学者许培扬 发表于 2010-1-29 7:20:00 分类：传染病学│查看评论：0 │ 浏览：884 打印 推荐给朋友
PMID- 20103959 OWN - NLM STAT- In-Data-Review DA - 20100127 IS - 0975-4466 (Electronic) IS - 0975-4466 (Linking) VI - 30 IP - 1 DP - 2010 Jan-Feb TI - Characteristics of pandemic influenza A (H1N1) infection in patients presenting to a university hospital in Riyadh, Saudi Arabia. PG - 59-62 AB - Background and Objectives : A national plan of management for flu-like illnesses was developed by the Saudi Ministry of Health after the first outbreak in Saudi Arabia in June. We describe the clinical presentation of the H1N1 cases attending King Khalid University Hospital (KKUH) between July through September 2009 and identify the high-risk age groups. Methods : All patients presenting with influenza-like illnesses (ILI) in the H1N1 clinics during the specified period were clinically examined and tested using reverse transcription polymerase chain reaction (RT-PCR). Those who were clinically diagnosed and confirmed positive for novel influenza A (H1N1) were included in the study. Results : Over a 6-week period, 117 cases of laboratory-confirmed cases were reported in KKUH with a mean (SD) age of 19.6 (16.7) years, of whom 72 (62.1%) were males. Most reported cases were Saudis (n=99, 85.3%); 94 (81%) had no travel history outside the country; 100 (86.2%) had had no contact with an H1N1-identified patient; 33% were aged 5-14 years and 28.4% were aged 15-29 years. The most commonly reported symptoms were fever in 99 (85.3%), cough in 9 (81%), runny nose (33.6%) and sore throat (21.3%). All 117 cases were confirmed positive using real time RT-PCR testing. Thirty-one cases (26%) were admitted and 22 of those (71%) recovered after receiving oseltamivir. Two deaths were attributed to the 2009 pandemic. One patient died of chronic pulmonary disease. The other cause of death was unknown. Conclusion : These findings indicate indigenous influenza A (H1N1) transmission, and confirm the urgent need for prevention strategies which specifically target children and young adults, who appear to have a higher risk of infection and hospitalization. Such measures include immunization, improved personal hygiene, and increased ventilation in habitations. AD - On behalf of the Standing Committee of Epidemic Control, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. FAU - Binsaeed, Abdulaziz A AU - Binsaeed AA LA - eng PT - Journal Article PL - Saudi Arabia TA - Ann Saudi Med JT - Annals of Saudi medicine JID - 8507355 SB - IM EDAT- 2010/01/28 06:00 MHDA- 2010/01/28 06:00 CRDT- 2010/01/28 06:00 AID - AnnSaudiMed_2010_30_1_59_59377 [pii] AID - 10.4103/0256-4947.59377 [doi] PST - ppublish SO - Ann Saudi Med. 2010 Jan-Feb;30(1):59-62. PMID- 20103952 OWN - NLM STAT- In-Data-Review DA - 20100127 IS - 0975-4466 (Electronic) IS - 0975-4466 (Linking) VI - 30 IP - 1 DP - 2010 Jan-Feb TI - Pandemic influenza A (H1N1) in Saudi Arabia: Description of the first one hundred cases. PG - 11-4 AB - Background and Objectives : In April 2009, the World Health Organization (WHO) declared pandemic influenza A (H1N1) "public health emergency of international concern". On June 11, 2009, WHO raised the pandemic alert level to phase 6, indicating a global pandemic. By December 2009, more than 208 countries and territories had reported swine flu cases. The descriptive epidemiology of the first reported 100 cases of this virus in Saudi Arabia are summarized in this report. Methods : Data were collected from 1 June to 3 July, 2009 using a predesigned questionnaire. Questionnaires were filled by Field Epidemiology Training Program residents. Data for the first 100 complete cases of confirmed pandemic influenza A (H1N1) were compiled and analyzed. Results : The age of reported cases was in the range of 1 to 56 years. The highest percentage of cases was in the age group of 20 to 30 years followed by the age group of 1 to 10 years. Females represented 55% of the cases; imported cases represented 47%, 58% of whom had come via the King Khaled Airport. The most common nationalities most were from Saudi Arabia and the Philippines. The main symptoms were fever (56%), cough (54%), and sore throat and the number of cases was seen to peak from the 27 to 29 June. Conclusion : Pandemic influenza A (H1N1) is still a threat to Saudi Arabia. Thus, comprehensive and effective measures for surveillance and prevention of the disease are needed to control its spread. AD - Ministry of Health, Riyadh, Saudi Arabia. FAU - Almazroa, Mohammad A AU - Almazroa MA FAU - Memish, Ziad A AU - Memish ZA FAU - Alwadey, Ali M AU - Alwadey AM LA - eng PT - Journal Article PL - Saudi Arabia TA - Ann Saudi Med JT - Annals of Saudi medicine JID - 8507355 SB - IM EDAT- 2010/01/28 06:00 MHDA- 2010/01/28 06:00 CRDT- 2010/01/28 06:00 AID - AnnSaudiMed_2010_30_1_11_59366 [pii] AID - 10.4103/0256-4947.59366 [doi] PST - ppublish SO - Ann Saudi Med. 2010 Jan-Feb;30(1):11-4. PMID- 20103951 OWN - NLM STAT- In-Data-Review DA - 20100127 IS - 0975-4466 (Electronic) IS - 0975-4466 (Linking) VI - 30 IP - 1 DP - 2010 Jan-Feb TI - The first influenza pandemic of the 21st century. PG - 1-10 AB - The 2009 H1N1 influenza virus (formerly known as swine flu) first appeared in Mexico and the United States in March and April 2009 and has swept the globe with unprecedented speed as a result of airline travel. On June 11, 2009, the World Health Organization raised its pandemic level to the highest level, Phase 6, indicating widespread community transmission on at least two continents. The 2009 H1N1 virus contains a unique combination of gene segments from human, swine and avian influenza A viruses. Children and young adults appear to be the most affected, perhaps reflecting protection in the elderly owing to exposure to H1N1 strains before 1957. Most clinical disease is relatively mild but complications leading to hospitalization, with the need for intensive care, can occur, especially in very young children, during pregnancy, in morbid obesity, and in those with underlying medical conditions such as chronic lung and cardiac diseases, diabetes, and immunosuppression. Bacterial co-infection has played a significant role in fatal cases. The case of fatality has been estimated at around 0.4%. Mathematical modeling suggests that the effect of novel influenza virus can be reduced by immunization, but the question remains: can we produce enough H1N1 vaccine to beat the pandemic? AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. FAU - Al Hajjar, Sami AU - Al Hajjar S FAU - McIntosh, Kenneth AU - McIntosh K LA - eng PT - Journal Article PL - Saudi Arabia TA - Ann Saudi Med JT - Annals of Saudi medicine JID - 8507355 SB - IM EDAT- 2010/01/28 06:00 MHDA- 2010/01/28 06:00 CRDT- 2010/01/28 06:00 AID - AnnSaudiMed_2010_30_1_1_59365 [pii] AID - 10.4103/0256-4947.59365 [doi] PST - ppublish SO - Ann Saudi Med. 2010 Jan-Feb;30(1):1-10. PMID- 20103836 OWN - NLM STAT- In-Data-Review DA - 20100127 IS - 1881-7815 (Print) IS - 1881-7815 (Linking) VI - 3 IP - 4 DP - 2009 Aug TI - Clinical analysis of 150 cases with the novel influenza A (H1N1) virus infection in Shanghai, China. PG - 127-30 AB - The aim of the present research was to analyze the epidemiological and clinical characteristics of the novel influenza A (H1N1) in China. We retrospectively analyzed the epidemiological information and clinical characteristics of 150 patients with the novel influenza A (H1N1) virus infection by descriptive epidemiology. There were 82 males and 68 females in this group. The median age of the 150 patients was 34.4 years (range, 4 to 77 years). There were 145 imported cases among the patients and most of these cases came from Australia, America and Canada. The main symptoms included fever, cough and sore throat. Other symptoms included: expectoration, runny nose, throat itching, sniffles, dry pharynx, headache, muscular ache, etc. CD4<sup>+</sup> T cell counts of 48% of the patients were lower than normal. Computed tomography (CT) of the chest in 32 cases was abnormal, including: increased bronchovascular shadows, pneumonia, pleural thickening and pleurisy, etc. Oseltamivir was the first choice for treatment of A (H1N1) influenza and it was safe and well tolerated. The symptoms were minor and the prognosis was good. All patients recovered fully after treatment. Considering the fact that the flu is highly infectious and can be carried through human to human contact rapidly, local Centers for Disease Control and prevention (CDC) should strengthen monitoring and take some measures in view of an influenza A (H1N1) onslaught. AD - Department of Microbiology and Parasitology, Shanghai Medical College of Fudan University, Shanghai, China; FAU - Ou, Q AU - Ou Q FAU - Lu, Yf AU - Lu Y FAU - Huang, Q AU - Huang Q FAU - Cheng, Xj AU - Cheng X LA - eng PT - Journal Article PL - Japan TA - Biosci Trends JT - Bioscience trends JID - 101502754 SB - IM EDAT- 2010/01/28 06:00 MHDA- 2010/01/28 06:00 CRDT- 2010/01/28 06:00 PST - ppublish SO - Biosci Trends. 2009 Aug;3(4):127-30. PMID- 20102323 OWN - NLM STAT- In-Data-Review DA - 20100127 IS - 0731-8898 (Print) IS - 0731-8898 (Linking) VI - 28 IP - 4 DP - 2009 TI - EDITORIALPandemic Preparedness for Swine Flu Influenza in the United States. PG - 261-4 AB - In March and early April 2009, Mexico experienced outbreaks of influenza caused by the H1N1 virus, which has spread throughout the world. With the pandemic of H1N1 infections, we have discussed in this scientific article strategies that should limit the spread of the influenza A (H1N1) virus in our country. Specific vaccines against the influenza H1N1 virus are being manufactured, and a licensed vaccine is expected to be available in the United States by mid-October 2009. However, some health-care workers may be hesitant to take a vaccine because it contains a mercury preservative-thimerosal-which can be harmful to their health. When caring for patients with respiratory infections, the health-care worker should be wearing a facial respirator. In a report from the Centers for Disease Control and Prevention (CDC), it was indicated that each health-care professional should be required to do a respiratory fit testing to identify the ideal model. Because it has been well documented that a vitamin D deficiency can precipitate the influenza virus, we strongly recommend that all health-care workers and patients be tested and treated for vitamin D deficiency to prevent exacerbation of a respiratory infection. AD - Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, Charlottesville, VA. FAU - Edlich, Richard F AU - Edlich RF FAU - Mason, Shelley S AU - Mason SS FAU - Dahlstrom, Jill J AU - Dahlstrom JJ FAU - Swainston, Erin AU - Swainston E FAU - Long Iii, William B AU - Long Iii WB FAU - Gubler, K AU - Gubler K LA - eng PT - Journal Article PL - United States TA - J Environ Pathol Toxicol Oncol JT - Journal of environmental pathology, toxicology and oncology : official organ of the International Society for Environmental Toxicology and Cancer JID - 8501420 SB - IM EDAT- 2010/01/28 06:00 MHDA- 2010/01/28 06:00 CRDT- 2010/01/28 06:00 AID - 53151bb00a708171,2c7c6c5f13d8b74b [pii] PST - ppublish SO - J Environ Pathol Toxicol Oncol. 2009;28(4):261-4. PMID- 20039806 OWN - NLM STAT- MEDLINE DA - 20100111 DCOM- 20100127 IS - 1537-6613 (Electronic) IS - 1537-6613 (Linking) VI - 201 IP - 3 DP - 2010 Feb 1 TI - A novel type of influenza vaccine: safety and immunogenicity of replication-deficient influenza virus created by deletion of the interferon antagonist NS1. PG - 354-62 AB - BACKGROUND. The nonstructural protein NS1 of influenza virus counteracts the interferon-mediated immune response of the host. By deleting the open reading frame of NS1, we have generated a novel type of influenza vaccine. We studied the safety and immunogenicity of an influenza strain lacking the NS1 gene (DeltaNS1-H1N1) in healthy volunteers. METHODS. Healthy seronegative adult volunteers were randomized to receive either a single intranasal dose of the DeltaNS1-H1N1 A/New Caledonia vaccine at 1 of 5 dose levels (6.4, 6.7, 7.0, 7.4, and 7.7 log(10) median tissue culture infective dose) ([Formula: see text] recipients) or placebo ([Formula: see text] recipients). RESULTS. Intranasal vaccination with the replication-deficient DeltaNS1-H1N1 vaccine was well tolerated. Rhinitis-like symptoms and headache were the most common adverse events identified during the 28-day observation period. Adverse events were similarly distributed between the treatment and placebo groups. Vaccine-specific local and serum antibodies were induced in a dose-dependent manner. In the highest dose group, vaccine-specific antibodies were detected in 10 of 12 volunteers. Importantly, the vaccine also induced neutralizing antibodies against heterologous drift variants. CONCLUSIONS. We show that vaccination with an influenza virus strain lacking the viral interferon antagonist NS1 induces statistically significant levels of strain-specific and cross-neutralizing antibodies despite the highly attenuated replication-deficient phenotype. Further studies are warranted to determine whether these results translate into protection from influenza virus infection. TRIAL REGISTRATION. ClinicalTrials.gov identifier: NCT00724997 . AD - Departments of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria. FAU - Wacheck, Volker AU - Wacheck V FAU - Egorov, Andrej AU - Egorov A FAU - Groiss, Franz AU - Groiss F FAU - Pfeiffer, Andrea AU - Pfeiffer A FAU - Fuereder, Thorsten AU - Fuereder T FAU - Hoeflmayer, Doris AU - Hoeflmayer D FAU - Kundi, Michael AU - Kundi M FAU - Popow-Kraupp, Therese AU - Popow-Kraupp T FAU - Redlberger-Fritz, Monika AU - Redlberger-Fritz M FAU - Mueller, Christian A AU - Mueller CA FAU - Cinatl, Jindrich AU - Cinatl J FAU - Michaelis, Martin AU - Michaelis M FAU - Geiler, Janina AU - Geiler J FAU - Bergmann, Michael AU - Bergmann M FAU - Romanova, Julia AU - Romanova J FAU - Roethl, Elisabeth AU - Roethl E FAU - Morokutti, Alexander AU - Morokutti A FAU - Wolschek, Markus AU - Wolschek M FAU - Ferko, Boris AU - Ferko B FAU - Seipelt, Joachim AU - Seipelt J FAU - Dick-Gudenus, Rosmarie AU - Dick-Gudenus R FAU - Muster, Thomas AU - Muster T LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Infect Dis JT - The Journal of infectious diseases JID - 0413675 RN - 0 (Antibodies, Viral) RN - 0 (INS1 protein, influenza virus) RN - 0 (Influenza Vaccines) RN - 0 (Vaccines, Attenuated) RN - 0 (Viral Nonstructural Proteins) SB - AIM SB - IM MH - Adult MH - Antibodies, Viral/blood/isolation & purification MH - Dose-Response Relationship, Immunologic MH - Double-Blind Method MH - Gene Deletion MH - Humans MH - Influenza A Virus, H1N1 Subtype/genetics/*immunology MH - Influenza Vaccines/administration & dosage/adverse effects/*immunology MH - Influenza, Human/*prevention & control MH - Nasal Lavage Fluid/immunology/virology MH - Vaccines, Attenuated/administration & dosage/adverse effects/*immunology MH - Viral Nonstructural Proteins/*genetics MH - Virus Shedding EDAT- 2009/12/31 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/12/31 06:00 AID - 10.1086/649428 [doi] PST - ppublish SO - J Infect Dis. 2010 Feb 1;201(3):354-62. PMID- 19929400 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Novel influenza A (H1N1) presenting as an acute febrile encephalopathy in a mother and daughter. PG - 1966-7 FAU - Gonzalez, Blanca E AU - Gonzalez BE FAU - Brust, Douglas G AU - Brust DG LA - eng PT - Case Reports PT - Letter PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 SB - IM MH - Acute Disease MH - Brain Diseases/*etiology MH - Child MH - Female MH - Fever/*etiology MH - Humans MH - *Influenza A Virus, H1N1 Subtype MH - Influenza, Human/*complications MH - Middle Aged EDAT- 2009/11/26 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/26 06:00 AID - 10.1086/649014 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1966-7. PMID- 19926552 OWN - NLM STAT- MEDLINE DA - 20091120 DCOM- 20100127 IS - 1544-3450 (Electronic) IS - 1544-3450 (Linking) VI - 49 IP - 6 DP - 2009 Nov-Dec TI - Pandemic H1N1 influenza virus: academy perspectives on pharmacy's critical role in treatment, prevention. PG - 722-8 AD - Rx Response Pharmaceutical Research and Manufacturers of America. emullen@rxresponse.org FAU - Mullen, Erin AU - Mullen E FAU - Smith, Gary H AU - Smith GH FAU - Irwin, Adriane N AU - Irwin AN FAU - Angeles, Mark AU - Angeles M LA - eng PT - Journal Article PL - United States TA - J Am Pharm Assoc (2003) JT - Journal of the American Pharmacists Association : JAPhA JID - 101176252 SB - IM MH - *Disease Outbreaks MH - Humans MH - Immunization MH - *Influenza A Virus, H1N1 Subtype MH - Influenza, Human/*drug therapy/prevention & control MH - *Pharmacists MH - *Professional Role MH - Public Health EDAT- 2009/11/21 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/21 06:00 AID - X60774H023546114 [pii] AID - 10.1331/JAPhA.2009.09539 [doi] PST - ppublish SO - J Am Pharm Assoc (2003). 2009 Nov-Dec;49(6):722-8. PMID- 19911972 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Oseltamivir resistance: what does it mean clinically? PG - 1836-7 FAU - Baum, Stephen G AU - Baum SG LA - eng PT - Comment PT - Editorial PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 RN - 0 (Antiviral Agents) RN - 0 (Enzyme Inhibitors) RN - 0 (Oseltamivir) RN - EC 3.2.1.18 (Neuraminidase) SB - IM CON - Clin Infect Dis. 2009 Dec 15;49(12):1828-35. PMID: 19911968 MH - Antiviral Agents/*therapeutic use MH - Drug Resistance, Viral MH - Enzyme Inhibitors/*therapeutic use MH - Humans MH - Influenza A Virus, H1N1 Subtype/*genetics MH - Influenza, Human/*drug therapy MH - Mutation MH - Neuraminidase/*antagonists & inhibitors MH - Oseltamivir/*therapeutic use EDAT- 2009/11/17 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/17 06:00 AID - 10.1086/648425 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1836-7. PMID- 19911968 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Clinical effectiveness of oseltamivir and zanamivir for treatment of influenza A virus subtype H1N1 with the H274Y mutation: a Japanese, multicenter study of the 2007-2008 and 2008-2009 influenza seasons. PG - 1828-35 AB - BACKGROUND: Influenza A virus subtype H1N1 with the H274Y mutation emerged and spread worldwide. However, the clinical effectiveness of the neuraminidase inhibitors, oseltamivir and zanamivir, has not been adequately reevaluated. METHODS: Data from 164 patients with H1N1 virus infection and 59 patients with H3N2 virus infection during the 2008-2009 influenza season and 68 patients with H1N1 virus infection during the 2007-2008 influenza season who received a neuraminidase inhibitor were analyzed. The duration of fever (body temperature 37.5 degrees C) after the first dose of oseltamivir or zanamivir and from onset of symptoms was calculated from patient reports. The influenza virus was isolated, and its subtype was determined by hemagglutinin inhibition assay and polymerase chain reaction. The H274Y neuraminidase mutation status was determined by sequencing the neuraminidase segment. RESULTS: Of 68 patients with H1N1 virus infection during the 2007-2008 season, 41 were treated with oseltamivir, and 27 were treated with zanamivir. During the 2008-2009 season, 77 patients with H1N1 virus infection were treated with oseltamivir, and 87 were treated with zanamivir; 31 and 28 patients with H3N2 virus infection were treated with oseltamivir and zanamivir, respectively. All 49 analyzed H1N1 virus isolates obtained during the 2008-2009 season, but none of the isolates obtained during the 2007-2008 season, contained the H274Y mutation. The mean +/- standard deviation duration of fever after the start of oseltamivir therapy was significantly longer for patients with H1N1 virus infection (49.1+/-30.2 h) than it was for patients with H3N2 virus infection (33.7+/-20.1 h; P < .01) during the 2008-2009 season and patients with H1N1 virus infection during the 2007-2008 season (32.0+/-18.9 h; P < .001). The duration of fever was significantly longer after the first dose of oseltamivir than it was after the first dose of zanamivir for patients with H1N1 virus infection during the 2008-2009 season (P <.001). The duration of fever from onset of H1N1 virus infection was significantly longer for children 15 years of age during 2008-2009 (70.6+/-34.5 h) than it was for such children during 2007-2008 (48.4+/-21.2). CONCLUSION: The effectiveness of oseltamivir, but not that of zanamivir, decreased significantly for H1N1 virus infection during the 2008-2009 season. AD - Japan Physicians Association, Tokyo, Japan. nkawai@city.gifu.med.or.jp FAU - Kawai, Naoki AU - Kawai N FAU - Ikematsu, Hideyuki AU - Ikematsu H FAU - Hirotsu, Nobuo AU - Hirotsu N FAU - Maeda, Tetsunari AU - Maeda T FAU - Kawashima, Takashi AU - Kawashima T FAU - Tanaka, Osame AU - Tanaka O FAU - Yamauchi, Satoshi AU - Yamauchi S FAU - Kawamura, Kenichi AU - Kawamura K FAU - Matsuura, Shinro AU - Matsuura S FAU - Nishimura, Mika AU - Nishimura M FAU - Iwaki, Norio AU - Iwaki N FAU - Kashiwagi, Seizaburo AU - Kashiwagi S LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 RN - 0 (Antiviral Agents) RN - 0 (Enzyme Inhibitors) RN - 0 (Oseltamivir) RN - 139110-80-8 (Zanamivir) RN - EC 3.2.1.18 (Neuraminidase) SB - IM CIN - Clin Infect Dis. 2009 Dec 15;49(12):1836-7. PMID: 19911972 MH - Adult MH - Antiviral Agents/*therapeutic use MH - Drug Resistance, Viral MH - Enzyme Inhibitors/*therapeutic use MH - Female MH - Fever/epidemiology MH - Humans MH - Influenza A Virus, H1N1 Subtype/*genetics MH - Influenza, Human/*drug therapy MH - Male MH - Middle Aged MH - *Mutation MH - Neuraminidase/antagonists & inhibitors/*genetics MH - Oseltamivir/*therapeutic use MH - Time Factors MH - Zanamivir/*therapeutic use EDAT- 2009/11/17 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/17 06:00 AID - 10.1086/648424 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1828-35. PMID- 19911967 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Economic value of seasonal and pandemic influenza vaccination during pregnancy. PG - 1784-92 AB - BACKGROUND: The cost-effectiveness of maternal influenza immunization against laboratory-confirmed influenza has never been studied. The current 2009 H1N1 influenza pandemic provides a timely opportunity to perform such analyses. The study objective was to evaluate the cost-effectiveness of maternal influenza vaccination using both single- and 2-dose strategies against laboratory-confirmed influenza secondary to both seasonal epidemics and pandemic influenza outbreaks. METHODS: A cost-effectiveness decision analytic model construct using epidemic and pandemic influenza characteristics from both the societal and third-party payor perspectives. A comparison was made between vaccinating all pregnant women in the United States versus not vaccinating pregnant women. Probabilistic (Monte Carlo) sensitivity analyses were also performed. The main outcome measures were incremental cost-effectiveness ratios (ICERs). RESULTS: Maternal influenza vaccination using either the single- or 2-dose strategy is a cost-effective approach when influenza prevalence > or =7.5% and influenza-attributable mortality is > or =1.05% (consistent with epidemic strains). As the prevalence of influenza and/or the severity of the outbreak increases the incremental value of vaccination also increases. At a higher prevalence of influenza (> or =30%) the single-dose strategy demonstrates cost-savings while the 2-dose strategy remains highly cost-effective (ICER, < or =$6787.77 per quality-adjusted life year). CONCLUSIONS: Maternal influenza immunization is a highly cost-effective intervention at disease rates and severity that correspond to both seasonal influenza epidemics and occasional pandemics. These findings justify ongoing efforts to optimize influenza vaccination during pregnancy from an economic perspective. AD - Division of Reproductive Infectious Diseases, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. rbeigi@mail.magee.edu FAU - Beigi, Richard H AU - Beigi RH FAU - Wiringa, Ann E AU - Wiringa AE FAU - Bailey, Rachel R AU - Bailey RR FAU - Assi, Tina-Marie AU - Assi TM FAU - Lee, Bruce Y AU - Lee BY LA - eng PT - Journal Article PT - Research Support, N.I.H., Extramural PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 RN - 0 (Influenza Vaccines) SB - IM MH - Computer Simulation MH - Cost-Benefit Analysis MH - *Disease Outbreaks MH - Female MH - Humans MH - Influenza A Virus, H1N1 Subtype/immunology MH - Influenza Vaccines/economics/*immunology MH - Influenza, Human/epidemiology/*prevention & control MH - Pregnancy MH - Pregnancy Complications, Infectious/*prevention & control MH - Quality-Adjusted Life Years MH - Vaccination/*economics EDAT- 2009/11/17 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/17 06:00 AID - 10.1086/649013 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1784-92. PMID- 19911964 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Notes from the field: outbreak of 2009 pandemic influenza A (H1N1) virus at a large public university in Delaware, April-May 2009. PG - 1811-20 AB - BACKGROUND: In late April 2009, the first documented 2009 pandemic influenza A (pH1N1) virus infection outbreak in a university setting occurred in Delaware, with large numbers of students presenting with respiratory illness. At the time of this investigation, little was known about the severity of illness, effectiveness of the vaccine, or transmission factors of pH1N1 virus infection. We characterized illness, determined the impact of this outbreak, and examined factors associated with transmission. METHODS: Health clinic records were reviewed. An online survey was administered to all students, staff, and faculty to assess influenza-like illness (ILI), defined as documented or subjective fever with cough or sore throat. RESULTS: From 26 April-2 May 2009, the health clinic experienced a sharp increase in visits for respiratory illness, with 1080 such visits among a total of 1430 student visits, and then a return to baseline visit levels within 2 weeks. More than 500 courses of oseltamivir were distributed, and 24 cases of influenza A (pH1N1) virus infection were confirmed. Of 29,000 university students and faculty/staff, 7450 (30%) responded to the survey. ILI was reported by 604 (10%) of the students and 73 (5%) of the faculty/staff. Travel to Mexico (relative risk [RR], 2.9; 95% confidence interval [CI], 1.8-4.7) and participation in "Greek Week" activities (RR, 2.2; 95% CI, 1.8-2.8) were associated with ILI. Recipients of the 2008-2009 seasonal influenza vaccine had the same risk of ILI as nonrecipients (RR, 1.0). Four (3%) of the students with ILI were hospitalized; there were no deaths. CONCLUSIONS: pH1N1 spread rapidly through the University of Delaware community with a surge in illness over a 2-week period. Although initial cases appear to be associated with travel to Mexico, a rapid increase in cases was likely facilitated by increased student interactions during Greek Week. No protective effect from receiving seasonal influenza vaccine was identified. Although severe illness was rare, the outbreak caused a substantial burden and challenge to the university health care system. Preparedness efforts in universities and similar settings should include enhancing health care surge capacity. AD - Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Aoi0@cdc.gov FAU - Iuliano, A Danielle AU - Iuliano AD FAU - Reed, Carrie AU - Reed C FAU - Guh, Alice AU - Guh A FAU - Desai, Mitesh AU - Desai M FAU - Dee, D L AU - Dee DL FAU - Kutty, Preeta AU - Kutty P FAU - Gould, L Hannah AU - Gould LH FAU - Sotir, Mark AU - Sotir M FAU - Grant, Gavin AU - Grant G FAU - Lynch, Michael AU - Lynch M FAU - Mitchell, Tarissa AU - Mitchell T FAU - Getchell, Jane AU - Getchell J FAU - Shu, Bo AU - Shu B FAU - Villanueva, J AU - Villanueva J FAU - Lindstrom, Stephen AU - Lindstrom S FAU - Massoudi, Mehran S AU - Massoudi MS FAU - Siebold, Joseph AU - Siebold J FAU - Silverman, Paul R AU - Silverman PR FAU - Armstrong, Gregory AU - Armstrong G FAU - Swerdlow, David L AU - Swerdlow DL LA - eng PT - Journal Article PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 SB - IM MH - Adult MH - Aged MH - Cross-Sectional Studies MH - Delaware/epidemiology MH - *Disease Outbreaks MH - Female MH - Humans MH - *Influenza A Virus, H1N1 Subtype MH - Influenza, Human/*epidemiology MH - Male MH - Middle Aged MH - Time Factors EDAT- 2009/11/17 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/17 06:00 AID - 10.1086/649555 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1811-20. PMID- 19911946 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1537-6591 (Electronic) IS - 1537-6591 (Linking) VI - 49 IP - 12 DP - 2009 Dec 15 TI - Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries. PG - 1801-10 AB - BACKGROUND: A novel swine-origin influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. The San Diego region was an early focal point of the emerging pandemic. We describe the clinical and epidemiologic characteristics of this novel strain in a military population to assist in future outbreak prevention and control efforts. METHODS: We performed an epidemiologic evaluation of novel H1N1 virus infections diagnosed in San Diego County among 96,258 local US military beneficiaries. The structured military medical system afforded the ability to obtain precise epidemiologic information on the impact on H1N1 virus infection in a population. The novel H1N1 virus was confirmed using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). RESULTS: From 21 April through 8 May 2009, 761 patients presented with influenza-like illness and underwent rRT-PCR testing. Of these patients, 97 had confirmed novel H1N1 virus infection, with an incidence rate of 101 cases per 100,000 persons. The median age of H1N1 patients with H1N1 virus infection was 21 years (interquartile range, 15-25 years). Fever was a universal symptom in patients with H1N1 virus infection; other symptoms included cough (present in 96% of patients), myalgia or arthralgia (57%), and sore throat (51%). Sixty-eight (70%) of our patients had an identifiable epidemiologic link to another confirmed patient. The largest cluster of cases of H1N1 virus infection occurred on a Navy ship and involved 32 (8%) of 402 crew members; the secondary attack rate was 6%-14%. The rapid influenza testing that was used during this outbreak had a sensitivity of 51% and specificity of 98%, compared with rRT-PCR. Only 1 patient was hospitalized, and there were no deaths. CONCLUSIONS: A novel H1N1 influenza A virus caused a significant outbreak among military beneficiaries in San Diego County, including a significant cluster of cases onboard a Navy ship. The outbreak described here primarily affected adolescents and young adults and resulted in a febrile illness without sequelae. AD - Infectious Disease Clinic, Naval Medical Center San Diego, San Diego, California 92134-1005, USA. FAU - Crum-Cianflone, Nancy F AU - Crum-Cianflone NF FAU - Blair, Patrick J AU - Blair PJ FAU - Faix, Dennis AU - Faix D FAU - Arnold, John AU - Arnold J FAU - Echols, Sara AU - Echols S FAU - Sherman, Sterling S AU - Sherman SS FAU - Tueller, John E AU - Tueller JE FAU - Warkentien, Tyler AU - Warkentien T FAU - Sanguineti, Gabriela AU - Sanguineti G FAU - Bavaro, Mary AU - Bavaro M FAU - Hale, Braden R AU - Hale BR LA - eng GR - Y1-AI-5072/AI/NIAID NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. PL - United States TA - Clin Infect Dis JT - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JID - 9203213 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Child MH - Child, Preschool MH - Cluster Analysis MH - *Disease Outbreaks MH - Female MH - Humans MH - Infant MH - Infant, Newborn MH - *Influenza A Virus, H1N1 Subtype MH - Influenza, Human/*epidemiology MH - Male MH - Middle Aged MH - *Military Personnel MH - Reverse Transcriptase Polymerase Chain Reaction MH - United States/epidemiology EDAT- 2009/11/17 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/17 06:00 AID - 10.1086/648508 [doi] PST - ppublish SO - Clin Infect Dis. 2009 Dec 15;49(12):1801-10. PMID- 19781448 OWN - NLM STAT- MEDLINE DA - 20090928 DCOM- 20100127 IS - 0213-9111 (Print) IS - 0213-9111 (Linking) VI - 23 IP - 5 DP - 2009 Sep-Oct TI - [Media epidemics: considerations for public health] PG - 362-4 FAU - Cayla, Joan A AU - Cayla JA LA - spa PT - Editorial TT - Epidemias mediaticas: una reflexion para la salud publica. PL - Spain TA - Gac Sanit JT - Gaceta sanitaria / S.E.S.P.A.S JID - 8901623 SB - IM MH - Humans MH - *Influenza A Virus, H1N1 Subtype MH - Influenza, Human/*epidemiology/prevention & control MH - *Internet MH - *Public Health MH - Severe Acute Respiratory Syndrome/*epidemiology/prevention & control EDAT- 2009/09/29 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/09/29 06:00 PHST- 2009/09/03 [received] PHST- 2009/09/03 [accepted] AID - S0213-9111(09)00307-0 [pii] AID - 10.1016/j.gaceta.2009.09.002 [doi] PST - ppublish SO - Gac Sanit. 2009 Sep-Oct;23(5):362-4. PMID- 19681951 OWN - NLM STAT- MEDLINE DA - 20091125 DCOM- 20100127 IS - 1469-0691 (Electronic) IS - 1469-0691 (Linking) VI - 15 IP - 12 DP - 2009 Dec TI - Kinetics of nasopharyngeal shedding of novel H1N1 (swine-like) influenza A virus in an immunocompetent adult under oseltamivir therapy. PG - 1189-91 AB - We describe a patient with confirmed novel H1N1 (swine-like) influenza A virus who had daily nasal swabs tested during oseltamivir therapy. Nasal shedding remained positive for 2 days and became negative on day 3. This report presents the first available data on the kinetics of shedding of this novel virus under antiviral therapy. AD - Universite Paris Descartes, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Charlier, C AU - Charlier C FAU - Enouf, V AU - Enouf V FAU - Lanternier, F AU - Lanternier F FAU - Grandadam, M AU - Grandadam M FAU - Amazzough, K AU - Amazzough K FAU - Blanche, S AU - Blanche S FAU - Lecuit, M AU - Lecuit M FAU - Lortholary, O AU - Lortholary O FAU - van der Werf, S AU - van der Werf S LA - eng PT - Case Reports PT - Journal Article DEP - 20090722 PL - France TA - Clin Microbiol Infect JT - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JID - 9516420 RN - 0 (Antiviral Agents) RN - 0 (Oseltamivir) SB - IM MH - Adult MH - Animals MH - Antiviral Agents/*therapeutic use MH - Humans MH - *Immunocompetence MH - Influenza A Virus, H1N1 Subtype/drug effects/genetics/isolation & purification/*physiology MH - Influenza, Human/diagnosis/drug therapy/virology MH - Kinetics MH - Male MH - Nasopharynx/*virology MH - Oseltamivir/*therapeutic use MH - Swine MH - *Virus Shedding EDAT- 2009/08/18 09:00 MHDA- 2010/01/28 06:00 CRDT- 2009/08/18 09:00 PHST- 2009/07/22 [aheadofprint] AID - CLM3007 [pii] AID - 10.1111/j.1469-0691.2009.03007.x [doi] PST - ppublish SO - Clin Microbiol Infect. 2009 Dec;15(12):1189-91. Epub 2009 Jul 22.