ID Flu assay were 94.5% and 99.0% for influenza A virus and 96.0% and 99.9% for influenza B virus, respectively. For the influenza A virus subtyping characterization, the PLEX-ID Flu assay had PPAs and NPAs of 98.3% and 97.5% for H1N1-p, 88.6% and 100.0% for H1N1-s, and 98.0% and 99.9% for H3N2, respectively. The overall agreements between the PLEX-ID and Prodesse ProFLU+/ProFAST+ assays were 97.1 to 100.0%. Bidirectional Sanger sequencing analysis revealed that 87.5% of 96 discrepant results between the PLEX-ID Flu and ProFLU+/ProFAST+ assays were found upon influenza A virus detection and H1N1-p subtyping. The PLEX-ID Flu assay demonstrated a high level of accuracy for the simultaneous detection and identification of influenza A and B viruses in patient specimens, providing a new laboratory tool for the rapid diagnosis and management of influenza A and B virus infections.

A mixed methods study to understand patient expectations for antibiotics for an upper respiratory tract infection.

PubMed

Gaarslev, Christina; Yee, Melissa; Chan, Georgi; Fletcher-Lartey, Stephanie; Khan, Rabia

2016-01-01

Antimicrobial resistance is a public health challenge supplemented by inappropriate prescribing, especially for an upper respiratory tract infection in primary care. Patient/carer expectations have been identified as one of the main drivers for inappropriate antibiotics prescribing by primary care physicians. The aim of this study was to understand who is more likely to expect an antibiotic for an upper respiratory tract infection from their doctor and the reasons underlying it. This study used a sequential mixed methods approach: a nationally representative cross sectional survey ( n  = 1509) and four focus groups. The outcome of interest was expectation and demand for an antibiotic from a doctor when presenting with a cold or flu. The study found 19.5 % of survey respondents reported that they would expect the doctor to prescribe antibiotics for a cold or flu. People younger than 65 years of age, those who never attended university and those speaking a language other than English at home were more likely to expect or demand antibiotics for a cold or flu. People who knew that 'antibiotics don't kill viruses' and agreed that 'taking an antibiotic when one is not needed means they won't work in the future' were less likely to expect or demand antibiotics. The main reasons for expecting antibiotics were believing that antibiotics are an effective treatment for a cold or flu and that they shortened the duration and potential deterioration of their illness. The secondary reason centered around the value or return on investment for visiting a doctor when feeling unwell. Our study found that patients do not appear to feel they have a sufficiently strong incentive to consider the impact of their immediate use of antibiotics on antimicrobial resistance. The issue of antibiotic resistance needs to be explained and reframed as a more immediate health issue with dire consequences to ensure the success of future health campaigns.

A Cellular Automaton Framework for Infectious Disease Spread Simulation

PubMed Central

Pfeifer, Bernhard; Kugler, Karl; Tejada, Maria M; Baumgartner, Christian; Seger, Michael; Osl, Melanie; Netzer, Michael; Handler, Michael; Dander, Andreas; Wurz, Manfred; Graber, Armin; Tilg, Bernhard

2008-01-01

In this paper, a cellular automaton framework for processing the spatiotemporal spread of infectious diseases is presented. The developed environment simulates and visualizes how infectious diseases might spread, and hence provides a powerful instrument for health care organizations to generate disease prevention and contingency plans. In this study, the outbreak of an avian flu like virus was modeled in the state of Tyrol, and various scenarios such as quarantine, effect of different medications on viral spread and changes of social behavior were simulated. The proposed framework is implemented using the programming language Java. The set up of the simulation environment requires specification of the disease parameters and the geographical information using a population density colored map, enriched with demographic data. The results of the numerical simulations and the analysis of the computed parameters will be used to get a deeper understanding of how the disease spreading mechanisms work, and how to protect the population from contracting the disease. Strategies for optimization of medical treatment and vaccination regimens will also be investigated using our cellular automaton framework. In this study, six different scenarios were simulated. It showed that geographical barriers may help to slow down the spread of an infectious disease, however, when an aggressive and deadly communicable disease spreads, only quarantine and controlled medical treatment are able to stop the outbreak, if at all. PMID:19415136

Choose your menu wisely: cuisine-associated food-poisoning risks in restaurants in England and Wales.

PubMed

Gormley, F J; Rawal, N; Little, C L

2012-06-01

The food service sector continues to be the most common setting for reported foodborne disease outbreaks in England and Wales. Using restaurant-associated foodborne outbreaks reported in England and Wales from 1992 to 2009, cuisine-specific risk factors were examined. Of 677 restaurant outbreaks, there were 11 795 people affected, 491 hospitalizations, and seven deaths; and Chinese, Indian, British and Italian cuisines were the most commonly implicated (26%, 16%, 13% and 10%, respectively). Salmonella spp. accounted for most outbreaks of all cuisine types, and particularly Chinese (76%, 133/175) and Italian (55%, 38/69). Poultry meat was the most frequently implicated food vehicle in outbreaks associated with Indian (30%), Chinese (21%), and British (18%) cuisines while for Italian cuisine, desserts and cakes were more frequently implicated (33%). Rice dishes were also a common outbreak food vehicle in those restaurants serving Chinese (22%) and Indian (16%) cuisine. Cross-contamination was the biggest contributory factor associated with Chinese (46%), British (33%) and Indian (30%) cuisines whereas inadequate cooking (38%) and use of raw shell eggs in lightly cooked or uncooked food (35%) were more often associated with Italian cuisine. Over the surveillance period, the proportion of Salmonella Enteritidis PT4 outbreaks in restaurants serving Chinese cuisine significantly decreased (P<0.0001) and this was mirrored by an increase in S. Enteritidis non-PT4 outbreaks (P<0.0001). Despite this change in proportion, contributory factors such as cross-contamination have continued to cause outbreaks throughout the 18 years. The results show that by stratifying the risks associated with restaurants by cuisine type, specific evidence of food control failures can be used to target foodborne illness reduction strategies.

Low-dose flutamide-metformin therapy for hyperinsulinemic hyperandrogenism in non-obese adolescents and women.

PubMed

Ibáñez, Lourdes; de Zegher, Francis

2006-01-01

Polycystic ovary syndrome (PCOS) is a variable disorder that is characterized in adolescents and young women by a broad spectrum of anomalies, including hyperandrogenemia, insulin resistance, dyslipidemia, body adiposity and low-grade inflammation. At present, there is no approved therapy for PCOS. Recent studies indicate that a low-dose combination of flutamide (Flu; a generic androgen-receptor blocker) and metformin (Met; a generic insulin-sensitizer) normalizes the adolescent PCOS spectrum more than an oral contraceptive (OC); in young women, the PCOS spectrum was found to be more normalized by OC plus Flu-Met than by OC alone. Within the pathophysiological cascade of PCOS, Flu-Met seems to counter upstream anomalies like hyperinsulinemia or hyperandrogenism, thereby preventing or reversing downstream effects. In contrast, an OC essentially masks downstream symptoms like hirsutism, acne or irregular menses, whereas the upstream aberrations remain unaltered or may even be worsened. The available experience with Flu-Met is limited but promising. We emphasize that Flu-Met may (as part of its efficacy) induce ovulation but is contra-indicated post-conception because of potential embryotoxicity; therefore, it seems wise to combine Flu-Met with an oral or a transdermal oestro-progestagen or with a non-endocrine method of contraception. May this update prompt further research into Flu-Met's therapeutic potential in patients with PCOS. Until the abovementioned effects have been broadly confirmed, Flu-Met should not be regarded as a standard therapy for widespread clinical practice.

Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study.

PubMed

Timpka, Toomas; Spreco, Armin; Dahlström, Örjan; Eriksson, Olle; Gursky, Elin; Ekberg, Joakim; Blomqvist, Eva; Strömgren, Magnus; Karlsson, David; Eriksson, Henrik; Nyce, James; Hinkula, Jorma; Holm, Einar

2014-04-28

There is abundant global interest in using syndromic data from population-wide health information systems--referred to as eHealth resources--to improve infectious disease surveillance. Recently, the necessity for these systems to achieve two potentially conflicting requirements has been emphasized. First, they must be evidence-based; second, they must be adjusted for the diversity of populations, lifestyles, and environments. The primary objective was to examine correlations between data from Google Flu Trends (GFT), computer-supported telenursing centers, health service websites, and influenza case rates during seasonal and pandemic influenza outbreaks. The secondary objective was to investigate associations between eHealth data, media coverage, and the interaction between circulating influenza strain(s) and the age-related population immunity. An open cohort design was used for a five-year study in a Swedish county (population 427,000). Syndromic eHealth data were collected from GFT, telenursing call centers, and local health service website visits at page level. Data on mass media coverage of influenza was collected from the major regional newspaper. The performance of eHealth data in surveillance was measured by correlation effect size and time lag to clinically diagnosed influenza cases. Local media coverage data and influenza case rates showed correlations with large effect sizes only for the influenza A (A) pH1N1 outbreak in 2009 (r=.74, 95% CI .42-.90; P<.001) and the severe seasonal A H3N2 outbreak in 2011-2012 (r=.79, 95% CI .42-.93; P=.001), with media coverage preceding case rates with one week. Correlations between GFT and influenza case data showed large effect sizes for all outbreaks, the largest being the seasonal A H3N2 outbreak in 2008-2009 (r=.96, 95% CI .88-.99; P<.001). The preceding time lag decreased from two weeks during the first outbreaks to one week from the 2009 A pH1N1 pandemic. Telenursing data and influenza case data showed correlations with large effect sizes for all outbreaks after the seasonal B and A H1 outbreak in 2007-2008, with a time lag decreasing from two weeks for the seasonal A H3N2 outbreak in 2008-2009 (r=.95, 95% CI .82-.98; P<.001) to none for the A p H1N1 outbreak in 2009 (r=.84, 95% CI .62-.94; P<.001). Large effect sizes were also observed between website visits and influenza case data. Correlations between the eHealth data and influenza case rates in a Swedish county showed large effect sizes throughout a five-year period, while the time lag between signals in eHealth data and influenza rates changed. Further research is needed on analytic methods for adjusting eHealth surveillance systems to shifts in media coverage and to variations in age-group related immunity between virus strains. The results can be used to inform the development of alert-generating eHealth surveillance systems that can be subject for prospective evaluations in routine public health practice.

Performance of eHealth Data Sources in Local Influenza Surveillance: A 5-Year Open Cohort Study

PubMed Central

Spreco, Armin; Dahlström, Örjan; Eriksson, Olle; Gursky, Elin; Ekberg, Joakim; Blomqvist, Eva; Strömgren, Magnus; Karlsson, David; Eriksson, Henrik; Nyce, James; Hinkula, Jorma; Holm, Einar

2014-01-01

Background There is abundant global interest in using syndromic data from population-wide health information systems—referred to as eHealth resources—to improve infectious disease surveillance. Recently, the necessity for these systems to achieve two potentially conflicting requirements has been emphasized. First, they must be evidence-based; second, they must be adjusted for the diversity of populations, lifestyles, and environments. Objective The primary objective was to examine correlations between data from Google Flu Trends (GFT), computer-supported telenursing centers, health service websites, and influenza case rates during seasonal and pandemic influenza outbreaks. The secondary objective was to investigate associations between eHealth data, media coverage, and the interaction between circulating influenza strain(s) and the age-related population immunity. Methods An open cohort design was used for a five-year study in a Swedish county (population 427,000). Syndromic eHealth data were collected from GFT, telenursing call centers, and local health service website visits at page level. Data on mass media coverage of influenza was collected from the major regional newspaper. The performance of eHealth data in surveillance was measured by correlation effect size and time lag to clinically diagnosed influenza cases. Results Local media coverage data and influenza case rates showed correlations with large effect sizes only for the influenza A (A) pH1N1 outbreak in 2009 (r=.74, 95% CI .42-.90; P<.001) and the severe seasonal A H3N2 outbreak in 2011-2012 (r=.79, 95% CI .42-.93; P=.001), with media coverage preceding case rates with one week. Correlations between GFT and influenza case data showed large effect sizes for all outbreaks, the largest being the seasonal A H3N2 outbreak in 2008-2009 (r=.96, 95% CI .88-.99; P<.001). The preceding time lag decreased from two weeks during the first outbreaks to one week from the 2009 A pH1N1 pandemic. Telenursing data and influenza case data showed correlations with large effect sizes for all outbreaks after the seasonal B and A H1 outbreak in 2007-2008, with a time lag decreasing from two weeks for the seasonal A H3N2 outbreak in 2008-2009 (r=.95, 95% CI .82-.98; P<.001) to none for the A p H1N1 outbreak in 2009 (r=.84, 95% CI .62-.94; P<.001). Large effect sizes were also observed between website visits and influenza case data. Conclusions Correlations between the eHealth data and influenza case rates in a Swedish county showed large effect sizes throughout a five-year period, while the time lag between signals in eHealth data and influenza rates changed. Further research is needed on analytic methods for adjusting eHealth surveillance systems to shifts in media coverage and to variations in age-group related immunity between virus strains. The results can be used to inform the development of alert-generating eHealth surveillance systems that can be subject for prospective evaluations in routine public health practice. PMID:24776527

Prospective and retrospective evaluation of the Cepheid Xpert® Flu/RSV XC assay for rapid detection of influenza A, influenza B, and respiratory syncytial virus.

PubMed

Salez, Nicolas; Nougairede, Antoine; Ninove, Laetitia; Zandotti, Christine; de Lamballerie, Xavier; Charrel, Remi N

2015-04-01

A total of 281 clinical specimens (nasal swabs and nasopharyngeal aspirates) were tested with the Xpert® Flu/RSV XC. The results were compared to those obtained with the real-time retro transcriptase-polymerase chain reaction assays routinely used in our laboratory. The Xpert® Flu/RSV XC showed sensitivity/specificity of 97.8%/100% and 97.9%/100% for flu and respiratory syncytial virus, respectively. Copyright © 2015 Elsevier Inc. All rights reserved.

Chemoenzymatic Site-Specific Labeling of Influenza Glycoproteins as a Tool to Observe Virus Budding in Real Time

PubMed Central

Ploegh, Hidde L.

2012-01-01

The influenza virus uses the hemagglutinin (HA) and neuraminidase (NA) glycoproteins to interact with and infect host cells. While biochemical and microscopic methods allow examination of the early steps in flu infection, the genesis of progeny virions has been more difficult to follow, mainly because of difficulties inherent in fluorescent labeling of flu proteins in a manner compatible with live cell imaging. We here apply sortagging as a chemoenzymatic approach to label genetically modified but infectious flu and track the flu glycoproteins during the course of infection. This method cleanly distinguishes influenza glycoproteins from host glycoproteins and so can be used to assess the behavior of HA or NA biochemically and to observe the flu glycoproteins directly by live cell imaging. PMID:22457626

Control Measures Used during Lymphogranuloma Venereum Outbreak, Europe

PubMed Central

Hulscher, Marlies E.J.L.; Vos, Dieuwke; van de Laar, Marita J.W.; Fenton, Kevin A.; van Steenbergen, Jim E.; van der Meer, Jos W.M.; Grol, Richard P.T.M.

2008-01-01

To assess the response to the reemergence of lymphogranuloma venereum, we conducted a cross-sectional survey by administering a structured questionnaire to representatives from 26 European countries. Responses were received from 18 countries. The ability to respond quickly and the measures used for outbreak detection and control varied. Evidence-based criteria were not consistently used to develop recommendations. We did not develop criteria to determine the effectiveness of the recommendations. The degree of preparedness for an unexpected outbreak, as well as the ability of countries to respond quickly to alerts, varied, which indicates weaknesses in the ability to control an outbreak. More guidance is needed to implement and evaluate control measures used during international outbreaks. PMID:18394274

Self-Mating in the Definitive Host Potentiates Clonal Outbreaks of the Apicomplexan Parasites Sarcocystis neurona and Toxoplasma gondii

PubMed Central

Wendte, Jered M.; Miller, Melissa A.; Lambourn, Dyanna M.; Magargal, Spencer L.; Jessup, David A.; Grigg, Michael E.

2010-01-01

Tissue-encysting coccidia, including Toxoplasma gondii and Sarcocystis neurona, are heterogamous parasites with sexual and asexual life stages in definitive and intermediate hosts, respectively. During its sexual life stage, T. gondii reproduces either by genetic out-crossing or via clonal amplification of a single strain through self-mating. Out-crossing has been experimentally verified as a potent mechanism capable of producing offspring possessing a range of adaptive and virulence potentials. In contrast, selfing and other life history traits, such as asexual expansion of tissue-cysts by oral transmission among intermediate hosts, have been proposed to explain the genetic basis for the clonal population structure of T. gondii. In this study, we investigated the contributing roles self-mating and sexual recombination play in nature to maintain clonal population structures and produce or expand parasite clones capable of causing disease epidemics for two tissue encysting parasites. We applied high-resolution genotyping against strains isolated from a T. gondii waterborne outbreak that caused symptomatic disease in 155 immune-competent people in Brazil and a S. neurona outbreak that resulted in a mass mortality event in Southern sea otters. In both cases, a single, genetically distinct clone was found infecting outbreak-exposed individuals. Furthermore, the T. gondii outbreak clone was one of several apparently recombinant progeny recovered from the local environment. Since oocysts or sporocysts were the infectious form implicated in each outbreak, the expansion of the epidemic clone can be explained by self-mating. The results also show that out-crossing preceded selfing to produce the virulent T. gondii clone. For the tissue encysting coccidia, self-mating exists as a key adaptation potentiating the epidemic expansion and transmission of newly emerged parasite clones that can profoundly shape parasite population genetic structures or cause devastating disease outbreaks. PMID:21203443

Vaccination against seasonal flu in Switzerland: The indecision of pregnant women encouraged by healthcare professionals.

PubMed

Schindler, M; Blanchard-Rohner, G; Meier, S; Martinez de Tejada, B; Siegrist, C-A; Burton-Jeangros, C

2012-12-01

The recommendation for seasonal flu immunization from the second trimester of pregnancy, adopted in summer 2010 in Switzerland, is situated within a social context characterized by reluctance toward some vaccinations, a relatively low vaccination coverage against flu in the general population, and still heated debates fuelled by vaccination campaigns organized around the A(H1N1)pdm09 flu pandemic in winter 2009 to 2010. This study examines Swiss pregnant women's representations of the risks associated with seasonal flu and its vaccination. Semi-structured interviews were conducted with 29 women, while in the maternity unit in March 2011, 3 to 5 days after giving birth. The interviews addressed the risks associated with flu, modes of protection, motivations for, and obstacles to vaccination. The interviewees did not show major preoccupations regarding seasonal flu and they tended to distance themselves from the at-risk status. They did not directly challenge seasonal flu immunization; however, they were reluctant to do it. Their attitudes were supported by their personal experience and the experience of their social networks. Healthcare professionals, particularly medical doctors, gave very little direction, or even did not raise the issue with them. Between the rather moderate positions of those who are against vaccination and those who support it, an intermediate grey zone, characterized by hesitation, was observed. Furthermore, the indecision of pregnant women is reinforced by doubts among the persons they are close to and also among the professionals they met during their pregnancy. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study.

PubMed

Alsan, Marcella; Morden, Nancy E; Gottlieb, Joshua D; Zhou, Weiping; Skinner, Jonathan

2015-12-01

Excessive antibiotic use in cold and flu season is costly and contributes to antibiotic resistance. The study objective was to develop an index of excessive antibiotic use in cold and flu season and determine its correlation with other indicators of prescribing quality. We included Medicare beneficiaries in the 40% random sample denominator file continuously enrolled in fee-for-service benefits for 2010 or 2011 (7,961,201 person-years) and extracted data on prescription fills for oral antibiotics that treat respiratory pathogens. We collapsed the data to the state level so they could be merged with monthly flu activity data from the Centers for Disease Control and Prevention. Linear regression, adjusted for state-specific mean antibiotic use and demographic characteristics, was used to estimate how antibiotic prescribing responded to state-specific flu activity. Flu-activity associated antibiotic use varied substantially across states-lowest in Vermont and Connecticut, highest in Mississippi and Florida. There was a robust positive correlation between flu-activity associated prescribing and use of medications that often cause adverse events in the elderly (0.755; P<0.001), whereas there was a strong negative correlation with beta-blocker use after a myocardial infarction (-0.413; P=0.003). Adjusted flu-activity associated antibiotic use was positively correlated with prescribing high-risk medications to the elderly and negatively correlated with beta-blocker use after myocardial infarction. These findings suggest that excessive antibiotic use reflects low-quality prescribing. They imply that practice and policy solutions should go beyond narrow, antibiotic specific, approaches to encourage evidence-based prescribing for the elderly Medicare population.

Journalism as health education: media coverage of a nonbranded pharma web site.

PubMed

Mackert, Michael; Love, Brad; Holton, Avery E

2011-03-01

As healthcare consumers increasingly use the Internet as a source for health information, direct-to-consumer (DTC) prescription drug advertising online merits additional attention. The purpose of this research was to investigate media coverage of the joint marketing program linking the movie Happy Feet and the nonbranded disease education Web site FluFacts-a resource from Tamiflu flu treatment manufacturer Roche Laboratories Inc. Twenty-nine articles (n = 29) were found covering the Happy Feet-FluFacts marketing campaign. A coding guide was developed to assess elements of the articles, including those common in the sample and information that ideally would be included in these articles. Two coders independently coded the articles, achieving intercoder agreement of κ = 0.98 before resolving disagreements to arrive at a final dataset. The majority of articles reported that Roche operated FluFacts (51.7%) and mentioned the product Tamiflu (58.6%). Almost half (48.3%) reported FluFacts was an educational resource; yet, no articles mentioned other antiviral medications or nonmedical options for preventing the flu. Almost a quarter of the articles (24.1%) provided a call to action-telling readers to visit FluFacts or providing a link for them to do so. Findings suggest that journalists' coverage of this novel campaign-likely one of the goals of the campaign-helped spread the message of the Happy Feet-FluFacts relationship, often omitting other useful health information. Additional research is needed to better understand online DTC campaigns and how consumers react to these campaigns and resulting media coverage and to inform the policymakers' decisions regarding DTC advertising online.

Comparison of the social contact patterns among school-age children in specific seasons, locations, and times.

PubMed

Luh, Dih-Ling; You, Zhi-Shin; Chen, Szu-Chieh

2016-03-01

Social contact patterns among school-age children play an important role in the epidemiology of infectious disease. This study explored how people interact in specific seasons (flu season and non-flu season), environmental settings (city and county), and times (weekend and weekday). We conducted a survey of junior high school students (grades 7-8) using an established questionnaire during May-June 2013 and December 2013. The sample size with pair-wise comparisons for the times (weekday/weekend) and stratification by location and seasons were 75, 87, 105 and 106, respectively. The sample size with pair-wise comparisons for the seasons (flu/non-flu) and stratification by location were 54 and 83, respectively. Conversation and skin-to-skin contact behaviors were surveyed through diary-based questionnaires, of which 665 valid questionnaires were returned. There was no difference in the number of contacts during the flu and non-flu seasons, with averages of 16.3 (S.D.=12.9) and 14.6 (S.D.=9.5) people, respectively. However, statistical analysis showed that the average number of contacts in Taichung City and Yilan County were significantly different (p<0.001). Weekdays were associated with 23-28% more contacts than weekend days during both the non-flu and flu seasons (p<0.001) (Wilcoxon signed-rank test). Our work has important implications for the dynamic modeling of infectious diseases and performance analysis of human contact numbers and contact characteristics for schoolchildren in specific seasons, places, and times. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Genetic Characterization of Feline Leukemia Virus from Florida Panthers

PubMed Central

Brown, Meredith A.; Cunningham, Mark W.; Roca, Alfred L.; Troyer, Jennifer L.; Johnson, Warren E.

2008-01-01

From 2002 through 2005, an outbreak of feline leukemia virus (FeLV) occurred in Florida panthers (Puma concolor coryi). Clinical signs included lymphadenopathy, anemia, septicemia, and weight loss; 5 panthers died. Not associated with FeLV outcome were the genetic heritage of the panthers (pure Florida vs. Texas/Florida crosses) and co-infection with feline immunodeficiency virus. Genetic analysis of panther FeLV, designated FeLV-Pco, determined that the outbreak likely came from 1 cross-species transmission from a domestic cat. The FeLV-Pco virus was closely related to the domestic cat exogenous FeLV-A subgroup in lacking recombinant segments derived from endogenous FeLV. FeLV-Pco sequences were most similar to the well-characterized FeLV-945 strain, which is highly virulent and strongly pathogenic in domestic cats because of unique long terminal repeat and envelope sequences. These unique features may also account for the severity of the outbreak after cross-species transmission to the panther. PMID:18258118

Genetic characterization of feline leukemia virus from Florida panthers.

PubMed

Brown, Meredith A; Cunningham, Mark W; Roca, Alfred L; Troyer, Jennifer L; Johnson, Warren E; O'Brien, Stephen J

2008-02-01

From 2002 through 2005, an outbreak of feline leukemia virus (FeLV) occurred in Florida panthers (Puma concolor coryi). Clinical signs included lymphadenopathy, anemia, septicemia, and weight loss; 5 panthers died. Not associated with FeLV outcome were the genetic heritage of the panthers (pure Florida vs. Texas/Florida crosses) and co-infection with feline immunodeficiency virus. Genetic analysis of panther FeLV, designated FeLV-Pco, determined that the outbreak likely came from 1 cross-species transmission from a domestic cat. The FeLV-Pco virus was closely related to the domestic cat exogenous FeLV-A subgroup in lacking recombinant segments derived from endogenous FeLV. FeLV-Pco sequences were most similar to the well-characterized FeLV-945 strain, which is highly virulent and strongly pathogenic in domestic cats because of unique long terminal repeat and envelope sequences. These unique features may also account for the severity of the outbreak after cross-species transmission to the panther.

Subregional Nowcasts of Seasonal Influenza Using Search Trends.

PubMed

Kandula, Sasikiran; Hsu, Daniel; Shaman, Jeffrey

2017-11-06

Limiting the adverse effects of seasonal influenza outbreaks at state or city level requires close monitoring of localized outbreaks and reliable forecasts of their progression. Whereas forecasting models for influenza or influenza-like illness (ILI) are becoming increasingly available, their applicability to localized outbreaks is limited by the nonavailability of real-time observations of the current outbreak state at local scales. Surveillance data collected by various health departments are widely accepted as the reference standard for estimating the state of outbreaks, and in the absence of surveillance data, nowcast proxies built using Web-based activities such as search engine queries, tweets, and access of health-related webpages can be useful. Nowcast estimates of state and municipal ILI were previously published by Google Flu Trends (GFT); however, validations of these estimates were seldom reported. The aim of this study was to develop and validate models to nowcast ILI at subregional geographic scales. We built nowcast models based on autoregressive (autoregressive integrated moving average; ARIMA) and supervised regression methods (Random forests) at the US state level using regional weighted ILI and Web-based search activity derived from Google's Extended Trends application programming interface. We validated the performance of these methods using actual surveillance data for the 50 states across six seasons. We also built state-level nowcast models using state-level estimates of ILI and compared the accuracy of these estimates with the estimates of the regional models extrapolated to the state level and with the nowcast estimates published by GFT. Models built using regional ILI extrapolated to state level had a median correlation of 0.84 (interquartile range: 0.74-0.91) and a median root mean square error (RMSE) of 1.01 (IQR: 0.74-1.50), with noticeable variability across seasons and by state population size. Model forms that hypothesize the availability of timely state-level surveillance data show significantly lower errors of 0.83 (0.55-0.23). Compared with GFT, the latter model forms have lower errors but also lower correlation. These results suggest that the proposed methods may be an alternative to the discontinued GFT and that further improvements in the quality of subregional nowcasts may require increased access to more finely resolved surveillance data. ©Sasikiran Kandula, Daniel Hsu, Jeffrey Shaman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.11.2017.

Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease.

PubMed

Underhill, R A

2015-12-01

The etiology of myalgic encephalomyelitis also known as chronic fatigue syndrome or ME/CFS has not been established. Controversies exist over whether it is an organic disease or a psychological disorder and even the existence of ME/CFS as a disease entity is sometimes denied. Suggested causal hypotheses have included psychosomatic disorders, infectious agents, immune dysfunctions, autoimmunity, metabolic disturbances, toxins and inherited genetic factors. Clinical, immunological and epidemiological evidence supports the hypothesis that: ME/CFS is an infectious disease; the causal pathogen persists in patients; the pathogen can be transmitted by casual contact; host factors determine susceptibility to the illness; and there is a population of healthy carriers, who may be able to shed the pathogen. ME/CFS is endemic globally as sporadic cases and occasional cluster outbreaks (epidemics). Cluster outbreaks imply an infectious agent. An abrupt flu-like onset resembling an infectious illness occurs in outbreak patients and many sporadic patients. Immune responses in sporadic patients resemble immune responses in other infectious diseases. Contagion is shown by finding secondary cases in outbreaks, and suggested by a higher prevalence of ME/CFS in sporadic patients' genetically unrelated close contacts (spouses/partners) than the community. Abortive cases, sub-clinical cases, and carrier state individuals were found in outbreaks. The chronic phase of ME/CFS does not appear to be particularly infective. Some healthy patient-contacts show immune responses similar to patients' immune responses, suggesting exposure to the same antigen (a pathogen). The chronicity of symptoms and of immune system changes and the occurrence of secondary cases suggest persistence of a causal pathogen. Risk factors which predispose to developing ME/CFS are: a close family member with ME/CFS; inherited genetic factors; female gender; age; rest/activity; previous exposure to stress or toxins; various infectious diseases preceding the onset of ME/CFS; and occupational exposure of health care professionals. The hypothesis implies that ME/CFS patients should not donate blood or tissue and usual precautions should be taken when handling patients' blood and tissue. No known pathogen has been shown to cause ME/CFS. Confirmation of the hypothesis requires identification of a causal pathogen. Research should focus on a search for unknown and known pathogens. Finding a causal pathogen could assist with diagnosis; help find a biomarker; enable the development of anti-microbial treatments; suggest preventive measures; explain pathophysiological findings; and reassure patients about the validity of their symptoms.

E-Learning's Potential Scrutinized in Flu Crisis

ERIC Educational Resources Information Center

Ash, Katie; Davis, Michelle R.

2009-01-01

The closing of hundreds of U.S. schools in recent weeks because of concerns about swine flu underscores the need for administrators to make plans for continuing their students' education during any extended shutdown, emergency experts and federal officials say. Fears about a severe flu pandemic had eased as of late last week, but experts say…

Managing a Bird Flu Pandemic

ERIC Educational Resources Information Center

Stover, Del

2006-01-01

Concern about a possible bird flu pandemic has grown in the medical community with the spread of the avian flu virus around the globe. Health officials say there is no immediate threat but add that an influenza pandemic occurs every 30 to 40 years, and prudence demands planning now. That planning will increasingly involve local school officials,…

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

Time delays in the response to the Neisseria meningitidis serogroup C outbreak in Nigeria - 2017.

PubMed

Hassan, Assad; Mustapha, G U; Lawal, Bola B; Na'uzo, Aliyu M; Ismail, Raji; Womi-Eteng Oboma, Eteng; Oyebanji, Oyeronke; Agenyi, Jeremiah; Thomas, Chima; Balogun, Muhammad Shakir; Dalhat, Mahmood M; Nguku, Patrick; Ihekweazu, Chikwe

2018-01-01

Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria. Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak. There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states. There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.

Sensitive and selective determination of fluvoxamine maleate using a sensitive chemiluminescence system based on the alkaline permanganate-Rhodamine B-gold nanoparticles reaction.

PubMed

Hassanzadeh, Javad; Amjadi, Mohammad

2015-06-01

A high-yield chemiluminescence (CL) system based on the alkaline permanganate-Rhodamine B reaction was developed for the sensitive determination of fluvoxamine maleate (Flu). Rhodamine B is oxidized by alkaline KMnO4 and a weak CL emission is produced. It was demonstrated that gold nanoparticles greatly enhance this CL emission due to their interaction with Rhodamine B molecules. It is also observed that sodium dodecyl sulfate, an anionic surfactant, can strongly increase this enhancement. In addition, it was demonstrated that a notable decrease in the CL intensity is observed in the presence of Flu. This may be related to Flu oxidation with KMnO4 . There is a linear relationship between the decrease in CL intensity and the Flu concentration over a range of 2-300 µg/L. A new simple, rapid and sensitive CL method was developed for the determination of Flu with a detection limit (3s) of 1.35 µg/L. The proposed method was used for the determination of Flu in pharmaceutical and urine samples. Copyright © 2014 John Wiley & Sons, Ltd.

[Pandemic without drama. Influenza vaccination and Asian flu in Germany].

PubMed

Witte, Wilfried

2013-01-01

The history of the 1957/58 Asian flu in Germany is systematically presented for the first time. The focus is on flu vaccination, which is discussed as a yardstick of the perception of the pandemic. International expertise on influenza virology was predominantly based in Anglo-Saxon countries. German microbiologists issued no clear recommendation for preventative vaccination until 1960. Instead, quinine was relied upon as the traditional medicinal prophylaxis. Antibiotics were more frequently administered. In East Germany, little fuss was made over the Asian flu. In line with the authorities' social hygiene orientation, vaccination was accepted as a matter of principle. In the Federal Republic and West Berlin, the population rejected the vaccination largely. It was seen as a scandal that many employees were on sick leave because of the flu, thus adversely affecting the economy.

Simultaneous determination of fluoxetine and norfluoxetine in dried blood spots using high-performance liquid chromatography-tandem mass spectrometry.

PubMed

da Silva, Anne Caroline Cezimbra; Raasch, Juliana Raquel; Vargas, Tainara Gomes; Peteffi, Giovana Piva; Hahn, Roberta Zilles; Antunes, Marina Venzon; Perassolo, Magda Susana; Linden, Rafael

2018-02-01

Therapeutic drug monitoring (TDM) of the widely prescribed antidepressant fluoxetine (FLU) is recommended in certain situations, such as occurrence of toxicity, inadequate response or suspect of poor adherence. Dried blood spot (DBS) sampling is an increasingly studied alternative for TDM, particularly for outpatients, due to its ease of collection and inherent stability. The aim of this study was to develop and validate an LC-MS/MS assay for the simultaneous quantification of FLU and norfluoxetine (NFLU) in DBS. The assay is based on a liquid extraction of single DBS with 8mm of diameter, using FLU-D6 as the internal standard, followed by reversed phase separation in an Accucore® C18 column (100×2.1mm, 2.6μm). Mobile phase was composed of water and acetonitrile (gradient from 80:20 to 50:50, v/v), both containing formic acid 0.1%. The assay was validated and applied to 30 patients under FLU pharmacotherapy. The assay was linear in the range 10-750ngmL -1 . Precision assays presented CV% of 3.13-9.61 and 3.54-7.99 for FLU and NFLU, respectively, and accuracy in the range of 97.98-110.44% and 100.25-105.8%. FLU and NFLU were stable at 25 and 45°C for 7days. The assay was evaluated in 30 patients under FLU treatment. Concentrations of both compounds were higher in DBS than in plasma, and the use of the multiplying factors 0.71 and 0.68 for FLU and NFLU, respectively, allowed acceptable estimation of plasma concentrations, with median prediction bias of -0.55 to 0.55% and mean differences of 0.4 to 2.2ngmL -1 . The presented data support the clinical use of DBS for therapeutic drug monitoring of FLU. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Stimulating Influenza Vaccination via Prosocial Motives

PubMed Central

Taylor, Eric G.; Atkins, Katherine E.; Chapman, Gretchen B.; Galvani, Alison P.

2016-01-01

Objective Americans do not vaccinate nearly enough against Influenza (flu) infection, despite severe health and economic burden of influenza. Younger people are disproportionately responsible for transmission, but do not suffer severely from the flu. Thus, to achieve herd immunity, prosocial motivation needs to be a partial driver of vaccination decisions. Past research has not established the causal role of prosociality in flu vaccination, and the current research evaluates such causal relationship by experimentally eliciting prosociality through messages about flu victims. Methods In an experimental study, we described potential flu victims who would suffer from the decision of others to not vaccinate to 3952 Internet participants across eight countries. We measured sympathy, general prosociality, and vaccination intentions. The study included two identifiable victim conditions (one with an elderly victim and another with a young victim), an unidentified victim condition, and a no message condition. Results We found that any of the three messages increased flu vaccination intentions. Moreover, this effect was mediated by enhanced prosocial motives, and was stronger among people who were historical non-vaccinators. In addition, younger victim elicited greater sympathy, and describing identifiable victims increased general sympathy and prosocial motives. Conclusions These findings provide direct experimental evidence on the causal role of prosocial motives in flu vaccination, by showing that people can be prompted to vaccinate for the sake of benefiting others. PMID:27459237

Conceptual Representations of Flu and Microbial Illness Held by Students, Teachers, and Medical Professionals

ERIC Educational Resources Information Center

Jones, M. Gail; Rua, Melissa J.

2008-01-01

This study describes 5th, 8th, and 11th-grade students', teachers', and medical professionals' conceptions of flu and microbial illness. Participants constructed a concept map on "flu" and participated in a semi-structured interview. The results showed that these groups of students, teachers and medical professionals held and structured their…

Know and Share the Facts about Flu Vaccination

ERIC Educational Resources Information Center

Grohskopf, Lisa

2012-01-01

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

Pathogenesis Studies of the 2009 Pandemic Influenza Virus and Pseudorabies Virus From Wild Pigs In Swine

USDA-ARS?s Scientific Manuscript database

Over the last ten years in the United States the epidemiology and ecology of swine flu and pseudorabies has been dynamic. Swine flu is caused by influenza A virus and the disease was first recognized in pigs concurrent with the 1918 Spanish flu pandemic in humans. Pigs displayed clinical signs simil...

The Emergence of Ebola as a Global Health Security Threat: From ‘Lessons Learned’ to Coordinated Multilateral Containment Efforts

PubMed Central

Kalra, Sarathi; Kelkar, Dhanashree; Galwankar, Sagar C.; Papadimos, Thomas J.; Stawicki, Stanislaw P.; Arquilla, Bonnie; Hoey, Brian A.; Sharpe, Richard P.; Sabol, Donna; Jahre, Jeffrey A.

2014-01-01

First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat. Here we present a review of EBOV infection in an effort to further educate medical and political communities on what the Ebolavirus disease entails, and what efforts are recommended to treat, isolate, and eventually eliminate it. PMID:25538455

The emergence of ebola as a global health security threat: from 'lessons learned' to coordinated multilateral containment efforts.

PubMed

Kalra, Sarathi; Kelkar, Dhanashree; Galwankar, Sagar C; Papadimos, Thomas J; Stawicki, Stanislaw P; Arquilla, Bonnie; Hoey, Brian A; Sharpe, Richard P; Sabol, Donna; Jahre, Jeffrey A

2014-10-01

First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat. Here we present a review of EBOV infection in an effort to further educate medical and political communities on what the Ebolavirus disease entails, and what efforts are recommended to treat, isolate, and eventually eliminate it.

On pandemics and the duty to care: whose duty? who cares?

PubMed Central

Ruderman, Carly; Tracy, C Shawn; Bensimon, Cécile M; Bernstein, Mark; Hawryluck, Laura; Shaul, Randi Zlotnik; Upshur, Ross EG

2006-01-01

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. PMID:16626488

Exploring racial influences on flu vaccine attitudes and behavior: Results of a national survey of White and African American adults.

PubMed

Quinn, Sandra Crouse; Jamison, Amelia; Freimuth, Vicki S; An, Ji; Hancock, Gregory R; Musa, Donald

2017-02-22

Racial disparities in adult flu vaccination rates persist with African Americans falling below Whites in vaccine acceptance. Although the literature has examined traditional variables including barriers, access, attitudes, among others, there has been virtually no examination of the extent to which racial factors including racial consciousness, fairness, and discrimination may affect vaccine attitudes and behaviors. We contracted with GfK to conduct an online, nationally representative survey with 819 African American and 838 White respondents. Measures included risk perception, trust, vaccine attitudes, hesitancy and confidence, novel measures on racial factors, and vaccine behavior. There were significant racial differences in vaccine attitudes, risk perception, trust, hesitancy and confidence. For both groups, racial fairness had stronger direct effects on the vaccine-related variables with more positive coefficients associated with more positive vaccine attitudes. Racial consciousness in a health care setting emerged as a more powerful influence on attitudes and beliefs, particularly for African Americans, with higher scores on racial consciousness associated with lower trust in the vaccine and the vaccine process, higher perceived vaccine risk, less knowledge of flu vaccine, greater vaccine hesitancy, and less confidence in the flu vaccine. The effect of racial fairness on vaccine behavior was mediated by trust in the flu vaccine for African Americans only (i.e., higher racial fairness increased trust in the vaccine process and thus the probability of getting a flu vaccine). The effect of racial consciousness and discrimination for African Americans on vaccine uptake was mediated by perceived vaccine risk and flu vaccine knowledge. Racial factors can be a useful new tool for understanding and addressing attitudes toward the flu vaccine and actual vaccine behavior. These new concepts can facilitate more effective tailored and targeted vaccine communications. Copyright © 2016. Published by Elsevier Ltd.

Transactivation of inducible nitric oxide synthase gene by Kruppel-like factor 6 regulates apoptosis during influenza A virus infection

PubMed Central

Mgbemena, Victoria; Segovia, Jesus A.; Chang, Te-Hung; Tsai, Su-Yu; Cole, Garry T.; Hung, Chiung-Yu; Bose, Santanu

2012-01-01

Influenza A virus (flu) is a respiratory tract pathogen causing high morbidity and mortality among the human population. Nitric oxide (NO) is a cellular mediator involved in tissue damage due to apoptosis of target cells and resulting enhancement of local inflammation. Inducible nitric oxide (iNOS) is involved in the production of NO following infection. Although NO is a key player in the development of exaggerated lung disease during flu infection, the underlying mechanism including the role of NO in apoptosis during infection has not been reported. Similarly, the mechanism of iNOS gene induction during flu infection is not well defined in terms of host trans-activator(s) required for iNOS gene expression. In the current study we have identified kruppel-like factor 6 (KLF6) as a critical transcription factor essential for iNOS gene expression during flu infection. We have also underscored the requirement of iNOS in inducing apoptosis during infection. KLF6 gene silencing in human lung epithelial cells resulted in drastic loss of NO production, iNOS-promoter specific luciferase activity and expression of iNOS mRNA following flu infection. Chromatin immuno-precipitation assay revealed a direct interaction of KLF6 with iNOS promoter during both in vitro and in vivo flu infection of human lung cells and mouse respiratory tract, respectively. Significant reduction in flu mediated apoptosis was noted in KLF6 silenced cells, cells treated with iNOS inhibitor and in primary murine macrophages derived from iNOS knock-out (KO) mice. A similar reduction in apoptosis was noted in the lungs following intra-tracheal flu infection of iNOS KO mice. PMID:22711891

Comparison of pediatric allogeneic transplant outcomes using myeloablative busulfan with cyclophosphamide or fludarabine

PubMed Central

Artz, Andrew; Frangoul, Haydar; Loren, Alison; Mineishi, Shin

2018-01-01

Busulfan combined with cyclophosphamide (BuCy) has long been considered a standard myeloablative conditioning regimen for allogeneic hematopoietic cell transplantation (HCT), including both nonmalignant conditions and myeloid diseases. Substituting fludarabine for cyclophosphamide (BuFlu) to reduce toxicity without an increase in relapse has been increasingly performed in children, but without comparison with BuCy. We retrospectively analyzed 1781 children transplanted from 2008 to 2014 to compare the effectiveness of BuCy with BuFlu. Nonmalignant and malignant disease populations were analyzed separately. Overall mortality was comparable for children with nonmalignant conditions who received BuFlu or BuCy (relative risk [RR], 1.14, P = .52). Lower incidences of sinusoidal obstruction syndrome (P = .04), hemorrhagic cystitis (P = .04), and chronic graft-versus-host disease (P = .02) were observed after BuFlu, but the influence of the conditioning regimen could not be assessed by multivariate analysis because of the low frequency of these complications. Children transplanted for malignancies were more likely to receive BuFlu if they had higher hematopoietic cell transplantation-comorbidity index scores (P < .001) or their donor was unrelated and HLA-mismatched (P = .004). Nevertheless, there were no differences in transplant toxicities and comparable transplant-related mortality (RR, 1.2; P = .46), relapse (RR, 1.2; P = .15), and treatment failure (RR, 1.2; P = .12). BuFlu was associated with higher overall mortality (RR, 1.4; P = .008) related to inferior postrelapse survival (P = .001). Our findings demonstrated that outcomes after BuFlu are similar to those for BuCy for children, but for unclear reasons, those receiving BuFlu for malignancy may be at risk for shorter postrelapse survival. PMID:29844205

Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study

PubMed Central

Alsan, Marcella; Morden, Nancy; Gottlieb, Joshua D.; Zhou, Weiping; Skinner, Jonathan

2016-01-01

Background Excessive antibiotic use in cold and flu season is costly and contributes to antibiotic resistance. The study objective was to develop an index of excessive antibiotic use in cold and flu season and determine its correlation with other indicators of prescribing quality. Methods and Findings We included Medicare beneficiaries in the 40% random sample denominator continuously enrolled in fee for service benefits for 2010 and/or 2011 (7,961,201 person-years (PY)) and extracted data on prescription fills for oral antibiotics that treat respiratory pathogens. We collapsed the data to the state-level so that it could be merged with monthly flu activity data from the Centers for Disease Control and Prevention (CDC). Linear regression, adjusted for state-specific mean antibiotic use and demographic characteristics, was used to estimate how antibiotic prescribing responded to state-specific flu activity. There was considerable geographic variation in flu-associated antibiotic use across states—lowest in Vermont and Connecticut and highest in Mississippi and Florida. There was a robust positive correlation between medications that often cause adverse events in the elderly and flu-associated prescribing (0.755; p<0.001), while there was a strong negative correlation with beta-blocker use after a myocardial infarction (MI) (−0.413; p=0.003). Conclusion Adjusted flu-associated antibiotic use was positively correlated with high-risk medications to the elderly and negatively correlated with beta-blocker use post MI. These findings suggest excessive antibiotic use reflects low quality prescribing, and imply that practice and policy solutions should go beyond narrow, antibiotic-specific, approaches to encourage evidence-based prescribing for the elderly Medicare population. PMID:26569644

Evaluation of the Xpert Flu test and comparison with in-house real-time RT-PCR assays for detection of influenza virus from 2008 to 2011 in Marseille, France.

PubMed

Salez, N; Ninove, L; Thirion, L; Gazin, C; Zandotti, C; de Lamballerie, X; Charrel, R N

2012-04-01

Rapid documentation of respiratory specimens can have an impact on the management of patients and their relatives in terms of preventive and curative measures. We compared the results of the Xpert(®) Flu assay (Cepheid) with three real-time RT-PCR assays using 127 nasopharyngeal samples, of which 75 were positive for influenza A (with 52 identified as A/H1N1-2009) and 52 were positive for influenza B. The Xpert(®) Flu assay presented a quasi-absence of non-interpretable tests, and showed sensitivity and specificity of 100% and 100% for Flu A, 98.4% and 100% for A/H1N1-2009, and 80.7% and 100% for Flu B. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

'By failing to prepare you are preparing to fail': lessons from the 2009 H1N1 'swine flu' pandemic.

PubMed

Crosier, Adam; McVey, Dominic; French, Jeff

2015-02-01

Pandemic influenza has the potential to cause widespread death and destruction. Communications with the public have a vital role in the prevention of pandemic influenza by promoting the effective uptake of behaviours that can delay the spread of infection. This study explored the development and implementation of communications in the pandemic influenza outbreak of H1N1 ('swine flu') in 2009 in three European countries. In-depth interviews were conducted with senior policy and communication officials involved in the planning and delivery of communications programmes in England, Italy and Hungary. The study found a lack of planning and a low value attached to the skills required to produce effective communications. In all case study countries there was a dearth of good quality audience research to inform the development of communications. Little thought had been given to the tone, targeting or channelling of messages. Instead, communications were characterized by a 'one size fits all' and a 'top down', expert-led response. There was also little effort to evaluate the impact of communications, but where this was done, very low levels of public compliance and engagement with key behavioural messages were found. Policy makers should prioritize investment in the skills and expertise required to achieve desired behaviour changes. Audience research should be conducted throughout the planning cycle to inform national communications strategies. This should include insights to inform the segmentation of public audiences, targeting of messages and consideration of content and emotional tone most likely to achieve desired behavioural outcomes. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Control of endemic swine flu persistence in farrow-to-finish pig farms: a stochastic metapopulation modeling assessment.

PubMed

Cador, Charlie; Andraud, Mathieu; Willem, Lander; Rose, Nicolas

2017-10-03

Swine influenza viruses (swIAVs) are known to persist endemically in farrow-to-finish pig farms, leading to repeated swine flu outbreaks in successive batches of pigs at a similar age (mostly around 8 weeks of age). This persistence in European swine herds involves swIAVs from European lineages including H1 av N1, H1 hu N2, H3N2, the 2009 H1N1 pandemic virus and their reassortants. The specific population dynamics of farrow-to-finish pig farms, the immune status of the animals at infection-time, the co-circulation of distinct subtypes leading to consecutive or concomitant infections have been evidenced as factors favouring swIAV persistence within herds. We developed a stochastic metapopulation model representing the co-circulation of two distinct swIAVs within a typical farrow-to-finish pig herd to evaluate the risk of reassortant viruses generation due to co-infection events. Control strategies related to herd management and/or vaccination schemes (batch-to-batch or mass vaccination of the sow herd and vaccination of growing pigs) were implemented to assess their relative efficacy regarding viral persistence. The overall probability of a co-infection event for France, possibly leading to reassortment, was evaluated to 16.8%. The export of consecutive piglets batches was identified as the most efficient measure facilitating swIAV infection fade-out. Although some vaccination schemes (batch-to-batch vaccination) had a beneficial effect in breeding sows by reducing the persistence of swIAVs within this subpopulation, none of vaccination strategies achieved swIAVs fade-out within the entire farrow-to-finish pig herd.

Attitudes of consumers and live-poultry workers to central slaughtering in controlling H7N9: a cross-sectional study.

PubMed

Lin, Xiao; Zhang, Dingmei; Wang, Xinwei; Huang, Yun; Du, Zhicheng; Zou, Yaming; Lu, Jiahai; Hao, Yuantao

2017-05-26

Guangdong Province in the Pearl River Delta of Southeast China is among the areas in the country with the highest rates of avian flu cases. In order to control the outbreak of human-infected H7N9 cases, Guangdong launched a new policy on the central slaughtering of live poultry in 2015. This study aims to evaluate attitudes of consumers and live-poultry workers toward the policy. The live-poultry workers consisted of two sub-groups: live-poultry traders and poultry farm workers. Consumers and live-poultry workers from Guangdong were enrolled by stratified multi-stage random sampling. Online and field surveys were conducted to investigate participants' attitudes on policy implementation. Questionnaires were developed to quantify participant demographics, to collect information about attitudes toward the policy, and to identify influential factors of policy acceptability. Proportional odds logistics regression was used in the univariate and multivariate analyses. A total of 1449 consumers, 181 live-poultry traders, and 114 poultry farm workers completed the study. Policy acceptability percentages among consumers, live-poultry traders, and poultry farm workers were 57.1, 37.9, and 62.6%, respectively. Logistics regression shows that consumers tended not to support the policy if they were males, if they were concerned with the food safety of chilled products, and if they preferred purchasing live poultry. Live-poultry traders tended not to support if they were subsidized by the government, if they were males, if they experienced a drop in trading volume, and if they were unclear whether avian flu was a preventable disease. Finally, poultry farm workers tended not to support if they experienced a drop in trading volume, if they operated a poultry farm on a small to medium scale, and if they experienced inconvenience in their work due to the policy. The study reveals a substantial refusal or slowness to accept the policy. Failure to accept the policy results from varying reasons. Among consumers, concern about food safety and dietary preference are two major causes of disapproval. Policy acceptability among live-poultry workers diverges within the two sub-groups. While a large percentage of poultry farm workers accept the policy, the drop in trading and an insufficient subsidy hamper acceptance by live-poultry traders. We recommend that policy-makers promote health education and alleviate the policy impact on trading with a reformed subsidy policy to increase acceptability. These findings are crucial for the prevention of human-infected H7N9 cases in Guangdong.

Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Schools (Grades K-12)

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2010

2010-01-01

The purpose of "Preparing for the Flu: A Communication Toolkit for Schools" is to provide basic information and communication resources to help school administrators implement recommendations from CDC's (Centers for Disease Control and Prevention) Guidance for State and Local Public Health Officials and School Administrators for School (K-12)…

Don't Confuse Common Flu with a Flu Pandemic

ERIC Educational Resources Information Center

St. Gerard, Vanessa

2007-01-01

It is the time of year once again when students and staff members who are going around with coughs, colds, fevers, and sneezes abound in schools everywhere. Although it may seem more immediate to focus on the matter of how the seasonal/common flu will affect a particular school during the course of this school year, the fact of the situation is…

Application of serological typing to the investigation of outbreaks of Clostridium perfringens food poisoning, 1970-1978.

PubMed Central

Stringer, M. F.; Turnbull, P. C.; Gilbert, R. J.

1980-01-01

Serological typing was used as an epidemiological tool in the investigation of 524 outbreaks of Clostridium perfringens food poisoning in the United Kingdom and 37 outbreaks in other countries. Five thousand five hundred and fifty-four (77%) of 7245 strains of C. perfringens associated with the 561 outbreaks were typable with the 75 Food Hygiene Laboratory antisera; in 354 (63%) of these outbreaks a specific serotype was established as being responsible for the outbreak. An assessment is made of the ability of two additional sets of antisera, prepared against 34 American and 34 Japanese strains of C. perfringens, to increase the number of strains which can be typed. The extent of cross-reaction between the three sets of antisera was determined and the results are discussed in relation to the source and history of the type strains. PMID:6300225

Synthetic Influenza vaccine (FLU-v) stimulates cell mediated immunity in a double-blind, randomised, placebo-controlled Phase I trial.

PubMed

Pleguezuelos, Olga; Robinson, Stuart; Stoloff, Gregory A; Caparrós-Wanderley, Wilson

2012-06-29

Current Influenza vaccines elicit antibody mediated prophylactic immunity targeted to viral capsid antigens. Despite their global use these vaccines must be administered yearly to the population, cannot be manufactured until the circulating viral strain(s) have been identified and have limited efficacy. A need remains for Influenza vaccines addressing these issues and here we report the results of a Phase Ib trial of a novel synthetic Influenza vaccine (FLU-v) targeting T cell responses to NP, M1 and M2. Forty-eight healthy males aged 18-40 were recruited for this single-centre, randomised, double blind study. Volunteers received one single low (250 μg) or high (500 μg) dose of FLU-v, either alone or adjuvanted. Safety, tolerability and basic immunogenicity (IgG and IFN-γ responses) parameters were assessed pre-vaccination and for 21 days post-vaccination. FLU-v was found to be safe and well tolerated with no vaccine associated severe adverse events. Dose-dependent IFN-γ responses >2-fold the pre-vaccination level were detected in 80% and 100% of volunteers receiving, respectively, the low and high dose adjuvanted FLU-v formulations. No formulation tested induced any significant FLU-v antibody response. FLU-v is safe and induces a vaccine-specific cellular immunity. Cellular immune responses are historically known to control and mitigate infection and illness during natural infection. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preparation and characterization of fast dissolving flurbiprofen and esomeprazole solid dispersion using spray drying technique.

PubMed

Pradhan, Roshan; Tran, Tuan Hiep; Kim, Sung Yub; Woo, Kyu Bong; Choi, Yong Joo; Choi, Han-Gon; Yong, Chul Soon; Kim, Jong Oh

2016-04-11

We aimed to develop an immediate-release flurbiprofen (FLU) and esomeprazole (ESO) combination formulation with enhanced gastric aqueous solubility and dissolution rate. Aqueous solubility can be enhanced by formulating solid dispersions (SDs) with a polyvinylpyrrolidone (PVP)-K30 hydrophilic carrier, using spray-drying technique. Aqueous and gastric pH dissolution can be achieved by macro-environmental pH modulation using sodium bicarbonate (NaHCO3) and magnesium hydroxide (Mg(OH)2) as the alkaline buffer. FLU/ESO-loaded SDs (FLU/ESO-SDs) significantly improved aqueous solubility of both drugs, compared to each drug powder. Dissolution studies in gastric pH and water were compared with the microenvironmental pH modulated formulations. The optimized FLU/ESO-SD powder formulation consisted of FLU/ESO/PVP-K30/sodium carbonate (Na2CO3) in a weight ratio 1:0.22:1.5:0.3, filled in the inner capsule. The outer capsule consisted of NaHCO3 and Mg(OH)2, which created the macro-environmental pH modulation. Increased aqueous and gastric pH dissolution of FLU and ESO from the SD was attributed to the alkaline buffer effects and most importantly, to drug transformation from crystalline to amorphous SD powder, clearly revealed by scanning electron microscopy, differential scanning calorimetry, and powder X-ray diffraction studies. Thus, the combined FLU and ESO SD powder can be effectively delivered as an immediate-release formulation using the macro-environmental pH modulation concept. Copyright © 2016. Published by Elsevier B.V.

Degradation of fluorobenzene and its central metabolites 3-fluorocatechol and 2-fluoromuconate by Burkholderia fungorum FLU100.

PubMed

Strunk, Niko; Engesser, Karl-Heinrich

2013-06-01

A halobenzene-degrading bacterium, Burkholderia fungorum FLU100 (DSM 23736), was isolated due to its outstanding trait to degrade fluorobenzene. Besides fluorobenzene, it utilizes, even in random mixtures, chlorobenzene, bromobenzene, iodobenzene, benzene, and toluene as sole sources of carbon and energy. FLU100 mineralizes mono-halogenated benzenes almost stoichiometrically (according to halide balance); after a lag phase, it also degrades 3-fluorophenol and 3-chlorophenol completely. The FLU100-derived transposon Tn5-mutant FLU100-P14R22 revealed 3-halocatechol to be a central metabolite of this new halobenzene degradation pathway. In FLU100, halocatechols are-as expected-strictly subject to ortho-cleavage of the catechol ring, with meta-cleavage never been observed. The strain is able to completely mineralize 3-fluorocatechol, the principal catecholic metabolite being nearly exclusively formed from fluorobenzene. The temporarily excreted 2-fluoromuconate formed thereof in turn is subsequently metabolized completely. This important finding falsifies the customary opinion of the persistence of 2-fluoromuconate valid up to now. The degradation of 4-fluorocatechol, however, being a very minor intermediate in FLU100, is substantially slower and incomplete and leads to the accumulation of uncharacterized derivatives of muconic acid and muconolactone in the medium. This branch therefore does not seem to be productive. To our knowledge, this represents the first example of the complete metabolism of 3-fluorocatechol via 2-fluoromuconate, a metabolite hitherto described as a dead-end metabolite in fluoroaromatic degradation.

Receipt of Preventive Health Services in Young Adults

PubMed Central

Lau, Josephine S.; Adams, Sally H.; Irwin, Charles E.; Ozer, Elizabeth M.

2013-01-01

Objective To examine self-reported rates and disparities in delivery of preventive services to young adults. Design Population-based cross-sectional analysis. Multivariate logistic regression was used to examine how age, gender, race/ethnicity, income, insurance, and usual source of care influence the receipt of preventive services. Setting 2005 and 2007 California Health Interview Surveys (CHIS). Participants 3670 and 3621 young adults aged 18-26 years who responded to CHIS 2005 and 2007, respectively. Main Outcome Measures Self-reported receipt of flu vaccination, STD screening, cholesterol screening, diet counseling, exercise counseling and emotional health screening. Results Delivery rates ranged from 16.7% (flu vaccine) to 50.6% (cholesterol screening). Being female and having a usual source of care significantly increased receipt of services, with females more likely to receive STD screening (p<.001), cholesterol screening (p<.01), emotional health screening (p<.001), diet counseling (p<.01) and exercise counseling (p<.05) than males after controlling for age, race/ethnicity, income, insurance and usual source of care. Young adults with a usual source of care were more likely to receive a flu vaccine (p<.05), STD screening (p<.01), cholesterol screening (p<.001), diet counseling (p<.05) and exercise counseling (p<.05) than those without a usual source of care after adjusting for age, race/ethnicity, income, and insurance. Conclusions Rates of preventive service delivery are generally low. Greater efforts are needed to develop guidelines for young adults to increase the delivery of preventive care to this age group, and to address the gender and ethnic/racial disparities in preventive services delivery. PMID:23260833

Modelling real disease dynamics with behaviourally adaptive complex networks. Comment on "Coupled disease-behavior dynamics on complex networks: A review" by Z. Wang et al.

NASA Astrophysics Data System (ADS)

Small, Michael

2015-12-01

Mean field compartmental models of disease transmission have been successfully applied to a host of different scenarios, and the Kermack-McKendrick equations are now a staple of mathematical biology text books. In Susceptible-Infected-Removed format these equations provide three coupled first order ordinary differential equations with a very mild nonlinearity and they are very well understood. However, underpinning these equations are two important assumptions: that the population is (a) homogeneous, and (b) well-mixed. These assumptions become closest to being true for diseases infecting a large portion of the population for which inevitable individual effects can be averaged away. Emerging infectious disease (such as, in recent times, SARS, avian influenza, swine flu and ebola) typically does not conform to this scenario. Individual contacts and peculiarities of the transmission network play a vital role in understanding the dynamics of such relatively rare infections - particularly during the early stages of an outbreak.

Applying social science and public health methods to community-based pandemic planning.

PubMed

Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

2010-11-01

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

Navy and Marine Corps Medical News, Issue 9, 11 September 2009

DTIC Science & Technology

2009-09-11

Honors Outstanding Female Physicians 4 NMCP Begins Seasonal Flu Shots for Staff Key West Health Clinic Improves Sailors’ Readiness 5 From...in Washington, DC in January 2010. NMCP Begins Seasonal Flu Shots for Staff By Deborah Kallgren Naval Medical Center Portsmouth Public Affairs...changing that perception. NMCP began administering seasonal flu shots to its staff last month, and its Commander, Rear Adm. William

Flu Plan: Colleges Struggle with How They Would React to a Pandemic

ERIC Educational Resources Information Center

Guterman, Lila

2005-01-01

Administrators of various education schools have vowed to ready their institutions for the next major disaster of flu pandemic. While a few colleges with expertise or interest in the area are trying to determine how their campuses should react to a flu pandemic, most seem to be struggling with how to fit all the unknowns of such a crisis into…

Performance of the inFLUenza Patient-Reported Outcome (FLU-PRO) diary in patients with influenza-like illness (ILI)

PubMed Central

Bacci, Elizabeth D.; Leidy, Nancy K.; Poon, Jiat-Ling; Stringer, Sonja; Memoli, Matthew J.; Han, Alison; Fairchok, Mary P.; Coles, Christian; Owens, Jackie; Chen, Wei-Ju; Arnold, John C.; Danaher, Patrick J.; Lalani, Tahaniyat; Burgess, Timothy H.; Millar, Eugene V.; Ridore, Michelande; Hernández, Andrés; Rodríguez-Zulueta, Patricia; Ortega-Gallegos, Hilda; Galindo-Fraga, Arturo; Ruiz-Palacios, Guillermo M.; Pett, Sarah; Fischer, William; Gillor, Daniel; Moreno Macias, Laura; DuVal, Anna; Rothman, Richard; Dugas, Andrea; Guerrero, M. Lourdes

2018-01-01

Background The inFLUenza Patient Reported Outcome (FLU-PRO) measure is a daily diary assessing signs/symptoms of influenza across six body systems: Nose, Throat, Eyes, Chest/Respiratory, Gastrointestinal, Body/Systemic, developed and tested in adults with influenza. Objectives This study tested the reliability, validity, and responsiveness of FLU-PRO scores in adults with influenza-like illness (ILI). Methods Data from the prospective, observational study used to develop and test the FLU-PRO in influenza virus positive patients were analyzed. Adults (≥18 years) presenting with influenza symptoms in outpatient settings in the US, UK, Mexico, and South America were enrolled, tested for influenza virus, and asked to complete the 37-item draft FLU-PRO daily for up to 14-days. Analyses were performed on data from patients testing negative. Reliability of the final, 32-item FLU-PRO was estimated using Cronbach’s alpha (α; Day 1) and intraclass correlation coefficients (ICC; 2-day reproducibility). Convergent and known-groups validity were assessed using patient global assessments of influenza severity (PGA). Patient report of return to usual health was used to assess responsiveness (Day 1–7). Results The analytical sample included 220 ILI patients (mean age = 39.3, 64.1% female, 88.6% white). Sixty-one (28%) were hospitalized at some point in their illness. Internal consistency reliability (α) of FLU-PRO Total score was 0.90 and ranged from 0.72–0.86 for domain scores. Reproducibility (Day 1–2) was 0.64 for Total, ranging from 0.46–0.78 for domain scores. Day 1 FLU-PRO scores correlated (≥0.30) with the PGA (except Gastrointestinal) and were significantly different across PGA severity groups (Total: F = 81.7, p<0.001; subscales: F = 6.9–62.2; p<0.01). Mean score improvements Day 1–7 were significantly greater in patients reporting return to usual health compared with those who did not (p<0.05, Total and subscales, except Gastrointestinal and Eyes). Conclusions Results suggest FLU-PRO scores are reliable, valid, and responsive in adults with influenza-like illness. PMID:29566007

Frequency-dependent actions of benzodiazepines on GABAA receptors in cultured murine cerebellar granule cells.

PubMed Central

Mellor, J R; Randall, A D

1997-01-01

1. Miniature IPSCs recorded from cultured murine cerebellar granule cells increased in half-width and amplitude following application of the benzodiazepine (BDZ) Flunitrazepam (Flu, 1 microM). The increase in the half-width was much greater than that in the amplitude. 2. Five-millisecond applications of 1 mM GABA to nucleated outside-out patches elicited rapidly rising biexponentially decaying responses that resembled IPSCs. Flu had no effect on the amplitude of such responses, but consistently slowed their deactivation by approximately 50%. This effect was reversed by Flu washout or application of the BDZ antagonist Ro15-1788. The partial inverse agonist. Ro15-4513 speeded deactivation and depressed peak current amplitude by 23 +/- 12%. 3. The EC50 for GABA was between 45 and 50 microM. At submaximally effective agonist concentrations, Flu increased response amplitude and slowed response deactivation. Both effects were present in all cells taken from young cultures (4-7 days in vitro) but the latter was absent in 55% of the neurones obtained from older cultures (14-27 days in vitro). 4. With 120 ms applications of 20 microM GABA, responses activated monoexponentially (time constant, 39.8 +/- 2.8 ms) and deactivated biexponentially (time constants, 40.4 +/- 2.1 and 251 +/- 15 ms). Application of Flu slowed both activation and deactivation. The latter effect arose from an increased contribution of the slower component of decay. 5. Desensitization of responses to 1 mM GABA was biexponential, with time constants of 47 +/- 11 and 479 +/- 49 ms. Flu speeded desensitization by decreasing both fast and slow time constants. GABAA receptor desensitization consistently slowed subsequent deactivation. No significant relationship between the level of desensitization and the amount of slowing of deactivation produced by Flu was found. 6. Responses to paired 5 ms applications of 1 mM GABA indicated that the slowing of deactivation and the speeding of desensitization produced by Flu combine to generate a marked frequency dependence in the actions of this BDZ. Thus when compared with control responses, GABA-induced charge transfer was only enhanced by Flu during the first of two successive agonist applications. PMID:9306278

Monitoring the emergence of community transmission of influenza A/H1N1 2009 in England: a cross sectional opportunistic survey of self sampled telephone callers to NHS Direct.

PubMed

Elliot, Alex J; Powers, Cassandra; Thornton, Alicia; Obi, Chinelo; Hill, Caterina; Simms, Ian; Waight, Pauline; Maguire, Helen; Foord, David; Povey, Enid; Wreghitt, Tim; Goddard, Nichola; Ellis, Joanna; Bermingham, Alison; Sebastianpillai, Praveen; Lackenby, Angie; Zambon, Maria; Brown, David; Smith, Gillian E; Gill, O Noel

2009-08-27

To evaluate ascertainment of the onset of community transmission of influenza A/H1N1 2009 (swine flu) in England during the earliest phase of the epidemic through comparing data from two surveillance systems. Cross sectional opportunistic survey. Results from self samples by consenting patients who had called the NHS Direct telephone health line with cold or flu symptoms, or both, and results from Health Protection Agency (HPA) regional microbiology laboratories on patients tested according to the clinical algorithm for the management of suspected cases of swine flu. Six regions of England between 24 May and 30 June 2009. Proportion of specimens with laboratory evidence of influenza A/H1N1 2009. Influenza A/H1N1 2009 infections were detected in 91 (7%) of the 1385 self sampled specimens tested. In addition, eight instances of influenza A/H3 infection and two cases of influenza B infection were detected. The weekly rate of change in the proportions of infected individuals according to self obtained samples closely matched the rate of increase in the proportions of infected people reported by HPA regional laboratories. Comparing the data from both systems showed that local community transmission was occurring in London and the West Midlands once HPA regional laboratories began detecting 100 or more influenza A/H1N1 2009 infections, or a proportion positive of over 20% of those tested, each week. Trends in the proportion of patients with influenza A/H1N1 2009 across regions detected through clinical management were mirrored by the proportion of NHS Direct callers with laboratory confirmed infection. The initial concern that information from HPA regional laboratory reports would be too limited because it was based on testing patients with either travel associated risk or who were contacts of other influenza cases was unfounded. Reports from HPA regional laboratories could be used to recognise the extent to which local community transmission was occurring.

Attitudes and perceptions among the pediatric health care providers toward influenza vaccination in Qatar: A cross-sectional study.

PubMed

Alhammadi, Ahmed; Khalifa, Mohamed; Abdulrahman, Hatem; Almuslemani, Eman; Alhothi, Abdullah; Janahi, Mohamed

2015-07-31

Influenza is a communicable but preventable viral illness. Despite safe and effective vaccine availability, compliance rates are globally low. Neither local data on percentage of vaccination nor reasons for poor compliance among pediatric health providers are available in Qatar. To estimate the percentage of vaccinated health care providers at pediatrics department and know their perception and attitudes toward influenza vaccinations. Cross-sectional survey, conducted on 300 pediatrics healthcare professionals from January through April 2013 at the main tertiary teaching hospital in Qatar, included details of demographics, frequency, perceptions and suggestive ways to improve the compliance. From among 230 respondents, 90 physicians and 133 allied health care professionals participated in this survey. Our study showed that percentages of participants who received flu vaccination were 67.7% and those who did not receive vaccination were 32.3%. Allied HCPs (69%) are more likely to get the vaccine compared to the physicians (66%). flu vaccination was approximately 5 times likely to be higher in the age group more than 40 years (P=0.002) compared to age less than or equals 40 years. Overall 70% healthcare providers were willing to recommend immunization to colleagues and patients compared to 30%, who were not willing. The reasons for noncompliance included fear of side effects, contracting the flu, vaccine safety and lack of awareness about the effectiveness. In order to promote immunization, participants believe that use of evidence-based statement, participating in an educational campaign, provides no cost/on site campaigns and leadership support is the most practical interventions. In the present study, the vaccine coverage among pediatrics HCPs seems higher than previously reported rates. Despite their positive attitude toward influenza vaccination, low acceptance and misconceptions of seasonal influenza vaccination by pediatric HCPs may have a negative effect on the successful immunization delivery and children immunization rate. Our findings would be useful for designing and implementing educational programs targeted to improve vaccination coverage rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

International standards for pandemic screening using infrared thermography

NASA Astrophysics Data System (ADS)

Pascoe, D. D.; Ring, E. F.; Mercer, J. B.; Snell, J.; Osborn, D.; Hedley-Whyte, J.

2010-03-01

The threat of a virulent strain of influenza, severe acute respiratory syndrome (SARS), tuberculosis, H1N1/A virus (swine flu) and possible mutations are a constant threat to global health. Implementation of pandemic infrared thermographic screening is based on the detection of febrile temperatures (inner canthus of the eyes) that are correlated with an infectious disease. Previous attempts at pandemic thermal screening have experienced problems (e.g. SARS outbreak, Singapore 2003) associated with the deployment plan, implementation and operation of the screening thermograph. Since this outbreak, the International Electrotechnical Commission has developed international standards that set minimum requirements for thermographic system fever screening and procedures that insure reliable and reproducible measurements. These requirements are published in IEC 80601-2-59:2008, Medical electrical equipment - Part 2-59: Particular requirements for the basic safety and essential performance of screening thermographs for human febrile temperature screening. The International Organization for Standardization has developed ISO/TR 13154:2009, Medical Electrical Equipment - which provides deployment, implementation and operational guidelines for identifying febrile humans using a screening thermograph. These new standards includes recommendations for camera calibrations, use of black body radiators, view field, focus, pixels within measurement site, image positioning, and deployment locations. Many current uses of thermographic screening at airports do not take into account critical issues addressed in the new standard, and are operating below the necessary effectiveness and efficiency. These documents, related thermal research, implications for epidemiology screening, and the future impact on medical thermography are discussed.

Effects of the 2014 Ebola outbreak on antenatal care and delivery outcomes in Liberia: a nationwide analysis

PubMed Central

Horace-Kwemi, E.; Najjemba, R.; Owiti, P.; Edwards, J.; Shringarpure, K.; Bhat, P.; Kateh, F. N.

2017-01-01

Setting: All health facilities, public and private, in Liberia, West Africa. Objectives: To determine access to antenatal care (ANC), deliveries and their outcomes before, during and after the 2014–2015 Ebola outbreak. Design: This was a descriptive cross-sectional study. Result: During the Ebola outbreak in Liberia, overall monthly reporting from health facilities plunged by 43%. Access to ANC declined by 50% and reported deliveries fell by one third during the outbreak. Reported deliveries by skilled attendants and Caesarian section declined by respectively 32% and 60%. Facility-based deliveries dropped by 35% and reported community deliveries fell by 47%. There was an overall decline in reported stillbirths, maternal and neonatal deaths, by 50%, during the outbreak. ANC, reported deliveries and related outcomes returned to pre-outbreak levels within one year following the outbreak. Conclusion: The Liberian health system was considerably weakened during the Ebola outbreak and had difficulties providing basic maternal health services. In the light of the major reporting gaps during the Ebola period, and the reduced use of health facilities for maternal care, these findings highlight the need for measures to avoid such disruptions during future outbreaks. PMID:28744445

Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein.

PubMed

Xiao, Julie Huiyuan; Rijal, Pramila; Schimanski, Lisa; Tharkeshwar, Arun Kumar; Wright, Edward; Annaert, Wim; Townsend, Alain

2018-02-15

We have produced a new Ebola virus pseudotype, E-S-FLU, that can be handled in biosafety level 1/2 containment for laboratory analysis. The E-S-FLU virus is a single-cycle influenza virus coated with Ebolavirus glycoprotein, and it encodes enhanced green fluorescence protein as a reporter that replaces the influenza virus hemagglutinin. MDCK-SIAT1 cells were transduced to express Ebolavirus glycoprotein as a stable transmembrane protein for E-S-FLU virus production. Infection of cells with the E-S-FLU virus was dependent on the Niemann-Pick C1 protein, which is the well-characterized receptor for Ebola virus entry at the late endosome/lysosome membrane. The E-S-FLU virus was neutralized specifically by an anti-Ebolavirus glycoprotein antibody and a variety of small drug molecules that are known to inhibit the entry of wild-type Ebola virus. To demonstrate the application of this new Ebola virus pseudotype, we show that a single laboratory batch was sufficient to screen a library (LOPAC 1280 ; Sigma) of 1,280 pharmacologically active compounds for inhibition of virus entry. A total of 215 compounds inhibited E-S-FLU virus infection, while only 22 inhibited the control H5-S-FLU virus coated in H5 hemagglutinin. These inhibitory compounds have very dispersed targets and mechanisms of action, e.g., calcium channel blockers, estrogen receptor antagonists, antihistamines, serotonin uptake inhibitors, etc., and this correlates with inhibitor screening results obtained with other pseudotypes or wild-type Ebola virus in the literature. The E-S-FLU virus is a new tool for Ebola virus cell entry studies and is easily applied to high-throughput screening assays for small-molecule inhibitors or antibodies. IMPORTANCE Ebola virus is in the Filoviridae family and is a biosafety level 4 pathogen. There are no FDA-approved therapeutics for Ebola virus. These characteristics warrant the development of surrogates for Ebola virus that can be handled in more convenient laboratory containment to study the biology of the virus and screen for inhibitors. Here we characterized a new surrogate, named E-S-FLU virus, that is based on a disabled influenza virus core coated with the Ebola virus surface protein but does not contain any genetic information from the Ebola virus itself. We show that E-S-FLU virus uses the same cell entry pathway as wild-type Ebola virus. As an example of the ease of use of E-S-FLU virus in biosafety level 1/2 containment, we showed that a single production batch could provide enough surrogate virus to screen a standard small-molecule library of 1,280 candidates for inhibitors of viral entry. © Crown copyright 2018.

Characterization of Influenza Virus Pseudotyped with Ebolavirus Glycoprotein

PubMed Central

Xiao, Julie Huiyuan; Rijal, Pramila; Schimanski, Lisa; Tharkeshwar, Arun Kumar; Wright, Edward; Annaert, Wim

2017-01-01

ABSTRACT We have produced a new Ebola virus pseudotype, E-S-FLU, that can be handled in biosafety level 1/2 containment for laboratory analysis. The E-S-FLU virus is a single-cycle influenza virus coated with Ebolavirus glycoprotein, and it encodes enhanced green fluorescence protein as a reporter that replaces the influenza virus hemagglutinin. MDCK-SIAT1 cells were transduced to express Ebolavirus glycoprotein as a stable transmembrane protein for E-S-FLU virus production. Infection of cells with the E-S-FLU virus was dependent on the Niemann-Pick C1 protein, which is the well-characterized receptor for Ebola virus entry at the late endosome/lysosome membrane. The E-S-FLU virus was neutralized specifically by an anti-Ebolavirus glycoprotein antibody and a variety of small drug molecules that are known to inhibit the entry of wild-type Ebola virus. To demonstrate the application of this new Ebola virus pseudotype, we show that a single laboratory batch was sufficient to screen a library (LOPAC1280; Sigma) of 1,280 pharmacologically active compounds for inhibition of virus entry. A total of 215 compounds inhibited E-S-FLU virus infection, while only 22 inhibited the control H5-S-FLU virus coated in H5 hemagglutinin. These inhibitory compounds have very dispersed targets and mechanisms of action, e.g., calcium channel blockers, estrogen receptor antagonists, antihistamines, serotonin uptake inhibitors, etc., and this correlates with inhibitor screening results obtained with other pseudotypes or wild-type Ebola virus in the literature. The E-S-FLU virus is a new tool for Ebola virus cell entry studies and is easily applied to high-throughput screening assays for small-molecule inhibitors or antibodies. IMPORTANCE Ebola virus is in the Filoviridae family and is a biosafety level 4 pathogen. There are no FDA-approved therapeutics for Ebola virus. These characteristics warrant the development of surrogates for Ebola virus that can be handled in more convenient laboratory containment to study the biology of the virus and screen for inhibitors. Here we characterized a new surrogate, named E-S-FLU virus, that is based on a disabled influenza virus core coated with the Ebola virus surface protein but does not contain any genetic information from the Ebola virus itself. We show that E-S-FLU virus uses the same cell entry pathway as wild-type Ebola virus. As an example of the ease of use of E-S-FLU virus in biosafety level 1/2 containment, we showed that a single production batch could provide enough surrogate virus to screen a standard small-molecule library of 1,280 candidates for inhibitors of viral entry. PMID:29212933

Modulation of porcine biotransformation enzymes by anthelmintic therapy with fenbendazole and flubendazole.

PubMed

Savlík, M; Fimanová, K; Szotáková, B; Lamka, J; Skálová, L

2006-06-01

Fenbendazole (FEN) and flubendazole (FLU) are benzimidazole anthelmintics often used in pig management for the control of nematodoses. The in vivo study presented here was designed to test the influence of FLU and FEN on cytochrome P4501A and other cytochrome P450 (CYP) isoforms, UDP-glucuronosyl transferase and several carbonyl reducing enzymes. The results indicated that FEN (in a single therapeutic dose as well as in repeated therapeutic doses) caused significant induction of pig CYP1A, while FLU did not show an inductive effect towards this isoform. Some of the other hepatic and intestinal biotransformation enzymes that were assayed were moderately influenced by FEN or FLU. Strong CYP1A induction following FEN therapy in pigs may negatively affect the efficacy and pharmacokinetics of FEN itself or other simultaneously or consecutively administered drugs. From the perspective of biotransformation enzyme modulation, FLU would appear to be a more convenient anthelmintic therapy of pigs than FEN.

Surveillance for waterborne-disease outbreaks--United States, 1995-1996.

PubMed

Levy, D A; Bens, M S; Craun, G F; Calderon, R L; Herwaldt, B L

1998-12-11

Since 1971, CDC and the U.S. Environmental Protection Agency have maintained a collaborative surveillance system for collecting and periodically reporting data that relate to occurrences and causes of waterborne-disease outbreaks (WBDOs). This summary includes data for January 1995 through December 1996 and previously unreported outbreaks in 1994. The surveillance system includes data about outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and for voluntarily reporting them to CDC on a standard form. For the period 1995-1996, 13 states reported a total of 22 outbreaks associated with drinking water. These outbreaks caused an estimated total of 2,567 persons to become ill. No deaths were reported. The microbe or chemical that caused the outbreak was identified for 14 (63.6%) of the 22 outbreaks. Giardia lamblia and Shigella sonnei each caused two (9.1%) of the 22 outbreaks; Escherichia coli O157:H7, Plesiomonas shigelloides, and a small round structured virus were implicated for one outbreak (4.5%) each. One of the two outbreaks of giardiasis involved the largest number of cases, with an estimated 1,449 ill persons. Seven outbreaks (31.8% of 22) of chemical poisoning, which involved a total of 90 persons, were reported. Copper and nitrite were associated with two outbreaks (9.1% of 22) each and sodium hydroxide, chlorine, and concentrated liquid soap with one outbreak (4.5%) each. Eleven (50.0%) of the 22 outbreaks were linked to well water, eight in noncommunity and three in community systems. Only three of the 10 outbreaks associated with community water systems were caused by problems at water treatment plants; the other seven resulted from problems in the water distribution systems and plumbing of individual facilities (e.g., a restaurant). Six of the seven outbreaks were associated with chemical contamination of the drinking water; the seventh outbreak was attributed to a small round structured virus. Four of the seven outbreaks occurred because of backflow or backsiphonage through a cross-connection, and two occurred because of high levels of copper that leached into water after the installation of new plumbing. For three of the four outbreaks caused by contamination from a cross-connection, an improperly installed vacuum breaker or a faulty backflow prevention device was identified; no protection against backsiphonage was found for the fourth outbreak. Thirty-seven outbreaks from 17 states were attributed to recreational water exposure and affected an estimated 9,129 persons, including 8,449 persons in two large outbreaks of cryptosporidiosis. Twenty-two (59.5%) of these 37 were outbreaks of gastroenteritis; nine (24.3%) were outbreaks of dermatitis; and six (16.2%) were single cases of primary amebic meningoencephalitis caused by Naegleria fowleri, all of which were fatal. The etiologic agent was identified for 33 (89.2%) of the 37 outbreaks. Six (27.3%) of the 22 outbreaks of gastroenteritis were caused by Cryptosporidium parvum and six (27.3%) by E. coli O157:H7. All of the latter were associated with unchlorinated water (i.e., in lakes) or inadequately chlorinated water (i.e., in a pool). Thirteen (59.1%) of these 22 outbreaks were associated with lake water, eight (36.4%) with swimming or wading pools, and one(4.5%) with a hot spring. Of the nine outbreaks of dermatitis, seven (77.8%) were outbreaks of Pseudomonas dermatitis associated with hot tubs, and two (22.2%) were lake-associated outbreaks of swimmer's itch caused by Schistosoma species. WBDOs caused by E. coli O157:H7 were reported more frequently than in previous years and were associated primarily with recreational lake water. This finding suggests the need for better monitoring of water quality and identification of sources of

The Construction of Defense Department Contracts in Thin Markets

DTIC Science & Technology

2014-04-30

future rounds of contracting. An example of a good or service with a high degree of specialized investments is the production of flu vaccines ...Producing flu vaccines requires a substantial investment in scientific research (a highly specialized human skill) and specialized laboratories and...equipment. If the purchasing government finds that the flu vaccine it purchases does not meets its needs, then it cannot easily find another vendor

Public Health Colloquium Conference Report

DTIC Science & Technology

2010-07-01

number of these patients also have a rash on their face and extremities. As flu season has not ended, patients are being sent home with the usual...response (e.g. flu vs. smallpox) can create associated challenges in decision making • Determine who is in charge for response (e.g. CDC for flu ...food to include more vegetables and fruits, perhaps healthier sandwiches like tuna fish or chicken salad. UCCS PUBLIC HEALTH COLLOQUIUM

Determination of fluvoxamine maleate in human urine and human serum using alkaline KMnO4 -rhodamine B chemiluminescence.

PubMed

Yang, Dongqin; He, Yanyan; Chen, Funan

2017-09-01

The flow-injection chemiluminescence (FI-CL) behavior of a gold nanocluster (Au NC)-enhanced rhodamine B-KMnO 4 system was studied under alkaline conditions for the first time. In the present study, the as-prepared bovine serum albumin-stabilized Au NCs showed excellent stability and reproducibility. The addition of trace levels of fluvoxamine maleate (Flu) led to an obvious decline in CL intensity in the rhodamine B-KMnO 4 -Au NCs system, which could be used for quantitative detection of Flu. Under optimized conditions, the proposed CL system exhibited a favorable analytical performance for Flu determination in the range 2 to 100 μg ml -1 . The detection limit for Flu measurement was 0.021 μg ml -1 . Moreover, this newly developed system revealed outstanding selectivity for Flu detection when compared with a multitude of other species, such as the usual ions, uric acid and a section of hydroxy compounds. Additionally, CL spectra, UV-visible spectroscopes and fluorescence spectra were measured in order to determine the possible reaction mechanism. This approach could be used to detect Flu in human urine and human serum samples with the desired recoveries and could have promising application under physiological conditions. Copyright © 2017 John Wiley & Sons, Ltd.

Molecular Dynamics Analysis of Antibody Recognition and Escape by Human H1N1 Influenza Hemagglutinin

PubMed Central

Ieong, Pek; Amaro, Rommie E.; Li, Wilfred W.

2015-01-01

The antibody immunoglobulin (Ig) 2D1 is effective against the 1918 hemagglutinin (HA) and also known to cross-neutralize the 2009 pandemic H1N1 influenza HA through a similar epitope. However, the detailed mechanism of neutralization remains unclear. We conducted molecular dynamics (MD) simulations to study the interactions between Ig-2D1 and the HAs from the 1918 pandemic flu (A/South Carolina/1/1918, 18HA), the 2009 pandemic flu (A/California/04/2009, 09HA), a 2009 pandemic flu mutant (A/California/04/2009, 09HA_mut), and the 2006 seasonal flu (A/Solomon Islands/3/2006, 06HA). MM-PBSA analyses suggest the approximate free energy of binding (ΔG) between Ig-2D1 and 18HA is −74.4 kcal/mol. In comparison with 18HA, 09HA and 06HA bind Ig-2D1 ∼6 kcal/mol (ΔΔG) weaker, and the 09HA_mut bind Ig-2D1 only half as strong. We also analyzed the contributions of individual epitope residues using the free-energy decomposition method. Two important salt bridges are found between the HAs and Ig-2D1. In 09HA, a serine-to-asparagine mutation coincided with a salt bridge destabilization, hydrogen bond losses, and a water pocket formation between 09HA and Ig-2D1. In 09HA_mut, a lysine-to-glutamic-acid mutation leads to the loss of both salt bridges and destabilizes interactions with Ig-2D1. Even though 06HA has a similar ΔG to 09HA, it is not recognized by Ig-2D1 in vivo. Because 06HA contains two potential glycosylation sites that could mask the epitope, our results suggest that Ig-2D1 may be active against 06HA only in the absence of glycosylation. Overall, our simulation results are in good agreement with observations from biological experiments and offer novel mechanistic insights, to our knowledge, into the immune escape of the influenza virus. PMID:26039171

Flu vaccination communication in Europe: What does the government communicate and how?

PubMed

Ohlrogge, Anne Wiebke; Suggs, L Suzanne

2018-04-24

The Flu vaccine is the most effective measure to prevent influenza. Yet, vaccination rates remain at sub-optimal levels, with 10%-29% coverage rates in the general population of the EU. As mistrust in vaccines has increased, effective strategies are needed and one is communication. The aim of this research is to identify vaccination recommendations of the health ministries in 5 European Member States and to investigate the communication strategies used. Two methods were employed in this study. A review of flu vaccination recommendations in the European Union and five Members States (Austria, Germany, Malta, Ireland and United Kingdom). Next a content analysis was conducted of flu vaccination communication in those six contexts. All countries recommend flu vaccination as a primary protection tool, but they differed in their recommendations for various target audiences. Channels for communication included seven websites and 42 other materials. The main messages used were gained framed promoting protection, either for oneself, family or patients. Most communications provided basic information replying on providing facts and knowledge about the flu and the benefits of vaccination. No information on the development of the communication or its effects were found. Communicating flu vaccination as a protective tool is common across countries and is consistent with the benefits of vaccination. Furthermore, the communications in the countries were not consistent with their recommendations. As the recommendations vary across and within countries, communication becomes a challenge. They should, at a minimum, be consistent with EU and country specific recommendations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Flexible Label-Free Quantitative Assay for Antibodies to Influenza Virus Hemagglutinins ▿

PubMed Central

Carney, Paul J.; Lipatov, Aleksandr S.; Monto, Arnold S.; Donis, Ruben O.; Stevens, James

2010-01-01

During the initial pandemic influenza H1N1 virus outbreak, assays such as hemagglutination inhibition and microneutralization provided important information on the relative protection afforded by the population's cross-reactivity from prior infections and immunizations with seasonal vaccines. However, these assays continue to be limited in that they are difficult to automate for high throughput, such as in pandemic situations, as well as to standardize between labs. Thus, new technologies are being sought to improve standardization, reliability, and throughput by using chemically defined reagents rather than whole cells and virions. We now report the use of a cell-free and label-free flu antibody biosensor assay (f-AbBA) for influenza research and diagnostics that utilizes recombinant hemagglutinin (HA) in conjunction with label-free biolayer interferometry technology to measure biomolecular interactions between the HA and specific anti-HA antibodies or sialylated ligands. We evaluated f-AbBA to determine anti-HA antibody binding activity in serum or plasma to assess vaccine-induced humoral responses. This assay can reveal the impact of antigenic difference on antibody binding to HA and also measure binding to different subtypes of HA. We also show that the biosensor assay can measure the ability of HA to bind a model sialylated receptor-like ligand. f-AbBA could be used in global surveillance laboratories since preliminary tests on desiccated HA probes showed no loss of activity after >2 months in storage at room temperature, indicating that the same reagent lots could be used in different laboratories to minimize interlaboratory assay fluctuation. Future development of such reagents and similar technologies may offer a robust platform for future influenza surveillance activities. PMID:20660137

Potent cross-reactive neutralization of SARS coronavirus isolates by human monoclonal antibodies

PubMed Central

Zhu, Zhongyu; Chakraborti, Samitabh; He, Yuxian; Roberts, Anjeanette; Sheahan, Tim; Xiao, Xiaodong; Hensley, Lisa E.; Prabakaran, Ponraj; Rockx, Barry; Sidorov, Igor A.; Corti, Davide; Vogel, Leatrice; Feng, Yang; Kim, Jae-Ouk; Wang, Lin-Fa; Baric, Ralph; Lanzavecchia, Antonio; Curtis, Kristopher M.; Nabel, Gary J.; Subbarao, Kanta; Jiang, Shibo; Dimitrov, Dimiter S.

2007-01-01

The severe acute respiratory syndrome coronavirus (SARS-CoV) caused a worldwide epidemic in late 2002/early 2003 and a second outbreak in the winter of 2003/2004 by an independent animal-to-human transmission. The GD03 strain, which was isolated from an index patient of the second outbreak, was reported to resist neutralization by the human monoclonal antibodies (hmAbs) 80R and S3.1, which can potently neutralize isolates from the first outbreak. Here we report that two hmAbs, m396 and S230.15, potently neutralized GD03 and representative isolates from the first SARS outbreak (Urbani, Tor2) and from palm civets (SZ3, SZ16). These antibodies also protected mice challenged with the Urbani or recombinant viruses bearing the GD03 and SZ16 spike (S) glycoproteins. Both antibodies competed with the SARS-CoV receptor, ACE2, for binding to the receptor-binding domain (RBD), suggesting a mechanism of neutralization that involves interference with the SARS-CoV–ACE2 interaction. Two putative hot-spot residues in the RBD (Ile-489 and Tyr-491) were identified within the SARS-CoV spike that likely contribute to most of the m396-binding energy. Residues Ile-489 and Tyr-491 are highly conserved within the SARS-CoV spike, indicating a possible mechanism of the m396 cross-reactivity. Sequence analysis and mutagenesis data show that m396 might neutralize all zoonotic and epidemic SARS-CoV isolates with known sequences, except strains derived from bats. These antibodies exhibit cross-reactivity against isolates from the two SARS outbreaks and palm civets and could have potential applications for diagnosis, prophylaxis, and treatment of SARS-CoV infections. PMID:17620608

Fluorescent carbohydrate probes for cell lectins

NASA Astrophysics Data System (ADS)

Galanina, Oxana; Feofanov, Alexei; Tuzikov, Alexander B.; Rapoport, Evgenia; Crocker, Paul R.; Grichine, Alexei; Egret-Charlier, Marguerite; Vigny, Paul; Le Pendu, Jacques; Bovin, Nicolai V.

2001-09-01

Fluorescein labeled carbohydrate (Glyc) probes were synthesized as analytical tools for the study of cellular lectins, i.e. SiaLe x-PAA-flu, Sia 2-PAA-flu, GlcNAc 2-PAA-flu, LacNAc-PAA-flu and a number of similar ones, with PAA a soluble polyacrylamide carrier. The binding of SiaLe x-PAA-flu was assessed using CHO cells transfected with E-selectin, and the binding of Sia 2-PAA-flu was assessed by COS cells transfected with siglec-9. In flow cytometry assays, the fluorescein probes demonstrated a specific binding to the lectin-transfected cells that was inhibited by unlabeled carbohydrate ligands. The intense binding of SiaLe x-PAA- 3H to the E-selectin transfected cells and the lack of binding to both native and permeabilized control cells lead to the conclusion that the polyacrylamide carrier itself and the spacer arm connecting the carbohydrate moiety with PAA did not contribute anymore to the binding. Tumors were obtained from nude mice by injection of CHO E-selectin or mock transfected cells. The fluorescent SiaLe x-PAA-flu probe could bind to the tumor sections from E-selectin positive CHO cells, but not from the control ones. Thus, these probes can be used to reveal specifically the carbohydrate binding sites on cells in culture as well as cells in tissue sections. The use of the confocal spectral imaging technique with Glyc-PAA-flu probes offered the unique possibility to detect lectins in different cells, even when the level of lectin expression was rather low. The confocal mode of spectrum recording provided an analysis of the probe localization with 3D submicron resolution. The spectral analysis (as a constituent part of the confocal spectral imaging technique) enabled interfering signals of the probe and intrinsic cellular fluorescence to be accurately separated, the distribution of the probe to be revealed and its local concentration to be measured.

wFlu: Characterization and Evaluation of a Native Wolbachia from the Mosquito Aedes fluviatilis as a Potential Vector Control Agent

PubMed Central

Gonçalves, Daniela da Silva; Moreira, Luciano Andrade

2013-01-01

There is currently considerable interest and practical progress in using the endosymbiotic bacteria Wolbachia as a vector control agent for human vector-borne diseases. Such vector control strategies may require the introduction of multiple, different Wolbachia strains into target vector populations, necessitating the identification and characterization of appropriate endosymbiont variants. Here, we report preliminary characterization of wFlu, a native Wolbachia from the neotropical mosquito Aedes fluviatilis, and evaluate its potential as a vector control agent by confirming its ability to cause cytoplasmic incompatibility, and measuring its effect on three parameters determining host fitness (survival, fecundity and fertility), as well as vector competence (susceptibility) for pathogen infection. Using an aposymbiotic strain of Ae. fluviatilis cured of its native Wolbachia by antibiotic treatment, we show that in its natural host wFlu causes incomplete, but high levels of, unidirectional cytoplasmic incompatibility, has high rates of maternal transmission, and no detectable fitness costs, indicating a high capacity to rapidly spread through host populations. However, wFlu does not inhibit, and even enhances, oocyst infection with the avian malaria parasite Plasmodium gallinaceum. The stage- and sex-specific density of wFlu was relatively low, and with limited tissue distribution, consistent with the lack of virulence and pathogen interference/symbiont-mediated protection observed. Unexpectedly, the density of wFlu was also shown to be specifically-reduced in the ovaries after bloodfeeding Ae. fluviatilis. Overall, our observations indicate that the Wolbachia strain wFlu has the potential to be used as a vector control agent, and suggests that appreciable mutualistic coevolution has occurred between this endosymbiont and its natural host. Future work will be needed to determine whether wFlu has virulent host effects and/or exhibits pathogen interference when artificially-transfected to the novel mosquito hosts that are the vectors of human pathogens. PMID:23555728

Poliomyelitis Outbreak,Pointe-Noire, Republic of the Congo, September 2010–February 2011

PubMed Central

Llosa, Augusto E.; Mouniaman-Nara, Isabelle; Kouassi, Felix; Ngala, Joseph; Boxall, Naomi; Porten, Klaudia; Grais, Rebecca F.

2011-01-01

On November 4, 2010, the Republic of the Congo declared a poliomyelitis outbreak. A cross-sectional survey in Pointe-Noire showed poor sanitary conditions and low vaccination coverage (55.5%), particularly among young adults. Supplementary vaccination should focus on older age groups in countries with evidence of immunity gaps. PMID:21801636

Toward unsupervised outbreak detection through visual perception of new patterns

PubMed Central

Lévy, Pierre P; Valleron, Alain-Jacques

2009-01-01

Background Statistical algorithms are routinely used to detect outbreaks of well-defined syndromes, such as influenza-like illness. These methods cannot be applied to the detection of emerging diseases for which no preexisting information is available. This paper presents a method aimed at facilitating the detection of outbreaks, when there is no a priori knowledge of the clinical presentation of cases. Methods The method uses a visual representation of the symptoms and diseases coded during a patient consultation according to the International Classification of Primary Care 2nd version (ICPC-2). The surveillance data are transformed into color-coded cells, ranging from white to red, reflecting the increasing frequency of observed signs. They are placed in a graphic reference frame mimicking body anatomy. Simple visual observation of color-change patterns over time, concerning a single code or a combination of codes, enables detection in the setting of interest. Results The method is demonstrated through retrospective analyses of two data sets: description of the patients referred to the hospital by their general practitioners (GPs) participating in the French Sentinel Network and description of patients directly consulting at a hospital emergency department (HED). Informative image color-change alert patterns emerged in both cases: the health consequences of the August 2003 heat wave were visualized with GPs' data (but passed unnoticed with conventional surveillance systems), and the flu epidemics, which are routinely detected by standard statistical techniques, were recognized visually with HED data. Conclusion Using human visual pattern-recognition capacities to detect the onset of unexpected health events implies a convenient image representation of epidemiological surveillance and well-trained "epidemiology watchers". Once these two conditions are met, one could imagine that the epidemiology watchers could signal epidemiological alerts, based on "image walls" presenting the local, regional and/or national surveillance patterns, with specialized field epidemiologists assigned to validate the signals detected. PMID:19515246

Pandemic Influenza: Domestic Preparedness Efforts

DTIC Science & Technology

2005-11-10

three different strains of influenza.77 Only one ( sanofi pasteur78) of nine manufacturers of injectable flu vaccine is located in the United States...has awarded contracts to Aventis Pasteur (now sanofi pasteur) to develop prototype human vaccines against H5N1 flu, and to Chiron Corporation to develop...occur in the next several years, the U.S. response would be affected by the limited availability of a vaccine (the best preventive measure for flu), as

FoodChain-Lab: A Trace-Back and Trace-Forward Tool Developed and Applied during Food-Borne Disease Outbreak Investigations in Germany and Europe.

PubMed

Weiser, Armin A; Thöns, Christian; Filter, Matthias; Falenski, Alexander; Appel, Bernd; Käsbohrer, Annemarie

2016-01-01

FoodChain-Lab is modular open-source software for trace-back and trace-forward analysis in food-borne disease outbreak investigations. Development of FoodChain-Lab has been driven by a need for appropriate software in several food-related outbreaks in Germany since 2011. The software allows integrated data management, data linkage, enrichment and visualization as well as interactive supply chain analyses. Identification of possible outbreak sources or vehicles is facilitated by calculation of tracing scores for food-handling stations (companies or persons) and food products under investigation. The software also supports consideration of station-specific cross-contamination, analysis of geographical relationships, and topological clustering of the tracing network structure. FoodChain-Lab has been applied successfully in previous outbreak investigations, for example during the 2011 EHEC outbreak and the 2013/14 European hepatitis A outbreak. The software is most useful in complex, multi-area outbreak investigations where epidemiological evidence may be insufficient to discriminate between multiple implicated food products. The automated analysis and visualization components would be of greater value if trading information on food ingredients and compound products was more easily available.

FoodChain-Lab: A Trace-Back and Trace-Forward Tool Developed and Applied during Food-Borne Disease Outbreak Investigations in Germany and Europe

PubMed Central

Filter, Matthias; Falenski, Alexander; Appel, Bernd; Käsbohrer, Annemarie

2016-01-01

FoodChain-Lab is modular open-source software for trace-back and trace-forward analysis in food-borne disease outbreak investigations. Development of FoodChain-Lab has been driven by a need for appropriate software in several food-related outbreaks in Germany since 2011. The software allows integrated data management, data linkage, enrichment and visualization as well as interactive supply chain analyses. Identification of possible outbreak sources or vehicles is facilitated by calculation of tracing scores for food-handling stations (companies or persons) and food products under investigation. The software also supports consideration of station-specific cross-contamination, analysis of geographical relationships, and topological clustering of the tracing network structure. FoodChain-Lab has been applied successfully in previous outbreak investigations, for example during the 2011 EHEC outbreak and the 2013/14 European hepatitis A outbreak. The software is most useful in complex, multi-area outbreak investigations where epidemiological evidence may be insufficient to discriminate between multiple implicated food products. The automated analysis and visualization components would be of greater value if trading information on food ingredients and compound products was more easily available. PMID:26985673

Large outbreak of infection with Escherichia coli O157 PT21/28 in Eccleston, Lancashire, due to cross contamination at a butcher's counter.

PubMed

Rajpura, A; Lamden, K; Forster, S; Clarke, S; Cheesbrough, J; Gornall, S; Waterworth, S

2003-12-01

An outbreak of infection with Escherichia coli O157 Phage Type 21/28 occurred between the 23rd November 2001 and the 7th December 2001 in Eccleston, Lancashire. There were 30 confirmed cases (23 with positive faecal isolates and seven serologically positive). Eccleston is a village of approximately 5,000 inhabitants with a single medical practice where many of the cases were patients. Initial investigations identified the suspected source as a butcher's counter, operated as a franchise, in a supermarket in Eccleston. The butcher closed voluntarily on the 24th November. The median age of cases was 60 with a mean of 56 and a range of 2-91 years. Of the 30 confirmed cases, 22 were admitted to hospital. Two patients developed serious complications but all 30 made a full recovery. Microbiological investigations confirmed the butcher's counter as the source of the outbreak. The epidemiological evidence implicated cooked meats and microbiological evidence confirmed that contamination had occurred between raw and cooked meats. The deficiencies in meat hygiene practice that were identified could have led to the cross contamination. This outbreak illustrates the risk associated with the handling of raw and cooked meats in the same shop. Complete physical separation of raw and cooked meat operations reduces the risk of such outbreaks.

INSaFLU: an automated open web-based bioinformatics suite "from-reads" for influenza whole-genome-sequencing-based surveillance.

PubMed

Borges, Vítor; Pinheiro, Miguel; Pechirra, Pedro; Guiomar, Raquel; Gomes, João Paulo

2018-06-29

A new era of flu surveillance has already started based on the genetic characterization and exploration of influenza virus evolution at whole-genome scale. Although this has been prioritized by national and international health authorities, the demanded technological transition to whole-genome sequencing (WGS)-based flu surveillance has been particularly delayed by the lack of bioinformatics infrastructures and/or expertise to deal with primary next-generation sequencing (NGS) data. We developed and implemented INSaFLU ("INSide the FLU"), which is the first influenza-oriented bioinformatics free web-based suite that deals with primary NGS data (reads) towards the automatic generation of the output data that are actually the core first-line "genetic requests" for effective and timely influenza laboratory surveillance (e.g., type and sub-type, gene and whole-genome consensus sequences, variants' annotation, alignments and phylogenetic trees). By handling NGS data collected from any amplicon-based schema, the implemented pipeline enables any laboratory to perform multi-step software intensive analyses in a user-friendly manner without previous advanced training in bioinformatics. INSaFLU gives access to user-restricted sample databases and projects management, being a transparent and flexible tool specifically designed to automatically update project outputs as more samples are uploaded. Data integration is thus cumulative and scalable, fitting the need for a continuous epidemiological surveillance during the flu epidemics. Multiple outputs are provided in nomenclature-stable and standardized formats that can be explored in situ or through multiple compatible downstream applications for fine-tuned data analysis. This platform additionally flags samples as "putative mixed infections" if the population admixture enrolls influenza viruses with clearly distinct genetic backgrounds, and enriches the traditional "consensus-based" influenza genetic characterization with relevant data on influenza sub-population diversification through a depth analysis of intra-patient minor variants. This dual approach is expected to strengthen our ability not only to detect the emergence of antigenic and drug resistance variants but also to decode alternative pathways of influenza evolution and to unveil intricate routes of transmission. In summary, INSaFLU supplies public health laboratories and influenza researchers with an open "one size fits all" framework, potentiating the operationalization of a harmonized multi-country WGS-based surveillance for influenza virus. INSaFLU can be accessed through https://insaflu.insa.pt .

Danio rerio embryos on Prozac - Effects on the detoxification mechanism and embryo development.

PubMed

Cunha, V; Rodrigues, P; Santos, M M; Moradas-Ferreira, P; Ferreira, M

2016-09-01

In the past decade the presence of psychopharmaceuticals, including fluoxetine (FLU), in the aquatic environment has been associated with the increasing trend in human consumption of these substances. Aquatic organisms are usually exposed to chronic low doses and, therefore, risk assessments should evaluate the effects of these compounds in non-target organisms. Teleost fish possess an array of active defence mechanisms to cope with the deleterious effects of xenobiotics. These include ABC transporters, phase I and II of cellular detoxification and oxidative stress enzymes. Hence, the present study aimed at characterising the effect of FLU on embryo development of the model teleost zebrafish (Danio rerio) concomitantly with changes in the detoxification mechanisms during early developmental phases. Embryos were exposed to different concentrations of FLU (0.0015, 0.05, 0.1, 0.5 and 0.8μM) for 80hours post fertilization. Development was screened and the impact in the transcription of key genes, i.e., abcb4, abcc1, abcc2, abcg2, cyp1a, cyp3a65, gst, sod, cat, ahr, pxr, pparα, pparβ, pparγ, rxraa, rxrab, rxrbb, rxrga, rxrgb, raraa, rarab, rarga evaluated. In addition, accumulation assays were performed to measure the activity of ABC proteins and antioxidant enzymes (CAT and Cu/ZnSOD) after exposure to FLU. Embryo development was disrupted at the lowest FLU concentration tested (0.0015μM), which is in the range of concentrations found in WWTP effluents. Embryos exposed to higher concentrations of FLU decreased Cu/Zn SOD, and increased CAT (0.0015 and 0.5μM) enzymatic activity. Exposure to higher concentrations of FLU decreased the expression of most genes belonging to the detoxification system and upregulated cat at 0.0015μM of FLU. Most of the tested concentrations downregulated pparα, pparβ, pparγ, and raraa, rxraa, rxrab, rxrbb rxrgb and ahr gene expression while pxr was significantly up regulated at all tested concentrations. In conclusion, this study shows that FLU can impact zebrafish embryo development, at concentrations found in effluents of WWTPs, concomitantly with changes in antioxidant enzymes, and the transcription of key genes involved in detoxification and development. These finding raises additional concerns supporting the need to monitor the presence of this compound in aquatic reservoirs. Copyright © 2016 Elsevier B.V. All rights reserved.

First Aid: Coughing

MedlinePlus

... Asthma Center Flu Center Whooping Cough Your Lungs & Respiratory System Flu Center Bronchitis Why Should I Care About Germs? Lungs and Respiratory System View more About Us Contact Us Partners Editorial ...

Consecutive salmonella outbreaks traced to the same bakery.

PubMed Central

Evans, M. R.; Tromans, J. P.; Dexter, E. L.; Ribeiro, C. D.; Gardner, D.

1996-01-01

Two consecutive community outbreaks of Salmonella enteritidis phage type 4 (PT4) traced to the same bakery occurred in Cardiff, Wales during August-September 1992. In the first outbreak, illness was associated with eating custard slices (odds ratio 23.8, 95% confidence interval 6.5-94.4, P < 0.0001), and in the second, with eating fresh cream cakes (odds ratio 15.8, 95% confidence interval 1.6-374, P = 0.004). Environmental investigations implicated cross-contamination during preparation of the cold-custard mix as the cause of the first outbreak, and inadequate cleaning and disinfection of nozzles used for piping cream in the second outbreak. S. enteritidis PT4 was isolated from fresh cream sponge cake retained by a case and from two fresh cream cakes and four environmental swabs obtained at the bakery. This incident illustrates the hazard of widespread environmental contamination with salmonella and the need for thorough environmental cleansing for any premises implicated in an outbreak of food poisoning. PMID:8620907

Comparison of Directigen Flu A+B with Real Time PCR in the Diagnosis of Influenza.

PubMed

Bosevska, Golubinka; Panovski, Nikola; Janceska, Elizabeta; Mikik, Vladimir; Topuzovska, Irena Kondova; Milenkovik, Zvonko

2015-01-01

Early diagnosis and treatment of patients with influenza is the reason why physicians need rapid high-sensitivity influenza diagnostic tests that require no complex lab equipment and can be performed and interpreted within 15 min. The Aim of this study was to compare the rapid Directigen Flu A+B test with real time PCR for detection of influenza viruses in the Republic of Macedonia. One-hundred-eight respiratory samples (combined nose and throat swabs) were routinely collected for detection of influenza virus during influenza seasons. Forty-one patients were pediatric cases and 59 were adult. Their mean age was 23 years. The patients were allocated into 6 age groups: 0-4 yrs, 5-9 yrs, 10-14 yrs, 15-19 yrs, 20-64 yrs and > 65 yrs. Each sample was tested with Directigen Flu A+B and CDC real time PCR kit for detection and typisation/subtypisation of influenza according to the lab diagnostic protocol. Directigen Flu A+B identified influenza A virus in 20 (18.5%) samples and influenza B virus in two 2 (1.9%) samples. The high specificity (100%) and PPV of Directigen Flu A+B we found in our study shows that the positive results do not need to be confirmed. The overall sensitivity of Directigen Flu A+B is 35.1% for influenza A virus and 33.0% for influenza B virus. The sensitivity for influenza A is higher among children hospitalized (45.0%) and outpatients (40.0%) versus adults. Directigen Flu A+B has relatively low sensitivity for detection of influenza viruses in combined nose and throat swabs. Negative results must be confirmed.

[Influenza virus].

PubMed

Juozapaitis, Mindaugas; Antoniukas, Linas

2007-01-01

Every year, especially during the cold season, many people catch an acute respiratory disease, namely flu. It is easy to catch this disease; therefore, it spreads very rapidly and often becomes an epidemic or a global pandemic. Airway inflammation and other body ailments, which form in a very short period, torment the patient several weeks. After that, the symptoms of the disease usually disappear as quickly as they emerged. The great epidemics of flu have rather unique characteristics; therefore, it is possible to identify descriptions of such epidemics in historic sources. Already in the 4th century bc, Hippocrates himself wrote about one of them. It is known now that flu epidemics emerge rather frequently, but there are no regular intervals between those events. The epidemics can differ in their consequences, but usually they cause an increased mortality of elderly people. The great flu epidemics of the last century took millions of human lives. In 1918-19, during "The Spanish" pandemic of flu, there were around 40-50 millions of deaths all over the world; "Pandemic of Asia" in 1957 took up to one million lives, etc. Influenza virus can cause various disorders of the respiratory system: from mild inflammations of upper airways to acute pneumonia that finally results in the patient's death. Scientist Richard E. Shope, who investigated swine flu in 1920, had a suspicion that the cause of this disease might be a virus. Already in 1933, scientists from the National Institute for Medical Research in London - Wilson Smith, Sir Christopher Andrewes, and Sir Patrick Laidlaw - for the first time isolated the virus, which caused human flu. Then scientific community started the exhaustive research of influenza virus, and the great interest in this virus and its unique features is still active even today.

Human Parainfluenza Viruses

MedlinePlus

... HPIVs Are Not the Same as Influenza (Flu) Viruses There are many different types of viruses that cause respiratory infections. Two of those viruses are HPIVs and influenza (flu). People get HPIV ...

A better prediction model for patient surges from influenza? New Internet-based tool shows promise, say researchers.

PubMed

2012-03-01

In a study focused on Baltimore, MD, researchers have found that data culled from Google Flu Trends, a free Internet-based influenza surveillance system, shows strong correlation with hikes in ED visits from patients with flu-like symptoms. While the approach has yet to be validated in other cities or regions, experts recommend that ED administrators and providers familiarize themselves with the new surveillance tool and stay abreast of developments regarding similar surveillance mechanisms. Google Flu Trends (www.google.org/flutrends/) is a free Internet-based tool that monitors Internet-based searches for flu information. Users can customize their search by location (city, state, country). Researchers say the advantage of this approach over traditional surveillance methods is that it provides real-time data about flu-related activity in a city or region. Traditional approaches, which rely on case reports from the Centers for Disease Control and Prevention, are delayed. Researchers hope to eventually leverage this tool, and perhaps other surveillance data, into a powerful early-warning mechanism that EDs can use to better plan for patient surges due to influenza.

Long term serious olfactory loss in colds and/or flu.

PubMed

de Haro-Licer, Josep; Roura-Moreno, Jordi; Vizitiu, Anabella; González-Fernández, Adela; González-Ares, Josep Antón

2013-01-01

In the general population, we can find 2-3% of lifelong olfactory disorders (from hyposmia to anosmia). Two of the most frequent aetiologies are the common cold and flu. The aim of this study was to show the degree of long-term olfactory dysfunction caused by a cold or flu. This study was based on 240 patients, with olfactory loss caused only by flu or a cold. We excluded all patients with concomitant illness (66 patients), the rest of patients (n=174) consisted of 51 men (29.3%) and 123 women (70.7%). They all underwent olfactometry study (i and v cranial nerve) and a nasal sinus computed tomography scan, as well as magnetic resonance imaging of the brain. Results were compared with a control group (n=120). Very significant differences in levels of olfactory impairment for the olfactory nerve (P<.00001) and trigeminal nerve (P<.0001) were confirmed. People that suffer olfactory dysfunction for more than 6 months, from flu or a cold, present serious impairment of olfactory abilities. Copyright © 2012 Elsevier España, S.L. All rights reserved.

The effects of a hot drink on nasal airflow and symptoms of common cold and flu.

PubMed

Sanu, A; Eccles, R

2008-12-01

Hot drinks are a common treatment for common cold and flu but there are no studies reported in the scientific and clinical literature on this mode of treatment. This study investigated the effects of a hot fruit drink on objective and subjective measures of nasal airflow, and on subjective scores for common cold/flu symptoms in 30 subjects suffering from common cold/flu. The results demonstrate that the hot drink had no effect on objective measurement of nasal airflow but it did cause a significant improvement in subjective measures of nasal airflow. The hot drink provided immediate and sustained relief from symptoms of runny nose, cough, sneezing, sore throat, chilliness and tiredness, whereas the same drink at room temperature only provided relief from symptoms of runny nose, cough and sneezing. The effects of the drinks are discussed in terms of a placebo effect and physiological effects on salivation and airway secretions. In conclusion the results support the folklore that a hot tasty drink is a beneficial treatment for relief of most symptoms of common cold and flu.

[Emergence of new viruses in Asia: is climate change involved?].

PubMed

Chastel, C

2004-11-01

Tropical Africa is not the only area where deadly viruses have recently emerged. In South-East Asia severe epidemics of dengue hemorrhagic fever started in 1954 and flu pandemics have originated from China such as the Asian flu (H2N2) in 1957, the Hong-Kong flu (H3N2) in 1968, and the Russian flu (H1N1) in 1977. However, it is especially during the last ten years that very dangerous viruses for mankind have repeatedly developed in Asia, with the occurrence of Alkhurma hemorrhagic fever in Saudi Arabia (1995), avian flu (H5N1) in Hong-Kong (1997), Nipah virus encephalitis in Malaysia (1998,) and, above all, the SARS pandemic fever from Southern China (2002). The evolution of these viral diseases was probably not directly affected by climate change. In fact, their emergential success may be better explained by the development of large industry poultry flocks increasing the risks of epizootics, dietary habits, economic and demographic constraints, and negligence in the surveillance and reporting of the first cases.

Photonic reagents for concentration measurement of flu-orescent proteins with overlapping spectra

NASA Astrophysics Data System (ADS)

Goun, Alexei; Bondar, Denys I.; Er, Ali O.; Quine, Zachary; Rabitz, Herschel A.

2016-05-01

By exploiting photonic reagents (i.e., coherent control by shaped laser pulses), we employ Optimal Dynamic Discrimination (ODD) as a novel means for quantitatively characterizing mixtures of fluorescent proteins with a large spectral overlap. To illustrate ODD, we simultaneously measured concentrations of in vitro mixtures of Enhanced Blue Fluorescent Protein (EBFP) and Enhanced Cyan Fluorescent Protein (ECFP). Building on this foundational study, the ultimate goal is to exploit the capabilities of ODD for parallel monitoring of genetic and protein circuits by suppressing the spectral cross-talk among multiple fluorescent reporters.

Trend Of Irrational Medication Among The Students Of Department Of Pharmacy Abbottabad University Of Science And Technology In Common Cold And Flu.

PubMed

Rehman, Mujeeb Ur; Mehsud, Saif Ullah; Ali, Sartaj; Ishaq, Muhammad; Khan, Mumtaz Ali

2017-01-01

Common cold and flu are mostly of viral pathogenesis with symptoms in upper respiratory tract. It is highly contagious and close inter-individual contact in winter season increase the spread spectrum. Mis-interpretation with bacterial cause leads to irrationality in its medication. A cross-sectional study was conducted among pharmacy department students in February-March 2016. Data were collected through self-administered questionnaire and expressed as percentage frequency. Total 180 students were provided with questionnaire to fill the desired data. 66 out of them were reported as patients of common cold and flu. Trend of medication after compilation and analyzing data reveal that: 60.60% (n=40/66) students got irrational medication, 4.54% (n=3/66) students presents with other disease, so were declared of complex nature and 9.1% (n=6/66) patients, presented only with symptoms were counseled accordingly to the standard therapy by Health Protection Agency-UK (Management of infection guidance for primary care for consultation and local adaptation, 2013), and Columbia University Medical Center (Guidelines for the empiric use of antibiotics in adult patients - Feb, 2005) and all of them were followed for their entire therapy time. All of the counseled patients recovered successfully. Total 25.76% (n=17/66) other than that of counseled group students also got rational medication. Use of medicine by students in study was found irrational. National and international awareness programs about such viral disease should be designed and arranged to promote information in the community and limit the irrational medication. It also need an active health regulatory authority in undeveloped and less developed countries specially to limit the availability of prescription drugs without physician advise through availability of qualified person in pharmacies.

Microgravity

NASA Image and Video Library

2004-04-15

The loss of productivity due to flu is staggering. Costs range as much as $20 billio a year. High mutation rates of the flu virus have hindered development of new drugs or vaccines. The secret lies in a small molecule which is attached to the host cell's surface. Each flu virus, no matter what strain, must remove this small molecule to escape the host cell to spread infection. Using data from space and earth grown crystals, researchers from the Center of Macromolecular Crystallography (CMC) are desining drugs to bind with this protein's active site. This lock and key fit reduces the spread of flu in the body by blocking its escape route. In collaboration with its corporate partner, the CMC has refined drug structure in preparation for clinical trials. Tested and approved relief is expected to reach drugstores by year 2004.

Seasonality in risk of pandemic influenza emergence

PubMed Central

Meyers, Lauren Ancel

2017-01-01

Influenza pandemics can emerge unexpectedly and wreak global devastation. However, each of the six pandemics since 1889 emerged in the Northern Hemisphere just after the flu season, suggesting that pandemic timing may be predictable. Using a stochastic model fit to seasonal flu surveillance data from the United States, we find that seasonal flu leaves a transient wake of heterosubtypic immunity that impedes the emergence of novel flu viruses. This refractory period provides a simple explanation for not only the spring-summer timing of historical pandemics, but also early increases in pandemic severity and multiple waves of transmission. Thus, pandemic risk may be seasonal and predictable, with the accuracy of pre-pandemic and real-time risk assessments hinging on reliable seasonal influenza surveillance and precise estimates of the breadth and duration of heterosubtypic immunity. PMID:29049288

An outbreak of adult measles by nosocomial transmission in a high vaccination coverage community.

PubMed

Wang, Fen-juan; Sun, Xiang-jue; Wang, Fu-liang; Jiang, Long-fang; Xu, Er-ping; Guo, Jian-feng

2014-09-01

The aims of this study were to determine the mechanism of an outbreak of measles in adults and to provide scientific measures for putting forward a measles elimination program. We performed a cross-sectional investigation during the measles outbreak to identify a possible communication link. From November 1, 2011 to January 26, 2012, the town reported 11 cases of measles in total. The case study identified an obvious propagation chain, which showed ordered and intimate exposure between cases. Hospital exposure 1-2 weeks before infection with measles was the main cause of the measles outbreak. We must be fully aware of the possibility of nosocomial infection in an outbreak of measles; controlling nosocomial infections is a vital step in the prevention and control of the propagation of measles. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Building Cross-Country Networks for Laboratory Capacity and Improvement.

PubMed

Schneidman, Miriam; Matu, Martin; Nkengasong, John; Githui, Willie; Kalyesubula-Kibuuka, Simeon; Silva, Kelly Araujo

2018-03-01

Laboratory networks are vital to well-functioning public health systems and disease control efforts. Cross-country laboratory networks play a critical role in supporting epidemiologic surveillance, accelerating disease outbreak response, and tracking drug resistance. The East Africa Public Health Laboratory Network was established to bolster diagnostic and disease surveillance capacity. The network supports the introduction of regional quality standards; facilitates the rollout and evaluation of new diagnostic tools; and serves as a platform for training, research, and knowledge sharing. Participating facilities benefitted from state-of-the art investments, capacity building, and mentorship; conducted multicountry research studies; and contributed to disease outbreak response. Copyright © 2017 Elsevier Inc. All rights reserved.

Nitrates

MedlinePlus

... your doctor about every medicine and vitamin or herbal supplement that you are taking, so he or she ... cough, cold, and flu medicines Over-the-counter herbal supplements for treating cough, cold, and flu While taking ...

Swine Influenza (Swine Flu) in Pigs

MedlinePlus

... Address What's this? Submit What's this? Submit Button Influenza Types Seasonal Avian Swine Variant Pandemic Other Key Facts about Swine Influenza (Swine Flu) in Pigs Language: English (US) Español ...

Sore Throat (For Parents)

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... another illness, like a cold , the flu , or mononucleosis . They also can be caused by a strep ... topic for: Parents Kids Teens Strep Throat Coughing Mononucleosis Strep Test: Rapid Strep Test: Throat Culture Flu ...

Bird Flu (Avian Influenza)

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... with bird and human flu viruses. Poultry and egg products Because heat destroys avian viruses, cooked poultry ... 165 F (74 C). Steer clear of raw eggs. Because eggshells are often contaminated with bird droppings, ...

Guillain-Barré Syndrome (GBS) and Flu Vaccine

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... million doses of flu vaccine administered. How do public health authorities investigate cases of GBS? CDC and the Food and Drug Administration (FDA) closely monitor the safety of vaccines approved ...

Cold and Flu

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... Long-term Abdominal Pain (Stomach Pain), Short-term Ankle Problems Breast Problems in Men Breast Problems in Women Chest Pain in Infants and Children Chest Pain, Acute Chest Pain, Chronic Cold and Flu Cough Diarrhea ...

Vomiting (For Parents)

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... Kids Teens First Aid: Dehydration First Aid: Vomiting E. Coli Dehydration Influenza (Flu) "Stomach Flu" What's Puke? Food Poisoning A Kid's Guide to Fever Dehydration E. Coli Gastrointestinal Infections and Diarrhea View more About Us ...

Individual and combined effects of fluoranthene, phenanthrene, mannitol and sulfuric acid on marigold (Calendula officinalis).

PubMed

Khpalwak, Wahdatullah; Abdel-Dayem, Sherif M; Sakugawa, Hiroshi

2018-02-01

A study was conducted to characterize marigold stress response to polycyclic aromatic hydrocarbons (PAHs) (oxidative stress inducers) with and without sulfuric acid (S.Acid; pH 3) (acid-stress inducer), and to evaluate reactive oxygen species (ROS) scavenging activity of mannitol (Mann). Marigold (Calendula officinalis) seedlings were grown in a greenhouse and fumigated with fluoranthene (FLU), phenanthrene (PHE), Mann, and S.Acid individually and in various combinations for 40 days. Various physiological and biochemical parameters among others were analyzed using standard methods. The results revealed that fumigation of FLU induced oxidative stress to the plants via ROS generation leading to negative effects on photosynthesis at near saturating irradiance (A max ), stomatal conductance (G s ), internal carbon dioxide concentration (C i ), leaf water relations and chlorophyll pigments. Significant per cent inhibition of A max (54%), G s (86%) and C i (32%), as well as per cent reductions in chlorophyll a (Chl.a) (33%), Chl.b (34%), and total chlorophyll (Tot. Chl) (48%) contents were recorded in FLU fumigated treatment in comparison to control. Combination of Mann with FLU scavenged the generated ROS and substantially lowered the oxidative stress on the plants hence all the measured parameters were not significantly different from control. PHE fumigation had varied effects on marigold plants and was not as deleterious as FLU. Combined fumigation of S.Acid with both the PAHs had significant negative effect on leaf water relations, and positive effect on fresh and turgid weight of the plants but had no effect on the other measured parameters. The lowest proline contents and highest catalase and ascorbate peroxidase activities in FLU fumigated plants further confirmed that oxidative stress was imposed via the generation of ROS. From the results, it is evident that Mann could be an efficient scavenger of ROS-generated by FLU in the marigold plants. We recommend Mann to be widely used for the protection of higher plants from FLU-generated stress in the urban areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Flu Vaccine Safety and Pregnancy

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... shot. Top of Page Can pregnant women with egg allergies get vaccinated? Most people who have an ... reaction following a flu shot. Special Consideration Regarding Egg Allergy The recommendations for vaccination of people with ...

Caring for Someone Sick (Flu)

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... person. Wash after handling their tissues or laundry. Digital Resources The Flu: A Guide for Parents Do ... by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs Email Recommend ...

HIV/AIDS and the Flu

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... Influenza Types Seasonal Avian Swine Variant Pandemic Other HIV/AIDS and the Flu Questions & Answers Language: English ( ... people with HIV and AIDS. Should people with HIV/AIDS receive the inactivated influenza vaccine? People with ...

HIV and Immunizations

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... to get vaccinated against the flu at the time of year when the risk of flu is greatest. Are all types of vaccines safe for people with HIV? The design of a vaccine depends on several factors, such ...

Influenza (flu) vaccine (Inactivated or Recombinant): What you need to know

MedlinePlus

... taken in its entirety from the CDC Inactivated Influenza Vaccine Information Statement (VIS) www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.html CDC review information for Inactivated Influenza VIS: ...

Flu and Heart Disease and Stroke

MedlinePlus

... Seasonal Avian Swine Variant Pandemic Other Flu and Heart Disease & Stroke Language: English (US) Español Recommend on Facebook Tweet Share Compartir People with Heart Disease* and Those Who Have Had a Stroke Are ...

3-Dimensional Protein Structure of Influenza

NASA Technical Reports Server (NTRS)

2004-01-01

The loss of productivity due to flu is staggering. Costs range as much as $20 billio a year. High mutation rates of the flu virus have hindered development of new drugs or vaccines. The secret lies in a small molecule which is attached to the host cell's surface. Each flu virus, no matter what strain, must remove this small molecule to escape the host cell to spread infection. Using data from space and earth grown crystals, researchers from the Center of Macromolecular Crystallography (CMC) are desining drugs to bind with this protein's active site. This lock and key fit reduces the spread of flu in the body by blocking its escape route. In collaboration with its corporate partner, the CMC has refined drug structure in preparation for clinical trials. Tested and approved relief is expected to reach drugstores by year 2004.

Measles, the media, and MMR: Impact of the 2014-15 measles outbreak.

PubMed

Cataldi, Jessica R; Dempsey, Amanda F; O'Leary, Sean T

2016-12-07

In late 2014, a measles outbreak beginning in California received significant media attention. To better understand the impact of this outbreak, we conducted a survey to assess and compare among vaccine hesitant and non-hesitant new mothers how this outbreak affected vaccine knowledge, attitudes, vaccination plans, and media use. A cross-sectional email survey of English-speaking women with a child ⩽1year old using a convenience sample of women from nine obstetrics and gynecology (OB/GYN) practices in Colorado assessed vaccine hesitancy, knowledge and attitudes about MMR vaccines and the outbreak, MMR vaccination plans before and after the outbreak, and use of and trust for media sources related to the outbreak. The response rate was 50% (351/701). Knowledge about the outbreak was high and vaccination attitudes were mostly favorable. Forty-eight percent of respondents thought MMR vaccine was more important after the outbreak. Online news (76%), television news (75%), and social media (68%) were the most frequently used media sources, yet were highly trusted by only 18%, 22%, and 1% of respondents respectively. Government websites (34%) and information from a doctor's office (34%) were infrequently used, but were highly trusted by 62% and 60% of respondents. Knowledge of the outbreak was lower among vaccine-hesitant respondents. Few mothers changed MMR vaccination plans after the outbreak. New mothers had high levels of knowledge and favorable attitudes about vaccination after the 2014-15 measles outbreak. Media sources used the most are not the most trusted. Communication about outbreaks of vaccine-preventable diseases should include spread of accurate information to new media sources and strengthening of existing trust in traditional media. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Long-Term Flutamide Treatment during Development on Sexual Behavior and Hormone Responsiveness in Rams

PubMed Central

Roselli, Charles E.; Meaker, Mary; Stormshak, Fred; Estill, Charles T.

2016-01-01

Testosterone (T) exposure during midgestation differentiates neural circuits controlling sex-specific behaviors and patterns of gonadotropin secretion in male sheep. T acts through androgen receptors (AR) and/or after aromatization to estradiol and binding to estrogen receptors. The current study assessed the role of AR activation in male sexual differentiation. We compared rams that were exposed to the AR antagonist flutamide (Flu) throughout the critical period (i.e. day 30 – 90 of gestation) to control rams and ewes that received no prenatal treatments. The external genitalia of all Flu rams were phenotypically female. Testes were positioned subcutaneously in the inguinal region of the abdomen, exhibited seasonally impaired androgen secretion and were azospermic. Flu rams displayed male-typical precopulatory and mounting behaviors, but could not intromit or ejaculate because they lacked a penis. Flu rams exhibited greater mounting behavior than control rams, and like controls, showed sexual partner preferences for estrous ewes. Neither control nor Flu rams responded to estradiol treatments with displays of female-typical receptive behavior or LH surge responses; whereas all control ewes responded as expected. The ovine sexually dimorphic nucleus in Flu rams was intermediate in volume between control rams and ewes and significantly different from both. . These results indicate that prenatal antiandrogen exposure is not able to block male sexual differentiation in sheep and suggest that compensatory mechanisms intervene to maintain sufficient androgen stimulation during development. PMID:27005749

FluG affects secretion in colonies of Aspergillus niger.

PubMed

Wang, Fengfeng; Krijgsheld, Pauline; Hulsman, Marc; de Bekker, Charissa; Müller, Wally H; Reinders, Marcel; de Vries, Ronald P; Wösten, Han A B

2015-01-01

Colonies of Aspergillus niger are characterized by zonal heterogeneity in growth, sporulation, gene expression and secretion. For instance, the glucoamylase gene glaA is more highly expressed at the periphery of colonies when compared to the center. As a consequence, its encoded protein GlaA is mainly secreted at the outer part of the colony. Here, multiple copies of amyR were introduced in A. niger. Most transformants over-expressing this regulatory gene of amylolytic genes still displayed heterogeneous glaA expression and GlaA secretion. However, heterogeneity was abolished in transformant UU-A001.13 by expressing glaA and secreting GlaA throughout the mycelium. Sequencing the genome of UU-A001.13 revealed that transformation had been accompanied by deletion of part of the fluG gene and disrupting its 3' end by integration of a transformation vector. Inactivation of fluG in the wild-type background of A. niger also resulted in breakdown of starch under the whole colony. Asexual development of the ∆fluG strain was not affected, unlike what was previously shown in Aspergillus nidulans. Genes encoding proteins with a signal sequence for secretion, including part of the amylolytic genes, were more often downregulated in the central zone of maltose-grown ∆fluG colonies and upregulated in the intermediate part and periphery when compared to the wild-type. Together, these data indicate that FluG of A. niger is a repressor of secretion.

Spectrophotometric Methods for Simultaneous Determination of Oxytetracycline HCl and Flunixin Meglumine in Their Veterinary Pharmaceutical Formulation.

PubMed

Merey, Hanan A; Abd-Elmonem, Mahmmoud S; Nazlawy, Hagar N; Zaazaa, Hala E

2017-01-01

Four precise, accurate, selective, and sensitive UV-spectrophotometric methods were developed and validated for the simultaneous determination of a binary mixture of Oxytetracycline HCl (OXY) and Flunixin Meglumine (FLU). The first method, dual wavelength (DW), depends on measuring the difference in absorbance (ΔA 273.4-327 nm) for the determination of OXY where FLU is zero while FLU is determined at ΔA 251.7-275.7 nm. The second method, first-derivative spectrophotometric method (1D), depends on measuring the peak amplitude of the first derivative selectively at 377 and 266.7 nm for the determination of OXY and FLU, respectively. The third method, ratio difference method, depends on the difference in amplitudes of the ratio spectra at ΔP 286.5-324.8 nm and ΔP 249.6-286.3 nm for the determination of OXY and FLU, respectively. The fourth method, first derivative of ratio spectra method (1DD), depends on measuring the amplitude peak to peak of the first derivative of ratio spectra at 296.7 to 369 nm and 259.1 to 304.7 nm for the determination of OXY and FLU, respectively. Different factors affecting the applied spectrophotometric methods were studied. The proposed methods were validated according to ICH guidelines. Satisfactory results were obtained for determination of both drugs in laboratory prepared mixture and pharmaceutical dosage form. The developed methods are compared favourably with the official ones.

A rapid method for assessing social versus independent interest in health issues: a case study of 'bird flu' and 'swine flu'.

PubMed

Bentley, R Alexander; Ormerod, Paul

2010-08-01

Effective communication strategies regarding health issues are affected by the way in which the public obtain their knowledge, particularly whether people become interested independently, or through their social networks. This is often investigated through localized ethnography or surveys. In rapidly-evolving situations, however, there may also be a need for swift, case-specific assessment as a guide to initial strategy development. With this aim, we analyze real-time online data, provided by the new 'Google Trends' tool, concerning Internet search frequency for health-related issues. To these data we apply a simple model to characterise the effective degree of social transmission versus decisions made individually. As case examples, we explore two rapidly-evolved issues, namely the world-wide interest in avian influenza, or 'bird flu', in 2005, and in H1N1, or 'swine flu', from late April to early May 2009. The 2005 'bird flu' scare demonstrated almost pure imitation for two months initially, followed by a spike of independent decision that corresponded with an announcement by US president George Bush. For 'swine flu' in 2009, imitation was the more prevalent throughout. Overall, the results show how interest in health scares can spread primarily by social means, and that engaging more independent decisions at the population scale may require a dramatic announcement to push a populace over the 'tipping point'. Copyright 2010 Elsevier Ltd. All rights reserved.

The H1N1 pandemic: media frames, stigmatization and coping

PubMed Central

2013-01-01

Background Throughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak’s alleged origin in Mexican pig farms. Methods In this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors. Results Twelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups. Conclusions Participants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions. PMID:24299568

Nowcasting influenza outbreaks using open-source media report.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ray, Jaideep; Brownstein, John S.

We construct and verify a statistical method to nowcast influenza activity from a time-series of the frequency of reports concerning influenza related topics. Such reports are published electronically by both public health organizations as well as newspapers/media sources, and thus can be harvested easily via web crawlers. Since media reports are timely, whereas reports from public health organization are delayed by at least two weeks, using timely, open-source data to compensate for the lag in %E2%80%9Cofficial%E2%80%9D reports can be useful. We use morbidity data from networks of sentinel physicians (both the Center of Disease Control's ILINet and France's Sentinelles network)more » as the gold standard of influenza-like illness (ILI) activity. The time-series of media reports is obtained from HealthMap (http://healthmap.org). We find that the time-series of media reports shows some correlation ( 0.5) with ILI activity; further, this can be leveraged into an autoregressive moving average model with exogenous inputs (ARMAX model) to nowcast ILI activity. We find that the ARMAX models have more predictive skill compared to autoregressive (AR) models fitted to ILI data i.e., it is possible to exploit the information content in the open-source data. We also find that when the open-source data are non-informative, the ARMAX models reproduce the performance of AR models. The statistical models are tested on data from the 2009 swine-flu outbreak as well as the mild 2011-2012 influenza season in the U.S.A.« less

Listeriosis Outbreaks in British Columbia, Canada, Caused by Soft Ripened Cheese Contaminated from Environmental Sources

PubMed Central

Wilcott, Lynn; Naus, Monika

2015-01-01

Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant's water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant's open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence. PMID:25918702

Cholera: a comparison of the 2008-9 and 2010 Outbreaks in Kadoma City, Zimbabwe

PubMed Central

Maponga, Brian Abel; Chirundu, Daniel; Gombe, Notion Tafara; Tshimanga, Mufuta; Bangure, Donewell; Takundwa, Lucia

2015-01-01

Introduction Kadoma City experienced cholera outbreaks in 2008-9, and 2010, affecting 6,393 and 123 people, respectively. A study was conducted to compare epidemiology of the cholera outbreaks. Methods A descriptive cross sectional study was conducted, analyzing line list data for the 2 outbreaks. Proportions, means were generated and compared using the Chi Square test at 5% level of significance. Results Cholera cases were similar by gender and age, with the 20-30 years group being most affected. Rimuka township contributed 80% and 100% of city cases in 2008-9 and 2010, respectively, p value = 0.000. In 2008-9, 91% of cholera cases presented within 2 days compared to 98% in 2010. Delay seeking treatment increased from 58% to 73% (p value = 0.001), with gender, and place equally affected. The 2010 outbreak evolved faster, resulting in higher proportion being managed in CTU. CFR was 2% in 2008-9, and 3.3% in 2010 (p value =0.31). Conclusion The 2008-9 and 2010 cholera outbreaks were similar by age and gender. Rimuka Township was most affected by the outbreaks. There was worsening of delay seeking treatment. The 2010 outbreak was more rapid, leading to early opening of CTC. CFR was consistently above 1%. PMID:26113952

Listeriosis outbreaks in British Columbia, Canada, caused by soft ripened cheese contaminated from environmental sources.

PubMed

McIntyre, Lorraine; Wilcott, Lynn; Naus, Monika

2015-01-01

Soft ripened cheese (SRC) caused over 130 foodborne illnesses in British Columbia (BC), Canada, during two separate listeriosis outbreaks. Multiple agencies investigated the events that lead to cheese contamination with Listeria monocytogenes (L.m.), an environmentally ubiquitous foodborne pathogen. In both outbreaks pasteurized milk and the pasteurization process were ruled out as sources of contamination. In outbreak A, environmental transmission of L.m. likely occurred from farm animals to personnel to culture solutions used during cheese production. In outbreak B, birds were identified as likely contaminating the dairy plant's water supply and cheese during the curd-washing step. Issues noted during outbreak A included the risks of operating a dairy plant in a farm environment, potential for transfer of L.m. from the farm environment to the plant via shared toilet facilities, failure to clean and sanitize culture spray bottles, and cross-contamination during cheese aging. L.m. contamination in outbreak B was traced to wild swallows defecating in the plant's open cistern water reservoir and a multibarrier failure in the water disinfection system. These outbreaks led to enhanced inspection and surveillance of cheese plants, test and release programs for all SRC manufactured in BC, improvements in plant design and prevention programs, and reduced listeriosis incidence.

Genetic line comparisons and genetic parameters for endoparasite infections and test-day milk production traits.

PubMed

May, Katharina; Brügemann, Kerstin; Yin, Tong; Scheper, Carsten; Strube, Christina; König, Sven

2017-09-01

Keeping dairy cows in grassland systems relies on detailed analyses of genetic resistance against endoparasite infections, including between- and within-breed genetic evaluations. The objectives of this study were (1) to compare different Black and White dairy cattle selection lines for endoparasite infections and (2) the estimation of genetic (co)variance components for endoparasite and test-day milk production traits within the Black and White cattle population. A total of 2,006 fecal samples were taken during 2 farm visits in summer and autumn 2015 from 1,166 cows kept in 17 small- and medium-scale organic and conventional German grassland farms. Fecal egg counts were determined for gastrointestinal nematodes (FEC-GIN) and flukes (FEC-FLU), and fecal larvae counts for the bovine lungworm Dictyocaulus viviparus (FLC-DV). The lowest values for gastrointestinal nematode infections were identified for genetic lines adopted to pasture-based production systems, especially selection lines from New Zealand. Heritabilities were low for FEC-GIN (0.05-0.06 ± 0.04) and FLC-DV (0.05 ± 0.04), but moderate for FEC-FLU (0.33 ± 0.06). Almost identical heritabilities were estimated for different endoparasite trait transformations (log-transformation, square root). The genetic correlation between FEC-GIN and FLC-DV was 1.00 ± 0.60, slightly negative between FEC-GIN and FEC-FLU (-0.10 ± 0.27), and close to zero between FLC-DV and FEC-FLU (0.03 ± 0.30). Random regression test-day models on a continuous time scale [days in milk (DIM)] were applied to estimate genetic relationships between endoparasite and longitudinal test-day production traits. Genetic correlations were negative between FEC-GIN and milk yield (MY) until DIM 85, and between FEC-FLU and MY until DIM 215. Genetic correlations between FLC-DV and MY were negative throughout lactation, indicating improved disease resistance for high-productivity cows. Genetic relationships between FEC-GIN and FEC-FLU with milk protein content were negative for all DIM. Apart from the very early and very late lactation stage, genetic correlations between FEC-GIN and milk fat content were negative, whereas they were positive for FEC-FLU. Genetic correlations between FEC-GIN and somatic cell score were positive, indicating similar genetic mechanisms for susceptibility to udder and endoparasite infections. The moderate heritabilities for FEC-FLU suggest inclusion of FEC-FLU into overall organic dairy cattle breeding goals to achieve long-term selection response for disease resistance. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Cross-species transmission and emergence of novel viruses from birds.

PubMed

Chan, Jasper Fuk-Woo; To, Kelvin Kai-Wang; Chen, Honglin; Yuen, Kwok-Yung

2015-02-01

Birds, the only living member of the Dinosauria clade, are flying warm-blooded vertebrates displaying high species biodiversity, roosting and migratory behavior, and a unique adaptive immune system. Birds provide the natural reservoir for numerous viral species and therefore gene source for evolution, emergence and dissemination of novel viruses. The intrusions of human into natural habitats of wild birds, the domestication of wild birds as pets or racing birds, and the increasing poultry consumption by human have facilitated avian viruses to cross species barriers to cause zoonosis. Recently, a novel adenovirus was exclusively found in birds causing an outbreak of Chlamydophila psittaci infection among birds and humans. Instead of being the primary cause of an outbreak by jumping directly from bird to human, a novel avian virus can be an augmenter of another zoonotic agent causing the outbreak. A comprehensive avian virome will improve our understanding of birds' evolutionary dynamics. Copyright © 2015 Elsevier B.V. All rights reserved.

Influence of affinity on antibody determination in microtiter ELISA systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peterman, J.H.; Voss, E.W. Jr.; Butler, J.E.

1986-03-01

Theoretically, all immunoassays are affinity (Ka) dependent when the product of the antibody (Ab) Ka and the free epitope concentration is less than 10. Thus, the degree of dependence on Ka depends on the concentration of available antigen in the system. The authors examined the binding of /sup 125/I-anti-fluorescein (a-FLU) monoclonal antibodies of different affinities to FLU-gelatin adsorbed on Immunlon 2 microtiter plates. Data obtained were in general agreement with our theoretical predictions; the percent of /sup 125/I-a-FLU which bound correlated with Ka, as did the shape of the titration curves. Measurement of 5 a-FLU monoclonals by the ELISA showedmore » that the determination of Ab concentrations depends on the FLU-gelatin concentration, epitope density, and on the relationship between the Kas of test samples and the reference standard Ab preparation. Thus the ELISA is Ka dependent and should not be used routinely to estimate the absolute amount to Ab in unknown samples. However, the Ka dependency of the ELISA might provide a convenient assay for the estimation of the relative functional Ka (rfKa) of antibody preparations.« less

Lethal Effect of CD3-Specific Antibody in Mice Deficient in TGF-β1 by Uncontrolled Flu-Like Syndrome1

PubMed Central

Perruche, Sylvain; Zhang, Pin; Maruyama, Takashi; Bluestone, Jeffrey A.; Saas, Philippe; Chen, WanJun

2010-01-01

CD3-specific Ab therapy results in a transient, self-limiting, cytokine-associated, flu-like syndrome in experimental animals and in patients, but the underlying mechanism for this spontaneous resolution remains elusive. By using an in vivo model of CD3-specific Ab-induced flu-like syndrome, we show in this paper that a single injection of sublethal dose of the Ab killed all TGF-β1−/− mice. The death of TGF-β1−/− mice was associated with occurrence of this uncontrolled flu-like syndrome, as demonstrated by a sustained storm of systemic inflammatory TNF and IFN-γ cytokines. We present evidence that deficiency of professional phagocytes to produce TGF-β1 after apoptotic T cell clearance may be responsible, together with hypersensitivity of T cells to both activation and apoptosis, for the uncontrolled inflammation. These findings indicate a key role for TGF-β1 and phagocytes in protecting the recipients from lethal inflammation and resolving the flu-like syndrome after CD3-specific Ab treatment. The study may also provide a novel molecular mechanism explaining the early death in TGF-β1−/− mice. PMID:19561097

In vitro enantioselective pharmacodynamics of Carprofen and Flunixin-meglumine in feedlot cattle.

PubMed

Miciletta, M; Cuniberti, B; Barbero, R; Re, G

2014-02-01

The activity of the anti-inflammatory agents Flunixin-meglumine (FLU), RS (±) Carprofen (CPF) and S (+) CPF on bovine cyclooxygenases (COXs) has been characterized in feedlot calves using an in vitro whole blood model. The drugs showed equivalent efficacy in their inhibitory activity on COXs, and the rank order of potency for both COX-1 and COX-2 inhibition was FLU > S (+) CPF > RS (±) CPF. Our results indicated that FLU is a nonselective inhibitor of bovine COXs, whereas RS (±) CPF and S (+) CPF exhibited different degrees of preferential inhibition of COX-2 isoenzyme. The rank order of IC50 COX-1: IC50 COX-2 potency ratios was in fact S (+) CPF (51.882) > RS (±) CPF (13.964) > FLU (0.606), and the calculated percentage inhibition of COX-1 corresponding to COX-2 inhibition values comprised between 80% and 95% was comprised between 57.697 and 79.865 for FLU, 33.373 and 51.319 for RS (±) CPF, and 0.230 and 4.622 for S (+) CPF, respectively. These findings are discussed in relation to the prediction of the clinical relevance of COX inhibition by the test drugs in cattle. © 2013 John Wiley & Sons Ltd.

[Seasonal flu vaccination for older people: Evaluation of the adjuvanted vaccine. Positioning report].

PubMed

López Mongil, Rosa; López Trigo, José Antonio; Mariano Lázaro, Alberto; Mato Chaín, Gloria; Ramos Cordero, Primitivo; Salleras Sanmartí, Luis

2017-11-01

Flu is a major public health problem, particularly for older people, and creates an important clinical and economic burden. A high mortality rate was reported in Spain during the period 2015 to 2016; 3,101 serious cases were hospitalised with a confirmed diagnosis of flu, of which 11% died (352 cases). Furthermore, financial and health costs are greatly increased by the complications of flu; people aged over 65 years represent approximately 64% of the total costs. Seasonal flu vaccination is the fundamental strategy, as demonstrated by cost-benefit and cost-effectiveness studies. A priority objective is to improve the vaccine's immune response and the search for and inclusion of adjuvants and immunostimulants in vaccines is a major line of research. This positioning report evaluates vaccination for older people and the importance of the adjuvanted vaccine in the elderly in strengthening immunogenicity, by means of a critical review of the literature based on the best evidence available on its immunogenicity and effectiveness, and an economic assessment. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

Did the 2014 Ebola outbreak in Liberia affect HIV testing, linkage to care and ART initiation?

PubMed Central

Bhat, P.; Owiti, P.; Edwards, J. K.; Tweya, H.; Najjemba, R.

2017-01-01

Setting: Health facilities providing human immunodeficiency virus (HIV) testing, care and treatment in Liberia. Objective: To evaluate individuals aged ⩾15 years who were tested, diagnosed and enrolled into HIV care before (2013), during (2014) and after the Ebola outbreak (2015). Design: A cross-sectional descriptive study. Results: A median of 6930 individuals aged ⩾15 years per county were tested for HIV before the Ebola outbreak; this number declined by 35% (2444/6930) during the outbreak. HIV positivity remained similar before (7028/207 314, 3.4%) and during the outbreak (4146/121 592, 3.5%). During Ebola, HIV testing declined more in highly affected counties (68 035/127 468, 47%) than in counties that were less affected (16 444/23 955, 31%, P < 0.001). Compared to the pre-Ebola period, HIV testing in less-affected counties recovered more quickly during the post-outbreak period, with a 19% increase in testing, while medium and highly affected counties remained at respectively 38% and 48% below pre-outbreak levels. Enrolment for HIV care increased during and after the outbreak compared to the pre-Ebola period. Conclusion: HIV testing and diagnosis were significantly limited during the Ebola outbreak, with the most severe effects occurring in highly affected counties. However, enrolment for HIV care and treatment were resilient throughout the outbreak. Pro-active measures are needed to sustain HIV testing rates in future epidemics. PMID:28744442

Bird Flu

MedlinePlus

... illness. They include pregnant women, people with weakened immune systems, and seniors aged 65 and older. Treatment with antiviral medicines may make the illness less severe. They may also help prevent the flu in people who were exposed to it. There ...

Colds and flus - antibiotics

MedlinePlus

Antibiotics - colds and flu ... treat infections that are caused by a virus. Colds and flu are caused by viruses. If you ... J, Ericson K, Werner S. Treatment of the common cold in children and adults. Am Fam Physician. 2012; ...

Caring for Your Child's Cold or Flu

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... Text Size Email Print Share Caring for Your Child’s Cold or Flu Page Content Unfortunately, there's no ... better after one week. Ways to Help a Child with a Stuffy Nose Feel Better: Nose drops ...

The Flu (For Kids)

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... town. If your doctor says you have the flu, start taking these steps to feel better: Rest in bed or on the couch. Drink lots of liquids, like water, chicken broth, and other fluids. Take the medicine your ...

Avian Influenza A Virus Infections in Humans

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... label> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Avian Influenza A Virus Infections ... label> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Language: English (US) Español File ...

Residue level, persistence, and storage performance of citrus fruit treated with fludioxonil.

PubMed

Schirra, Mario; D'Aquino, Salvatore; Palma, Amedeo; Marceddu, Salvatore; Angioni, Alberto; Cabras, Paolo; Scherm, Barbara; Migheli, Quirico

2005-08-24

The potential of postharvest dip treatments with fludioxonil (FLU) (a synthetic analogue of the bacterial metabolite of pyrrolnitrin), in controlling postharvest decay caused by Penicillium digitatum and Penicillium italicum of citrus fruit was investigated in comparison with the conventional fungicide imazalil (IMZ). The ultrastructural changes of fruit epicuticular wax was investigated as a function of water dip temperature, and the possible role of these changes was related to residue accumulation under FLU treatment. Residues retained by fruit were determined as a function of fungicide concentration, dip temperature, and fruit storage conditions. Scanning electron microscopy analysis revealed that fruit dipping in water at 30 or 40 degrees C did not cause differences in cuticular wax's ultrastructure in comparison to control fruit, while treatments at 50, 55, or 60 degrees C caused the disappearance of wax platelets, resulting in relatively homogeneous skin surface, due to partial "melting" of epicuticular wax. Residues of FLU in fruit treated at 20 or 50 degrees C were significantly correlated with the doses of fungicide applied. When equal amounts of fungicide were employed, the residue concentrations were notably higher (from 2.6- to 4-fold) in fruit treated at 50 degrees C than in fruit treated at 20 degrees C. The dissipation rate of FLU in "Salustiana" and "Tarocco" oranges was lower in fruit subjected to treatment at 50 degrees C. The minimal FLU concentration for almost complete decay control in artificially wounded fruit during 7-d storage at 20 degrees C was 400 mg/L active ingredient (ai) in fruit treated at 20 degrees C and 100 mg/L ai in fruit treated at 50 degrees C. Results on nonwounded Tarocco oranges subjected to 3 weeks of simulated quarantine conditions at 1 degrees C, plus 6 weeks of standard storage at 8 degrees C and an additional two weeks of simulated marketing period (SMP) at 20 degrees C revealed that almost complete decay control with FLU applications of 100 mg/L at 50 degrees C and 400 mg/L at 20 degrees C resulted in ca. 0.8 mg/kg FLU fruit residues, in agreement with results on wounded citrus fruit. When equal concentrations and temperatures were applied, FLU treatments were as effective as IMZ. In vitro trials showed a low sensitivity to FLU against P. digitatum and P. italicum isolates. MIC values for the complete inhibition of mycelium growth were >or=100 microg/mL, while ED(50) values ranged from 0.1 to 1 microg/mL for P. digitatum and from 1 to >100 microg/mL for P. italicum. The latter result suggests that care should be taken to avoid exclusive application of FLU in a sustainable program for management of fruit decay. However, integrating fungicide application and hot water dip may reduce the possibility of selecting fungicide-resistant populations of the pathogen, by increasing the effectiveness of the treatment.

[A health promotion campaign to improve flu vaccination adherence among medical residents in an Italian Teaching Hospital].

PubMed

Barbara, Andrea; Poscia, Andrea; De Meo, Concetta; De Waure, Chiara; Anzelmo, Vincenza; Santoro, Paolo Emilio; Maruccia, Antonio; Giubbini, Gabriele; Corsaro, Alice; Berloco, Filippo; Damiani, Gianfranco; Ricciardi, Walter; Laurenti, Patrizia

2017-01-01

In Italy annual flu vaccination for health care workers is recommended but coverage is usually unsatisfying. The compliance is even worse among medical residents (MRs) both in literature, both in our experience: in the flu season 2014/ 15 only 0.6% of MRs enrolled at the Università Cattolica del Sacro Cuore (UCSC) were vaccinated. For this reason, during the influenza season 2015/16, the Institute of Public Health of the UCSC, in collaboration with the Health Management of the "Agostino Gemelli" Teaching Hospital (FPG) and with the directive board of the Medical Specialization Schools (SSM) present at the University has tested several strategies to improve awareness and adherence to flu vaccination campaign by its staff. This study aims to analyze the impact of the strategies used during the 2015/16 campaign on flu vaccination coverage among MRs of an important Italian Teaching Hospital. The study was conducted among MRs enrolled at the UCSC - FPG in 2015/16. The data was collected by the Occupational Medicine which, during the influenza seasons, immunize MRs against influenza free of charge. For each variable - vaccination, area of specialization (surgical, medical, clinical services), typology of SSM - was measured the absolute and percentage frequency. In order to compare the flu vaccination coverage between seasons 2014/15 and 2015/16 and between areas of specialization in 2015/16 chi-square test was used (statistical significance level of 0.05). The data were analyzed using STATA Software. Were included in the analysis 42 SSM with a total of 1041 MRs. During the vaccination campaign 2015/16, flu vaccine was administered to 99 MRs (9.5%), 8.9% more than in the previous season (p<0.001). There is also a significant difference in vaccine coverage between surgical, medical and clinical services areas in 2015/16 (p <0.001). The highest vaccination coverage was recorded among MRs of Hematology and Urology (54.5%). However, no one MRs had undergone flu vaccination in about 40% of SSM. Seasonal flu vaccination among HCWs is important to protect patients as well as them self and their family members. Considering that MRs represent the next generation of HCWs, they should be sensitized about the importance of preventing the spread of influenza in hospital population, becoming an active part of the necessary cultural change. This study highlights a first and promising, although insufficient, increase in flu vaccination coverage among MRs enrolled at the UCSC - FPG after introducing simple strategies to promote vaccination itself and, more generally, positive and proactive behaviors. The study summarizes the results in the short term, but it is well known that cultural changes require time and constancy. Therefore, it will be useful to monitor the improvement over time and extend the assessment to all health care professionals.

Outbreaks Attributed to Cheese: Differences Between Outbreaks Caused by Unpasteurized and Pasteurized Dairy Products, United States, 1998–2011

PubMed Central

Gould, L. Hannah; Mungai, Elisabeth; Behravesh, Casey Barton

2015-01-01

Introduction The interstate commerce of unpasteurized fluid milk, also known as raw milk, is illegal in the United States, and intrastate sales are regulated independently by each state. However, U.S. Food and Drug Administration regulations allow the interstate sale of certain types of cheeses made from unpasteurized milk if specific aging requirements are met. We describe characteristics of these outbreaks, including differences between outbreaks linked to cheese made from pasteurized or unpasteurized milk. Methods We reviewed reports of outbreaks submitted to the Foodborne Disease Outbreak Surveillance System during 1998–2011 in which cheese was implicated as the vehicle. We describe characteristics of these outbreaks, including differences between outbreaks linked to cheese made from pasteurized versus unpasteurized milk. Results During 1998–2011, 90 outbreaks attributed to cheese were reported; 38 (42%) were due to cheese made with unpasteurized milk, 44 (49%) to cheese made with pasteurized milk, and the pasteurization status was not reported for the other eight (9%). The most common cheese–pathogen pairs were unpasteurized queso fresco or other Mexican-style cheese and Salmonella (10 outbreaks), and pasteurized queso fresco or other Mexican-style cheese and Listeria (6 outbreaks). The cheese was imported from Mexico in 38% of outbreaks caused by cheese made with unpasteurized milk. In at least five outbreaks, all due to cheese made from unpasteurized milk, the outbreak report noted that the cheese was produced or sold illegally. Outbreaks caused by cheese made from pasteurized milk occurred most commonly (64%) in restaurant, delis, or banquet settings where cross-contamination was the most common contributing factor. Conclusions In addition to using pasteurized milk to make cheese, interventions to improve the safety of cheese include limiting illegal importation of cheese, strict sanitation and microbiologic monitoring in cheese-making facilities, and controls to limit food worker contamination. PMID:24750119

NMR structure and dynamics of the engineered fluorescein-binding lipocalin FluA reveal rigidification of beta-barrel and variable loops upon enthalpy-driven ligand binding.

PubMed

Mills, Jeffrey L; Liu, Gaohua; Skerra, Arne; Szyperski, Thomas

2009-08-11

The NMR structure of the 21 kDa lipocalin FluA, which was previously obtained by combinatorial design, elucidates a reshaped binding site specific for the dye fluorescein resulting from 21 side chain replacements with respect to the parental lipocalin, the naturally occurring bilin-binding protein (BBP). As expected, FluA exhibits the lipocalin fold of BBP, comprising eight antiparallel beta-strands forming a beta-barrel with an alpha-helix attached to its side. Comparison of the NMR structure of free FluA with the X-ray structures of BBP.biliverdin IX(gamma) and FluA.fluorescein complexes revealed significant conformational changes in the binding pocket, which is formed by four loops at the open end of the beta-barrel as well as adjoining beta-strand segments. An "induced fit" became apparent for the side chain conformations of Arg 88 and Phe 99, which contact the bound fluorescein in the complex and undergo concerted rearrangement upon ligand binding. Moreover, slower internal motional modes of the polypeptide backbone were identified by measuring transverse (15)N backbone spin relaxation times in the rotating frame for free FluA and also for the FluA.fluorescein complex. A reduction in the level of such motions was detected upon complex formation, indicating rigidification of the protein structure and loss of conformational entropy. This hypothesis was confirmed by isothermal titration calorimetry, showing that ligand binding is enthalpy-driven, thus overcompensating for the negative entropy associated with both ligand binding per se and rigidification of the protein. Our investigation of the solution structure and dynamics as well as thermodynamics of lipocalin-ligand interaction not only provides insight into the general mechanism of small molecule accommodation in the deep and narrow cavity of this abundant class of proteins but also supports the future design of corresponding binding proteins with novel specificities, so-called "anticalins".

Postinfection activity, residue levels, and persistence of azoxystrobin, fludioxonil, and pyrimethanil applied alone or in combination with heat and imazalil for green mold control on inoculated oranges.

PubMed

Schirra, Mario; Palma, Amedeo; Barberis, Antonio; Angioni, Alberto; Garau, Vincenzo Luigi; Cabras, Paolo; D'Aquino, Salvatore

2010-03-24

The postinfection activity of azoxystrobin (AZX), fludioxonil (FLU), and pyrimethanil (PYR), applied alone or in combination with imazalil (IMZ), in controlling postharvest green mold in 'Salustiana' oranges inoculated with Penicillium digitatum was studied. Fruits were immersed for 30 or 60 s in (i) water or water mixtures at 20 degrees C containing AZX, FLU, or PYR at 600 mg/L; and (ii) IMZ at 600 mg/L, alone or in combination with AZX, FLU, or PYR at 600 mg/L. Similar treatments were performed at 50 degrees C using the active ingredients at half rates with respect to the treatments at 20 degrees C. Fungicide residues in fruits were analyzed following treatments and after 14 days of simulated shelf life at 17 degrees C. AZX or FLU mixtures at 20 degrees C for 30-60 s similarly but moderately reduced green mold decay with respect to control fruit; differences due to dip time were not significant. Superior control of decay was achieved by PYR and, especially, IMZ, applied alone or in combination with AZX, FLU, or PYR. The activity of PYR at 20 degrees C was significantly dependent on treatment time, whereas that of IMZ and combined treatments at 20 degrees C was not. The effectiveness of FLU or PYR mixtures at 50 degrees C in controlling decay was similar and superior to that of AZX. The action of single- or double-fungicide application was not dependent on dip time in most samples. IMZ or combined mixtures at 50 degrees C were consistently more effective with respect to single-fungicide treatments with AZX, FLU, or PYR. The application of heated fungicide mixtures resulted in significantly higher residue accumulation in most fruit samples compared to treatments performed at 20 degrees C. The degradation rate of fungicides was generally low and dependent on treatment conditions such as time, temperature, and the presence or not of other fungicides.

A review of outbreaks of waterborne disease associated with ships: evidence for risk management.

PubMed Central

Rooney, Roisin M.; Bartram, Jamie K.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Suraj, Rohini; Todd, Ewen C. D.

2004-01-01

OBJECTIVE: The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future. METHODS: The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant. CONCLUSIONS: Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance. PMID:15219801

A review of outbreaks of waterborne disease associated with ships: evidence for risk management.

PubMed

Rooney, Roisin M; Bartram, Jamie K; Cramer, Elaine H; Mantha, Stacey; Nichols, Gordon; Suraj, Rohini; Todd, Ewen C D

2004-01-01

The organization of water supply to and on ships differs considerably from that of water supply on land. Risks of contamination can arise from source water at the port or during loading, storage, or distribution on the ship. The purpose of this article is to review documented outbreaks of waterborne diseases associated with passenger, cargo, fishing, and naval ships to identify contributing factors so that similar outbreaks can be prevented in the future. The authors reviewed 21 reported outbreaks of waterborne diseases associated with ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and remedial action are presented. The findings of this review show that the majority of reported outbreaks were associated with passenger ships and that more than 6,400 people were affected. Waterborne outbreaks due to Enterotoxigenic Escherichia coli, noroviruses, Salmonella spp, Shigella sp, Cryptosporidium sp, and Giardia lamblia occurred on ships. Enterotoxigenic E. coli was the pathogen most frequently associated with outbreaks. One outbreak of chemical water poisoning also occurred on a ship. Risk factors included contaminated port water, inadequate treatment, improper loading techniques, poor design and maintenance of storage tanks, ingress of contamination during repair and maintenance, cross-connections, back siphonage, and insufficient residual disinfectant. Waterborne disease outbreaks on ships can be prevented. The factors contributing to outbreaks emphasize the need for hygienic handling of water along the supply chain from source to consumption. A comprehensive approach to water safety on ships is essential. This may be achieved by the adoption of Water Safety Plans that cover design, construction, operation, and routine inspection and maintenance.

Deterministic Factors Overwhelm Stochastic Environmental Fluctuations as Drivers of Jellyfish Outbreaks.

PubMed

Benedetti-Cecchi, Lisandro; Canepa, Antonio; Fuentes, Veronica; Tamburello, Laura; Purcell, Jennifer E; Piraino, Stefano; Roberts, Jason; Boero, Ferdinando; Halpin, Patrick

2015-01-01

Jellyfish outbreaks are increasingly viewed as a deterministic response to escalating levels of environmental degradation and climate extremes. However, a comprehensive understanding of the influence of deterministic drivers and stochastic environmental variations favouring population renewal processes has remained elusive. This study quantifies the deterministic and stochastic components of environmental change that lead to outbreaks of the jellyfish Pelagia noctiluca in the Mediterranen Sea. Using data of jellyfish abundance collected at 241 sites along the Catalan coast from 2007 to 2010 we: (1) tested hypotheses about the influence of time-varying and spatial predictors of jellyfish outbreaks; (2) evaluated the relative importance of stochastic vs. deterministic forcing of outbreaks through the environmental bootstrap method; and (3) quantified return times of extreme events. Outbreaks were common in May and June and less likely in other summer months, which resulted in a negative relationship between outbreaks and SST. Cross- and along-shore advection by geostrophic flow were important concentrating forces of jellyfish, but most outbreaks occurred in the proximity of two canyons in the northern part of the study area. This result supported the recent hypothesis that canyons can funnel P. noctiluca blooms towards shore during upwelling. This can be a general, yet unappreciated mechanism leading to outbreaks of holoplanktonic jellyfish species. The environmental bootstrap indicated that stochastic environmental fluctuations have negligible effects on return times of outbreaks. Our analysis emphasized the importance of deterministic processes leading to jellyfish outbreaks compared to the stochastic component of environmental variation. A better understanding of how environmental drivers affect demographic and population processes in jellyfish species will increase the ability to anticipate jellyfish outbreaks in the future.

Stopping the Spread of Germs at Home, Work and School

MedlinePlus

... influenza viruses that research indicates will be most common during the upcoming season. There are several flu vaccine options for the 2017-2018 flu season . Good Health Habits Avoid close contact. Avoid close contact ...

Shared Bacterial and Viral Respiratory Agents in Bighorn Sheep (Ovis canadensis), Domestic Sheep (Ovis aries), and Goats (Capra hircus) in Montana

PubMed Central

Miller, David S.; Weiser, Glen C.; Aune, Keith; Roeder, Brent; Atkinson, Mark; Anderson, Neil; Roffe, Thomas J.; Keating, Kim A.; Chapman, Phillip L.; Kimberling, Cleon; Rhyan, Jack; Clarke, P. Ryan

2011-01-01

Transmission of infectious agents from livestock reservoirs has been hypothesized to cause respiratory disease outbreaks in bighorn sheep (Ovis canadensis), and land management policies intended to limit this transmission have proven controversial. This cross-sectional study compares the infectious agents present in multiple populations of bighorn sheep near to and distant from their interface with domestic sheep (O. aries) and domestic goat (Capra hircus) and provides critical baseline information needed for interpretations of cross-species transmission risks. Bighorn sheep and livestock shared exposure to Pasteurellaceae, viral, and endoparasite agents. In contrast, although the impact is uncertain, Mycoplasma sp. was isolated from livestock but not bighorn sheep. These results may be the result of historic cross-species transmission of agents that has resulted in a mosaic of endemic and exotic agents. Future work using longitudinal and multiple population comparisons is needed to rigorously establish the risk of outbreaks from cross-species transmission of infectious agents. PMID:22195293

Shared Bacterial and Viral Respiratory Agents in Bighorn Sheep (Ovis canadensis), Domestic Sheep (Ovis aries), and Goats (Capra hircus) in Montana.

PubMed

Miller, David S; Weiser, Glen C; Aune, Keith; Roeder, Brent; Atkinson, Mark; Anderson, Neil; Roffe, Thomas J; Keating, Kim A; Chapman, Phillip L; Kimberling, Cleon; Rhyan, Jack; Clarke, P Ryan

2011-01-01

Transmission of infectious agents from livestock reservoirs has been hypothesized to cause respiratory disease outbreaks in bighorn sheep (Ovis canadensis), and land management policies intended to limit this transmission have proven controversial. This cross-sectional study compares the infectious agents present in multiple populations of bighorn sheep near to and distant from their interface with domestic sheep (O. aries) and domestic goat (Capra hircus) and provides critical baseline information needed for interpretations of cross-species transmission risks. Bighorn sheep and livestock shared exposure to Pasteurellaceae, viral, and endoparasite agents. In contrast, although the impact is uncertain, Mycoplasma sp. was isolated from livestock but not bighorn sheep. These results may be the result of historic cross-species transmission of agents that has resulted in a mosaic of endemic and exotic agents. Future work using longitudinal and multiple population comparisons is needed to rigorously establish the risk of outbreaks from cross-species transmission of infectious agents.

Shared bacterial and viral respiratory agents in bighorn sheep (Ovis canadensis), domestic sheep (Ovis aries), and goats (Capra hircus) in Montana

USGS Publications Warehouse

Miller, David S.; Weiser, Glen C.; Aune, Keith; Roeder, Brent; Atkinson, Mark; Anderson, Neil; Roffe, Thomas J.; Keating, Kim A.; Chapman, Phillip L.; Kimberling, Cleon; Rhyan, Jack C.; Clarke, P. Ryan

2011-01-01

Transmission of infectious agents from livestock reservoirs has been hypothesized to cause respiratory disease outbreaks in bighorn sheep (Ovis canadensis), and land management policies intended to limit this transmission have proven controversial. This cross-sectional study compares the infectious agents present in multiple populations of bighorn sheep near to and distant from their interface with domestic sheep (O. aries) and domestic goat (Capra hircus) and provides critical baseline information needed for interpretations of cross-species transmission risks. Bighorn sheep and livestock shared exposure to Pasteurellaceae, viral, and endoparasite agents. In contrast, although the impact is uncertain, Mycoplasma sp. was isolated from livestock but not bighorn sheep. These results may be the result of historic cross-species transmission of agents that has resulted in a mosaic of endemic and exotic agents. Future work using longitudinal and multiple population comparisons is needed to rigorously establish the risk of outbreaks from cross-species transmission of infectious agents.

Fine spatiotemporal control of nitric oxide release by infrared pulse-laser irradiation of a photolabile donor.

PubMed

Nakagawa, Hidehiko; Hishikawa, Kazuhiro; Eto, Kei; Ieda, Naoya; Namikawa, Tomotaka; Kamada, Kenji; Suzuki, Takayoshi; Miyata, Naoki; Nabekura, Jun-ichi

2013-11-15

Two-photon-excitation release of nitric oxide (NO) from our recently synthesized photolabile NO donor, Flu-DNB, was confirmed to allow fine spatial and temporal control of NO release at the subcellular level in vitro. We then evaluated in vivo applications. Femtosecond near-infrared pulse laser irradiation of predefined regions of interest in living mouse brain treated with Flu-DNB induced NO-release-dependent, transient vasodilation specifically at the irradiated site. Photoirradiation in the absence of Flu-DNB had no effect. Further, NO release from Flu-DNB by pulse laser irradiation was shown to cause chemoattraction of microglial processes to the irradiated area in living mouse brain. To our knowledge, this is the first demonstration of induction of biological responses in vitro and in vivo by means of precisely controlled, two-photon-mediated release of NO.

Role of non-traditional locations for seasonal flu vaccination: Empirical evidence and evaluation.

PubMed

Kim, Namhoon; Mountain, Travis P

2017-05-19

This study investigated the role of non-traditional locations in the decision to vaccinate for seasonal flu. We measured individuals' preferred location for seasonal flu vaccination by examining the National H1N1 Flu Survey (NHFS) conducted from late 2009 to early 2010. Our econometric model estimated the probabilities of possible choices by varying individual characteristics, and predicted the way in which the probabilities are expected to change given the specific covariates of interest. From this estimation, we observed that non-traditional locations significantly influenced the vaccination of certain individuals, such as those who are high-income, educated, White, employed, and living in a metropolitan statistical area (MSA), by increasing the coverage. Thus, based on the empirical evidence, our study suggested that supporting non-traditional locations for vaccination could be effective in increasing vaccination coverage. Copyright © 2017 Elsevier Ltd. All rights reserved.

Making Vaccine Messaging Stick: Perceived Causal Instability as a Barrier to Effective Vaccine Messaging.

PubMed

Dixon, Graham N

2017-08-01

Health officials often face challenges in communicating the risks associated with not vaccinating, where persuasive messages can fail to elicit desired responses. However, the mechanisms behind these failures have not been fully ascertained. To address this gap, an experiment (N = 163) tested the differences between loss-framed messages-one emphasizing the consequence of not receiving a flu vaccine; the other emphasizing the consequence of receiving the flu vaccine. Despite an identical consequence (i.e., Guillain-Barre syndrome), the message highlighting the consequence of not receiving the flu vaccine produced lower negative affect scores as compared to the message highlighting the consequence of receiving the flu vaccine. Mediation analyses suggest that one reason for this difference is due to non-vaccination being perceived as temporary and reversible, whereas vaccination is perceived as being permanent. Implications on health communication and future research are discussed.

Giving the influenza jab: a review of the law.

PubMed

Griffiths, Richard

2004-10-01

District nursing sister June Harris recently completed the administration of 30 'flu jabs to frail older residents of a local care home. June encountered a number of problems when administering the vaccinations. Relatives of five residents with advanced dementia did not want them to have the injection, mainly because they had heard that it would give the recipient the 'flu. An 85-year-old resident has complained that while she agreed to have a 'flu jab it now appears she also had a pneumococcal vaccination as well that no one told her about. More seriously, June has recently heard that one resident is in hospital having contracted Guillian-Barre Syndrome as a result of the vaccination. June remembers that this reluctant resident specifically asked if the 'flu jab would leave her paralysed and June had laughingly replied that she had not paralysed anyone to date. The residents and their families are now threatening legal action.

Role of health care professionals in preventative activities and vaccination programs during outbreaks.

PubMed

Balogh, Sándor; Papp, Renáta; Busa, Csilla; Csikós, Ágnes

2016-12-01

The general purpose of TELL ME study was to give an insight into the experiences of European family physicians with management of H1N1 pandemic flu. Qualitative research methods (focus group discussions, one-to-one interviews, and online data collection) were used to explore family doctors' opinion and suggestions. Overall 158 family physicians took part in the study from six European countries. Family doctors' most important experience was that the official campaign was not able to compensate negative effects of the mass media. Due to the poor evidence-based information about new vaccines, it was difficult to convince the public and some health care professionals too. Lack of unified directives - under unclear circumstances - made the routine patient care more difficult and hampered the collaboration between different health care providers. Family physicians felt a pressure from health authorities to achieve high immunization rate, but got only a little support from them. Despite the difficulties, vaccination program was a success, mainly among high-risk population. For better handling of a future pandemic, Hungarian family physician made many general and practical suggestions.

Similarity of currently circulating H1N1 virus with the 2009 pandemic clone: viability of an imminent pandemic.

PubMed

Banerjee, Rachana; Roy, Ayan; Das, Santasabuj; Basak, Surajit

2015-06-01

The first influenza pandemic in the 21st century commenced in March, 2009 causing nearly 300,000 deaths globally within the first year of the pandemic. In late 2013 and in early 2014, there was gradual increase in the reported case of H1N1 infection and according to World Health Organization (WHO) report, influenza activity increased in several areas of the Southern Hemisphere and was dominated by the H1N1 pandemic strain of 2009. In the present study, a comprehensive comparison of the global amino acid composition and the structural features of all HA gene sequences of H1N1, available in the Flu Database (NCBI), from 1918 to December, 2014 has been performed to trace out the possibility of a further H1N1 pandemic in near future. The results suggest that the increased potential to enhance pathogenicity for the H1N1 samples of 2013 (latter part) and 2014 could lead to a more severe outbreak in the near future. Copyright © 2015 Elsevier B.V. All rights reserved.

[The North African plague and Charles Nicolle's theory of infectious diseases].

PubMed

Ben, Néfissa Kmar; Moulin, Anne Marie

2010-01-01

Many infectious diseases were described in North Africa in 18th-19th centuries by European travellers. Most of them were allegedly imported by new migrant populations coming from sub-Saharan, European or Middle East countries. Plague outbreaks have been described since the Black Death as diseases of the Mediterranean harbours. Charles Nicolle and his collaborators at the Pasteur Institute were witnesses to the extinction of plague and typhus fever in Tunisia. Both could be considered as endemo-epidemic diseases propagated by ancient nomad communities for centuries. Typhus was exported to other countries; plague was imported by Mediterranean travellers but also hid in unknown wild-animal reservoirs. The role of the bite of a rat's flea was not confirmed and the pneumonic form might have prevailed in the medieval North African cities. Association between plague, typhus, flu and other causes of immune deficiencies could explain the high morbidity and mortality caused by plague in the past. The authors comment the local history of plague at the light of the evolutionary laws of infectious disease proposed by Charles Nicolle in 1930.

Novel phage display-derived H5N1-specific scFvs with potential use in rapid avian flu diagnosis.

PubMed

Wu, Jie; Zeng, Xian-Qiao; Zhang, Hong-Bin; Ni, Han-Zhong; Pei, Lei; Zou, Li-Rong; Liang, Li-Jun; Zhang, Xin; Lin, Jin-Yan; Ke, Chang-Wen

2014-05-01

The highly pathogenic avian influenza A (HPAI) viruses of the H5N1 subtype infect poultry and have also been spreading to humans. Although new antiviral drugs and vaccinations can be effective, rapid detection would be more efficient to control the outbreak of infections. In this study, a phage-display library was applied to select antibody fragments for HPAI strain A/Hubei/1/2010. As a result, three clones were selected and sequenced. A hemagglutinin inhibition assay of the three scFvs revealed that none exhibited hemagglutination inhibition activity towards the H5N1 virus, yet they showed a higher binding affinity for several HPAI H5N1 strains compared with other influenza viruses. An ELISA confirmed that the HA protein was the target of the scFvs, and the results of a protein structure simulation showed that all the selected scFvs bound to the HA2 subunit of the HA protein. In conclusion, the three selected scFVs could be useful for developing a specific detection tool for the surveillance of HPAI epidemic strains.

Application of the FluEgg model to predict transport of Asian carp eggs in the Saint Joseph River (Great Lakes tributary)

USGS Publications Warehouse

Garcia, Tatiana; Murphy, Elizabeth A.; Jackson, P. Ryan; Garcia, Marcelo H.

2015-01-01

The Fluvial Egg Drift Simulator (FluEgg) is a three-dimensional Lagrangian model that simulates the movement and development of Asian carp eggs until hatching based on the physical characteristics of the flow field and the physical and biological characteristics of the eggs. This tool provides information concerning egg development and spawning habitat suitability including: egg plume location, egg vertical and travel time distribution, and egg-hatching risk. A case study of the simulation of Asian carp eggs in the Lower Saint Joseph River, a tributary of Lake Michigan, is presented. The river hydrodynamic input for FluEgg was generated in two ways — using hydroacoustic data and using HEC-RAS model data. The HEC-RAS model hydrodynamic input data were used to simulate 52 scenarios covering a broad range of flows and water temperatures with the eggs at risk of hatching ranging from 0 to 93% depending on river conditions. FluEgg simulations depict the highest percentage of eggs at risk of hatching occurs at the lowest discharge and at peak water temperatures. Analysis of these scenarios illustrates how the interactive relation among river length, hydrodynamics, and water temperature influence egg transport and hatching risk. An improved version of FluEgg, which more realistically simulates dispersion and egg development, is presented. Also presented is a graphical user interface that facilitates the use of FluEgg and provides a set of post-processing analysis tools to support management decision-making regarding the prevention and control of Asian carp reproduction in rivers with or without Asian carp populations.

Spanish flu, Asian flu, Hong Kong flu, and seasonal influenza in Japan under social and demographic influence: review and analysis using the two-population model.

PubMed

Yoshikura, Hiroshi

2014-01-01

When cumulative numbers of patients (X) and deaths (Y) associated with an influenza epidemic are plotted using the log-log scale, the plots fall on an ascending straight line generally expressed as logY = k(logX - logN0). For the 2009 H1N1 influenza pandemic, the slope k was ～0.6 for Mexico and ～2 for other countries. The two-population model was proposed to explain this phenomenon (Yoshikura H. Jpn J Infect Dis. 2012;65:279-88; Yoshikura H. Jpn J Infect Dis. 2009;62:411-2; and Yoshikura H. Jpn J Infect Dis. 2009;62:482-4). The current article reviews and analyzes previous influenza epidemics in Japan to examine whether the two-population model is applicable to them. The slope k was found to be ～2 for the Spanish flu during 1918-1920 and the Asian flu during 1957-1958, and ～1 for the Hong Kong flu and seasonal influenza prior to 1960-1961; however, k was ～0.6 for seasonal influenza after 1960-1961. This transition of the slope k of seasonal influenza plots from ～1 to ～0.6 corresponded to the shift in influenza mortality toward the older age groups and a drastic reduction in infant mortality rates due to improvements in the standard of living during the 1950s and 1960s. All the above observations could be well explained by reconstitution of the influenza epidemic based on the two-population model.

Spectrophotometric Methods for Simultaneous Determination of Oxytetracycline HCl and Flunixin Meglumine in Their Veterinary Pharmaceutical Formulation

PubMed Central

Abd-Elmonem, Mahmmoud S.; Nazlawy, Hagar N.; Zaazaa, Hala E.

2017-01-01

Four precise, accurate, selective, and sensitive UV-spectrophotometric methods were developed and validated for the simultaneous determination of a binary mixture of Oxytetracycline HCl (OXY) and Flunixin Meglumine (FLU). The first method, dual wavelength (DW), depends on measuring the difference in absorbance (ΔA 273.4–327 nm) for the determination of OXY where FLU is zero while FLU is determined at ΔA 251.7–275.7 nm. The second method, first-derivative spectrophotometric method (1D), depends on measuring the peak amplitude of the first derivative selectively at 377 and 266.7 nm for the determination of OXY and FLU, respectively. The third method, ratio difference method, depends on the difference in amplitudes of the ratio spectra at ΔP 286.5–324.8 nm and ΔP 249.6–286.3 nm for the determination of OXY and FLU, respectively. The fourth method, first derivative of ratio spectra method (1DD), depends on measuring the amplitude peak to peak of the first derivative of ratio spectra at 296.7 to 369 nm and 259.1 to 304.7 nm for the determination of OXY and FLU, respectively. Different factors affecting the applied spectrophotometric methods were studied. The proposed methods were validated according to ICH guidelines. Satisfactory results were obtained for determination of both drugs in laboratory prepared mixture and pharmaceutical dosage form. The developed methods are compared favourably with the official ones. PMID:28811956