Influenza Laboratory Capacity Assessment in the EMR

In view of the need to enhance the functions of Influenza Laboratories in the Region, an assessment of the existing capacity and gaps have been conducted in the Eastern Mediterranean Region recently. Currently, 16 National Influenza Centres [NICs] in 15 Member States of the Region and Influenza Laboratories in seven countries, namely -Djibouti, Libya, Palestine, Saudi Arabia, Somalia, UAE and Yemen have been included in this assessment

Incidence of influenza virus-associated severe acute respiratory infection in Damanhour district, Egypt, 2013

The epidemiology, seasonality and risk factors for influenza virus infection remains poorly defined in countries such as Egypt. Between 1 January and 31 December 2013, we used surveillance data on patients hospitalized with severe acute respiratory infection in three Egyptian government hospitals in Damanhour district to estimate the incidence rate of laboratory-confirmed seasonal influenza. Samples were taken from 1727 of 1856 patients; of these, 19% were influenza virus positive. The overall incidence of influenza virus-associated SARI during the study period was estimated to be 44 cases per 100 000 person-years [95% CI: 39-48]. The highest incidence of 166 cases per 100 000 person year [95% CI: 125-220] was observed in children aged 2 to 4 years. The incidence of influenza-virus associated SARI cases in pregnant women was estimated to be 17.3 cases per 100 000 person-years [95% CI: 6-54]. Majority of influenza virus-associated SARI occurred in autumn and early winter, and influenza A[H3N2] virus predominated. This was the first ever description of the epidemiology of seasonal influenza in Egypt. However, additional works are needed for greater understanding of influenza burden in Egypt

Characterization of influenza outbreaks in Lebanon during the 2013/14 and 2014/15 seasons

Despite the significant burden of influenza outbreaks, active disease monitoring has been largely absent in the Middle East, including Lebanon. In this study we characterized influenza virus in 440 nasopharyngeal swabs collected from patients with acute respiratory infections during two influenza seasons in Lebanon. Influenza A[H3N2] was dominant in the 2013/14 season while the A[H1N1]pdm09 and B/Yamagata strains were most prevalent in the 2014/15 season. All tested isolates were susceptible to 4 neuraminidase inhibitors [oseltamivir, zanamivir, peramivir and laninamivir]. Genetic analysis of the haemagglutinin gene revealed multiple introductions of influenza viruses into Lebanon from different geographic sources during each season. Additionally, large data gaps were identified in the Middle East region, as indicated by the lack of current influenza sequences in the database from many countries in the region

Infecção pelo vírus Influenza pandêmico (H1N1) 2009 / Infection by the Influenza virus pandêmico (H1N1) 2009

Apresenta-se abordagem da infecção pelo vírus Influenza pandêmico (H1N1) 2009 como fonte de consulta para organização de sistemas de atendimento em vários níveis de atenção à saúde.

This is the approach of the pandemic influenza virus infection (H1N1) 2009 as a consulting resource to the organization of care systems at various levels of health care.

Influenza virus / Orthomyxoviridae

EL conocimiento acerca de las estructuras virales ha posibilitado a la humanidad la visión de partículas que se pensaban eran inexistentes. Con la información sobre estructuras víricas podemos interpretar su virulencia y su capacidad para producir enfermedades sobre todo en el caso del virus de la influenza, que puede ser tipo A, B y C pudiéndose dar en cada uno de ellos las combinaciones especificas según hemaglutininas y neuraminidasas, generando así nuevas variantes de virus con características totalmente diferentes a las anteriores; a ello se debe su variabilidad genética. La transmisibilidad entre grupos no solo entre humanos sino también de animales a humanos, produce lo que llamamos epidemia y pandemias que ocurren actualmente a nivel mundial; debido a éstos fenómenos debemos extremar medidas de seguridad, como las vacunaciones a los grupos susceptibles que son los niños y ancianos. No sólo en el hombre pueden darse las combinaciones genéticas que producen nuevas alteraciones sino también en los animales, y de ellos transmitirse a humanos. En base a estos nuevos conocimientos debemos estar alerta ante la presencia de personas portadoras de este virus y proporcionar información pertinente a nuestros pacientes sobre los tipos y la posible complicación a que puedan dar lugar. El objetivo de este trabajo es proporcionar información sobre las características de los virus en general y en forma muy específica del virus de la influenza de manera a conocer su patogenicidad. El propósito del trabajo es proporcionar herramientas para ayudar a establecer medidas que minimicen la posibilidad de transmisión del virus en el consultorio odontológico.

Respiratory tract infection during Hajj

Respiratory tract infection during Hajj [pilgrimage to Mecca] is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections

Co-infection between influenza virus and flagellated bacteria

Tripsina é necessária na ativação da clivagem do vírus influenza A in vitro. Esta clivagem é importante para entrada do vírus na célula por endocitose mediada pelo receptor celular. Bactérias presentes no trato respiratório são fontes de proteases que podem contribuir na replicação do vírus influenza in vivo. Entre 47 amostras coletadas de cavalos, suínos e humanos, a influenza foi isolada e confirmada em 13 que estavam co-infectadas com bactéria flagelada: Stenotrophomonas maltophilia desde o início destes experimentos. Apesar do tratamento das amostras com antibióticos, as bactérias resistiram em diversas delas (48.39%). A protease (elastase), secretada pela Stenotrophomonas maltophilia, desenvolveu papel decisivo na potencialização da infecção pelo vírus influenza. Essa atividade proteolítica foi detectada pelo teste de ágar-caseína. Amostras positivas para o vírus influenza isolado em animais, bem como em humanos tiveram potencialização da infectividade (ECP) em células MDCK e NCI-H292, sempre que a Stenotrophomonas maltophilia esteve presente. Os referidos microorganismos, bactéria e vírus foram observados ultra-estruturalmente. Esses achados in vitro demonstram como complicações respiratórias podem ocorrer in vivo, através da contribuição de protease microbiana, provocando aumento da inflamação ou destruição dos inibidores celulares de proteases endógenas, nos hospedeiros susceptíveis à influenza.

Prevalence of parainfluenza and influenza viruses amongst children with upper respiratory tract infection

The objective of this study was to determine the prevalence of Parainfluenza and Influenza causing upper respiratory tract infections and to evaluate shell vial culture assay and direct immunofluorescence assay. A retrospective study during the period between November 1997 and May 1998. A total of 350 nasopharyngeal aspirates were obtained from children suffering from respiratory tract infections. Nasopharyngeal aspirates were investigated for the presence of Parainfluenza 1, 2 and 3, Influenza A and B using shell vial culture assay, conventional culture assay and direct immunofluorescence assay. Parainfluenza 1 were identified in 3%, Parainfluenza 2 in 5% and Parainfluenza 3 in 6%. Influenza A were identified in 4% and Influenza B in 2%. Parainfluenza 1, 2 and 3 were isolated in children less than 5 years old. Most of Parainfluenza cases were associated with other upper respiratory infections. Shell vial assay showed a sensitivity of 90-93% and specificity of 99-100% for detecting Parainfluenza 1, 2 and 3. These results emphasize that shell vial assay is important for the diagnosis of Parainfluenza and Influenza, although direct immunofluorescence assay is the superior diagnositic assay

Vigilancia sistemática de virus influenza, respiratorio sincicial, parainfluenza y adenovirus en niños ambulatorios con infecciones respiratorias agudas / Systematic surveillance of influenza, syncytial respiratory, parainfluenza and adenovirus in ambulatory children with acute respiratory infections

Background: The efficacy of influenza vaccination programs depends on the antigenic similitude between vaccine and the influenza virus circulating in the community. Therefore the surveillance of clinical activity and antigenic features of influenza virus is of utmost importance. Aim: To perform a systematic surveillance of clinical activity and antigenic characteristics of influenza virus. Material and methods: Since 1996 and during the cold months (may to september), 20 samples of upper respiratory secretions per week, were obtained from children with acute respiratory infections consulting to the emergency room of a public hospital. Using indirect immunofluorescence and cellular cultures, the presence of influenza, syncytial respiratory, parainfluenza and adenovirus was assessed. The weekly number of consultations in the emergency room and the number of hospital discharges due to acute respiratory infections, were registered. Results: Influenza and syncytial respiratory were the predominant virus detected since 1996. In 1996 and 1998, the weekly detection of influenza virus followed a single seasonal curve. The maximal weekly positively results reached 85 and 80 percent of the obtained samples, respectively. During 1997, two curves of influenza virus activity were observed, but none reached more than 50 percent of weekly positive samples. The demand for outpatient care evolved in parallel to the weekly detection of influenza virus. The hospital discharges due to acute respiratory infections paralleled the syncytial respiratory virus detection rates. Conclusions: This surveillance model is effective for the detection of influenza and other virus responsible for acute respiratory infections and their relationship with the demand for health care during the cold months

Estado actual de la influenza. Avances en la prevención 1998-1999 (primera parte) / Current state of influenza

Se revisan las características epidemiológicas, clínicas, de diagnóstico y prevención de la infección por influenza. Se da información concerniente a la vacuna y agentes antivirales disponibles para el control de esta infección durante el periodo de 1998-1999. El principal cambio incluye información acerca de: a) los cultivos virales de influenza incluidas en la vacuna trivalente para 1998-1999; b) la vacunación en embarazadas y mujeres que amamantan; c) efectos colaterales y reacciones adversas, y d) importancia de la vacunación en pacientes de alto riesgo y personal al cuidado de la salud

Influenza

La influenza es una enfermedad aguda respiratoria, producida por un virus Orthomyxo, de muy fácil y rápida transmisión aérea, que tiene la característica de modificarse biológicamente cada 10 a 12 años, emergiendo con cambios en las estructuras correspondientes a la hemaglutinina y la neuraminidasa, lo que tiene importancia en la epidemiología de la enfermedad debido a la posibilidad de infección de los individuos que previamente hayan sido infectados. La influenza tiene un período de incubación clínico de dos a tres días. Se presenta en brotes epidémicos y causa una alta morbilidad entre la población general. Los grupos de alto riesgo como los enfermos crónicos pulmonares, los que tienen enfermedades cardivasculares, los inmunocomprometidos, los niños y los ancianos, son los que tienen mayor mortalidad que puede llegar hasta el 5 por ciento. Existen tratamientos como el clorhidrato de amantadina y la rimantadina y también se dispone de una vacuna que es producida periódicamente en concordancia con los virus que están circulando en el orbe; contiene una mezcla de virus A y B. En la actualidad se ha aislado por el Instituto Nacional de Salud, el virus A de la unfluenza H3N2 de pacientes de varias ciudades del país.

Actividad del virus de influenza humana en Medellín, Colombia, 1990-1993

Para determinar el virus de influenza en Medellín y contribuir al programa de la Organización Mundial de la Salud (OMS), sobre la investigación de esta enfermedad, se realizó entre 1990-1993 un estudio serológico y virológico en población sana y en pacientes con infección respiratoria aguda (IRA), respectivamente. En 1991 y 1992 se detectó un aumento en el porcentaje de individuos con anticuerpos contra el virus A/Taiwan/1/86 (H1N1). Este porcentaje disminuyó en el año 1993, pero en este mismo año se presentó el mayor número de individuos con anticuerpos contra otras dos cepas del mismo tipo viral: A/Sichuan/2/87 (HGRX -97) y A/Shangai/16/89 (H3N2). También en los primeros meses de 1993 se encontró un porcentaje de individuos sanos con anticuerpos contra el virus A/Beijing/353/89 (H3N2), algo no detectado en el año anterior. Igualmente en el mes de enero de 1993 se aisló un virus A/Beijing/353/89, semejante al que circuló en Estados Unidos en 1992 y 1993. Para el virus de influenza tipo B, no se hallaron anticuerpos contra las cepas estudiadas: B/Victoria/2/87 y B/Panamá/45/90. No se descarta la posibilidad de que haya circulado otra cepa B diferente, que no pudo ser detectado. También se incluyó la búsqueda de anticuerpos contra virus de influenza humana, en cerdos post-infección respiratoria aguda; los resultados fueron negativos. El presente estudio nos muestra la circulación reciente, en muestro medio,de varias cepas de influenza tipo A

Role of influenza Virus as A causative agent of acute upper respiratory tract infection in Port Said

Two hundred patients diagnosed clinically as having acute upper respiratory illness [URl] together with 30 normal healthy individuals as controls were the subject of this study, Influenza viruses were detected in 86 [43%] patients, none of the controls showed isolation of influenza viruses. As regards the relation between influenza viruses and different respiratory syndromes, our study revealed that the commonest respiratory syndrome was nasopharyngitis [46.55] followed by common cold and laryngitis accounting for 34.9% and 18.6% respectively, Studying the causative strains of influenza viruses, it was found that 17 out of the 22 tested specimens reacted with antisera against influenze type A/Bangkok/1/79 [H[3]N[2]] and 5 specimens with antisera against influenza type A/Brazil/78 [H[1]N[1]]. None of the specimens showed reaction with antisera against influenza type B/Singapore/78