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The panzootic caused by H5N1 avian influenza viruses is a high concern for wild birds' conservation and the study of spillover events into mammals. The near coding-complete genome of H5N1 clade 2.3.3.4b sequencing in the Miseq Illumina platform was performed from a bird located in Pantanos of Villa National Wildlife Refuge.
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Streptococcus pneumoniae is a major pathogen responsible for severe complications in patients with prior influenza A virus (IAV) infection. We have previously demonstrated that S. pneumoniae exhibits increased intracellular survival within IAV-infected cells. Fluoroquinolones (FQs) are widely used to treat pneumococcal infections. However, our prior work has shown that S. pneumoniae can develop intracellular FQ persistence, a phenomenon triggered by oxidative stress within host cells. This persistence allows the bacteria to withstand high FQ concentrations. In this study, we show that IAV infection enhances pneumococcal FQ persistence during intracellular survival within pneumocytes, macrophages, and neutrophils. This enhancement is partly due to increased oxidative stress induced by the viral infection. We find that this phenotype is particularly pronounced in autophagy-proficient host cells, potentially resulting from IAV-induced blockage of autophagosome-lysosome fusion. Moreover, we identified several S. pneumoniae genes involved in oxidative stress response that contribute to FQ persistence, including sodA (superoxide dismutase), clpL (chaperone), nrdH (glutaredoxin), and psaB (Mn+2 transporter component). Our findings reveal a novel mechanism of antibiotic persistence promoted by viral infection within host cells. This underscores the importance of considering this phenomenon when using FQs to treat pneumococcal infections, especially in patients with concurrent influenza A infection.
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Aquatic habitats provide a bridge for influenza transmission among wild and domestic species. However, water sources pose highly variable physicochemical and ecological characteristics that affect avian influenza virus (AIV) stability. Therefore, the risk of survival or transmissibility of AIV in the environment is quite variable and has been understudied. In this study, we determine the risk of waterborne transmission and environmental persistence of AIV in a wild/domestic bird interface in the Central Mexico plateau (North America) during the winter season using a multi-criteria decision analysis (MCDA). A total of 13 eco-epidemiological factors were selected from public-access databases to develop the risk assessment. The MCDA showed that the Atarasquillo wetland presents a higher persistence risk in January. Likewise, most of the backyard poultry farms at this wild-domestic interface present a high persistence risk (50%). Our results suggest that drinking water may represent a more enabling environment for AIV persistence in contrast with wastewater. Moreover, almost all backyard poultry farms evidence a moderate or high risk of waterborne transmission especially farms close to water bodies. The wildlife/domestic bird interface on the Atarasquillo wetland holds eco-epidemiological factors such as the presence of farms in flood-prone areas, the poultry access to outdoor water, and the use of drinking-water troughs among multiple animal species that may enhance waterborne transmission of AIV. These findings highlight the relevance of understanding the influence of multiple factors on AIV ecology for early intervention and long-term control strategies.
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Influenza A viruses (IAV) impose significant respiratory disease burdens in both swine and humans worldwide, with frequent human-to-swine transmission driving viral evolution in pigs and highlighting the risk at the animal-human interface. Therefore, a comprehensive One Health approach (interconnection among human, animal, and environmental health) is needed for IAV prevention, control, and response. Animal influenza genomic surveillance remains limited in many Latin American countries, including Colombia. To address this gap, we genetically characterized 170 swine specimens from Colombia (2011-2017). Whole genome sequencing revealed a predominance of pandemic-like H1N1 lineage, with a minority belonging to H3N2 and H1N2 human seasonal-like lineage and H1N1 early classical swine lineages. Significantly, we have identified reassortant and recombinant viruses (H3N2, H1N1) not previously reported in Colombia. This suggests a broad genotypic viral diversity, likely resulting from reassortment between classical endemic viruses and new introductions established in Colombia's swine population (e.g. the 2009 H1N1 pandemic). Our study highlights the importance of a One Health approach in disease control, particularly in an ecosystem where humans are a main source of IAV to swine populations, and emphasizes the need for continued surveillance and enhanced biosecurity measures. The co-circulation of multiple subtypes in regions with high swine density facilitates viral exchange, underscoring the importance of monitoring viral evolution to inform vaccine selection and public health policies locally and globally.
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Evolução Molecular , Variação Genética , Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A Subtipo H3N2 , Infecções por Orthomyxoviridae , Filogenia , Doenças dos Suínos , Animais , Suínos , Colômbia/epidemiologia , Infecções por Orthomyxoviridae/virologia , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/epidemiologia , Doenças dos Suínos/virologia , Doenças dos Suínos/epidemiologia , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/classificação , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/classificação , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Saúde Única , Humanos , Vírus da Influenza A/genética , Vírus da Influenza A/classificação , Vírus da Influenza A/isolamento & purificação , Sequenciamento Completo do Genoma , Genoma Viral , Monitoramento Epidemiológico , Vírus Reordenados/genética , Vírus Reordenados/classificação , Vírus Reordenados/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/genética , Vírus da Influenza A Subtipo H1N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/classificação , Influenza Humana/virologia , Influenza Humana/epidemiologiaRESUMO
Introduction: During the outbreak of avian influenza, A (H5N1) (IA) in wild and domestic birds recorded in January 2023, the epidemiological alert has been extended due to its potential contagion to humans, particularly in those exposed occupational groups. Objective: to identify the primary occupational risk groups, as well as the preventive, safety, and control measures against IA intended or implemented in these positions. Material and methods: A systematic search was conducted in Pubmed, Scopus, Web of science, Scielo and literature databases. Scientific articles, normative documents, and technical reports identifying vulnerable occupational groups and preventive measures against IA were included. Two authors conducted a full-text review, extracting information independently, and findings were summarized narratively. Results: A total of 5518 documents were identified, and 30 reports were included. 20% of the reports were published in 2023, 13/30 were affiliated to a university institution. Occupationally exposed groups were identified both directly and indirectly. 63.3% of reports identified breeders, poultry farmers and sellers as the most concerning occupational group, while 60% identified biosecurity practices (use of PPE, handwashing) as the primary measure against IA, followed by strategies such as education (training and capacity-building). Conclusion: Occupational groups of interest were identified, primarily those involved in sales, commerce, and the handling of bird waste with potential exposure to IA. Furthermore, the maintenance of biosecurity measures, cleaning-disinfection practices, and educational strategies in workplace settings are recommended.
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Influenza A virus (IAV) is an important pathogen in Brazilian swine herds, and monitoring the viral circulation is essential to control and reduce the transmission. Surveillance programs for IAV are often based on individual piglets level sampling, making the evaluation of the available diagnostic tools crucial to assessing IAV circulation in herds. Thus, two sample collection methodologies were compared in pig herds in southern Brazil to detect IAV by RT-qPCR: nasal swab (NS) and nasal wipe (NW). A Bayesian latent class model (BLCM) was set for two tests and two populations. The NW and NS used are more specific (higher than 95â¯% for both) than sensitive. The sensitivity for NW was lower than the NS, 84.14â¯% (70â¯% - 95â¯%; posterior probability interval (PPI): 95â¯%) and 87.15â¯% (73â¯% - 97â¯%; PPI: 95â¯%), respectively, and the specificity was 95â¯% (90â¯% - 99â¯%; PPI: 95â¯%) and 99â¯% (96â¯% - 100â¯%; PPI: 95â¯%), respectively. Although the wipe sample collection loses both sensitivity and specificity compared with nasal swab, differences in test performance were very limited and PPIs largely overlapped. Therefore NW can also be considered a valuable tool. The decision about the use of both techniques should be based on the trade-off between their performance limitations and feasibility in routine monitoring.
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Teorema de Bayes , Vírus da Influenza A , Análise de Classes Latentes , Infecções por Orthomyxoviridae , Sensibilidade e Especificidade , Doenças dos Suínos , Animais , Doenças dos Suínos/virologia , Doenças dos Suínos/diagnóstico , Suínos , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/virologia , Infecções por Orthomyxoviridae/diagnóstico , Infecções por Orthomyxoviridae/epidemiologia , Vírus da Influenza A/isolamento & purificação , Brasil/epidemiologia , Manejo de Espécimes/veterinária , Manejo de Espécimes/métodos , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Nariz/virologiaRESUMO
Background: An epizootic of highly pathogenic avian influenza A (H5N1) has spread worldwide since 2022. Even though this virus has been extensively studied for many decades, little is known about its evolution in South America. Methods: Here, we describe the sequencing and characterization of 13 H5N1 genomes collected from wild birds, poultry, and wild mammals in Peru during the genomic surveillance of this outbreak. Results: The samples belonged to the highly pathogenic avian influenza (H5N1) 2.3.4.4b clade. Chilean and Peruvian samples clustered in the same group and therefore share a common ancestor. An analysis of the hemagglutinin and neuraminidase genes detected new mutations, some dependent upon the host type. Conclusions: The genomic surveillance of highly pathogenic avian influenza is necessary to promote the One Health policy and to overcome the new problems entailed by climate change, which may alter the habitats of resident and migratory birds.
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Many recent outbreaks of influenza A (H1N1) in the world, especially in Brazil, it has become clear that the severity of the disease is not known in the same form. On Wednesday, June 7, 2023, Brazil notified the WHO of a fatal case of human infection with a variant of the influenza A(H1N1) virus of swine origin, this case was confirmed in a laboratory in the region of the interior state of Paraná. This is the first human infection caused by an influenza A (H1N1) virus reported in 2023 nationwide in Brazil. To mitigate H1N1 flu in Brazil, we urge the Brazillian government through its Ministry of Health to improve on mass awareness about the signs and symptoms of H1N1 flu among the Brazillians. The Brazillian government should also implement the One Health approach towards the control of H1N1 flu in Brazil, as we believe that these recommendations would go a long way in preventing future cases and the spread of H1N1 flu in Brazil. This article aims to present the clinical presentations of the H1N1 flu and the implications, recommendations and the way forward to protect the Brazilian population against the H1N1 flu.
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Introducción. Durante 2020 y 2021, la circulación de los virus influenza se mantuvo por debajo de lo esperado en todo el mundo. En Argentina, en el año 2022 observamos una circulación ininterrumpida de influenza todo el año. Nuestros objetivos fueron describir los patrones de circulación y las características clínicas de niños internados con influenza. Población y métodos. Estudio retrospectivo, analítico, observacional. Se incluyeron todos los niños internados en un centro pediátrico con detección del virus influenza durante los años 2019-2022. Resultados. Se internaron 138 pacientes en 4 años; en 2019 se observó una tasa del 4,5/1000 egresos hospitalarios mientras que en 2022, fue del 15,1/1000. En 2020 y 2021 no hubo casos. En el 2019 la mayoría de los casos ocurrieron en invierno, la causa de la internación fue la infección respiratoria aguda baja (IRAB) en el 79 % y se detectó influenza A en el 92 % de los casos. En el 2022, la mayoría de los casos ocurrieron en primavera, el 62 % presentó IRAB y en el 56 % se detectó influenza A. Ambos períodos tuvieron similares frecuencias de vacunación y de comorbilidades. Conclusiones. En el 2022 se registraron más internaciones por influenza, lo que podría corresponder a que se realizaron métodos diagnósticos moleculares, que son más sensibles, y se observó un cambio en la estacionalidad con más casos en primavera. En 2019 predominó influenza A en infecciones del tracto respiratorio inferior, mientras que en el 2022 influenza A y B fueron similares, y hubo más formas extrapulmonares.
Introduction. During 2020 and 2021, the circulation of influenza virus remained below expectations worldwide. In Argentina, in 2022, we observed an uninterrupted circulation of influenza all year round. Our objectives were to describe the circulation patterns and clinical characteristics of hospitalized children with influenza. Population and methods. Retrospective, analytical, observational study. All children with influenza virus admitted to a children's hospital during the 20192022 period were included. Results. A total of 138 patients were admitted over 4 years; in 2019, the rate of hospital discharges was 4.5/1000, compared to 15.1/1000 in 2022. No cases were recorded in 2020 and 2021. In 2019, most cases were observed in the winter; in 79%, the cause was acute lower respiratory tract infection (ALRTI); influenza A was detected in 92%. In 2022, most cases occurred in the spring; 62% developed ALRTI; and influenza A was detected in 56%. Similar rates of vaccination and comorbidities were observed in both periods. Conclusions. In 2022, more hospitalizations due to influenza were recorded, which may have correlated with the use of more sensitive molecular diagnostic testing and a change in seasonality, with more cases observed in the spring. In 2019, influenza A predominated in lower respiratory tract infections, while in 2022, cases of influenza A and B were similar, with more extra-pulmonary forms.
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Humanos , Pré-Escolar , Criança , Infecções Respiratórias/epidemiologia , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Argentina/epidemiologia , Estudos Retrospectivos , Pandemias , Hospitalização , HospitaisRESUMO
Inactivated influenza A virus (IAV) vaccines help reduce clinical disease in suckling piglets, although endemic infections still exist. The objective of this study was to evaluate the detection of IAV in suckling and nursery piglets from IAV-vaccinated sows from farms with endemic IAV infections. Eight nasal swab collections were obtained from 135 two-week-old suckling piglets from four farms every other week from March to September 2013. Oral fluid samples were collected from the same group of nursery piglets. IAV RNA was detected in 1.64% and 31.01% of individual nasal swabs and oral fluids, respectively. H1N2 was detected most often, with sporadic detection of H1N1 and H3N2. Whole-genome sequences of IAV isolated from suckling piglets revealed an H1 hemagglutinin (HA) from the 1B.2.2.2 clade and N2 neuraminidase (NA) from the 2002A clade. The internal gene constellation of the endemic H1N2 was TTTTPT with a pandemic lineage matrix. The HA gene had 97.59% and 97.52% nucleotide and amino acid identities, respectively, to the H1 1B.2.2.2 used in the farm-specific vaccine. A similar H1 1B.2.2.2 was detected in the downstream nursery. These data demonstrate the low frequency of IAV detection in suckling piglets and downstream nurseries from farms with endemic infections in spite of using farm-specific IAV vaccines in sows.
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Fazendas , Vírus da Influenza A , Vacinas contra Influenza , Infecções por Orthomyxoviridae , Filogenia , Doenças dos Suínos , Animais , Suínos , Doenças dos Suínos/virologia , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/prevenção & controle , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/virologia , Infecções por Orthomyxoviridae/epidemiologia , Vírus da Influenza A/genética , Vírus da Influenza A/imunologia , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza A/classificação , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/administração & dosagem , Animais Lactentes , Vacinação/veterinária , Doenças Endêmicas/veterinária , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/imunologia , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , RNA Viral/genética , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/imunologia , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/genética , Vírus da Influenza A Subtipo H1N2/isolamento & purificação , Vírus da Influenza A Subtipo H1N2/imunologia , Genoma ViralAssuntos
Influenza Aviária , Influenza Humana , Colômbia/epidemiologia , Humanos , América Latina/epidemiologia , Animais , Influenza Aviária/epidemiologia , Influenza Aviária/virologia , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Aves/virologia , Doenças Transmissíveis Emergentes/epidemiologiaRESUMO
Novel H1N2 and H3N2 swine influenza A viruses (IAVs) have recently been identified in Chile. The objective of this study was to evaluate their zoonotic potential. We perform phylogenetic analyses to determine the genetic origin and evolution of these viruses, and a serological analysis to determine the level of cross-protective antibodies in the human population. Eight genotypes were identified, all with pandemic H1N1 2009-like internal genes. H1N1 and H1N2 were the subtypes more commonly detected. Swine H1N2 and H3N2 IAVs had hemagglutinin and neuraminidase lineages genetically divergent from IAVs reported worldwide, including human vaccine strains. These genes originated from human seasonal viruses were introduced into the swine population since the mid-1980s. Serological data indicate that the general population is susceptible to the H3N2 virus and that elderly and young children also lack protective antibodies against the H1N2 strains, suggesting that these viruses could be potential zoonotic threats. Continuous IAV surveillance and monitoring of the swine and human populations is strongly recommended.IMPORTANCEIn the global context, where swine serve as crucial intermediate hosts for influenza A viruses (IAVs), this study addresses the pressing concern of the zoonotic potential of novel reassortant strains. Conducted on a large scale in Chile, it presents a comprehensive account of swine influenza A virus diversity, covering 93.8% of the country's industrialized swine farms. The findings reveal eight distinct swine IAV genotypes, all carrying a complete internal gene cassette of pandemic H1N1 2009 origin, emphasizing potential increased replication and transmission fitness. Genetic divergence of H1N2 and H3N2 IAVs from globally reported strains raises alarms, with evidence suggesting introductions from human seasonal viruses since the mid-1980s. A detailed serological analysis underscores the zoonotic threat, indicating susceptibility in the general population to swine H3N2 and a lack of protective antibodies in vulnerable demographics. These data highlight the importance of continuous surveillance, providing crucial insights for global health organizations.
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Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A , Influenza Humana , Infecções por Orthomyxoviridae , Doenças dos Suínos , Criança , Humanos , Animais , Suínos , Pré-Escolar , Idoso , Vírus da Influenza A/genética , Vírus da Influenza A Subtipo H3N2/genética , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Vírus da Influenza A Subtipo H1N1/genética , Filogenia , Chile/epidemiologia , Vírus Reordenados/genética , Doenças dos Suínos/epidemiologia , Influenza Humana/epidemiologiaRESUMO
The rapid availability of effective antiviral treatments would be beneficial during the early phases of a pandemic, as they could reduce viral loads and control serious infections until antigenic vaccines become widely available. One promising alternative therapy to combat pandemics is nanotechnology, which has the potential to inhibit a wide variety of viruses, including the influenza virus. This review summarizes the recent progress using gold, copper, silver, silicone, zinc and selenium nanoparticles, since these materials have shown remarkable antiviral capacity against influenza A virus.
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Introduction. During 2020 and 2021, the circulation of influenza virus remained below expectations worldwide. In Argentina, in 2022, we observed an uninterrupted circulation of influenza all year round. Our objectives were to describe the circulation patterns and clinical characteristics of hospitalized children with influenza. Population and methods. Retrospective, analytical, observational study. All children with influenza virus admitted to a children's hospital during the 2019-2022 period were included. Results. A total of 138 patients were admitted over 4 years; in 2019, the rate of hospital discharges was 4.5/1000, compared to 15.1/1000 in 2022. No cases were recorded in 2020 and 2021. In 2019, most cases were observed in the winter; in 79%, the cause was acute lower respiratory tract infection (ALRTI); influenza A was detected in 92%. In 2022, most cases occurred in the spring; 62% developed ALRTI; and influenza A was detected in 56%. Similar rates of vaccination and comorbidities were observed in both periods. Conclusions. In 2022, more hospitalizations due to influenza were recorded, which may have correlated with the use of more sensitive molecular diagnostic testing and a change in seasonality, with more cases observed in the spring. In 2019, influenza A predominated in lower respiratory tract infections, while in 2022, cases of influenza A and B were similar, with more extra-pulmonary forms.
Introducción. Durante 2020 y 2021, la circulación de los virus influenza se mantuvo por debajo de lo esperado en todo el mundo. En Argentina, en el año 2022 observamos una circulación ininterrumpida de influenza todo el año. Nuestros objetivos fueron describir los patrones de circulación y las características clínicas de niños internados con influenza. Población y métodos. Estudio retrospectivo, analítico, observacional. Se incluyeron todos los niños internados en un centro pediátrico con detección del virus influenza durante los años 2019-2022. Resultados. Se internaron 138 pacientes en 4 años; en 2019 se observó una tasa del 4,5/1000 egresos hospitalarios mientras que en 2022, fue del 15,1/1000. En 2020 y 2021 no hubo casos. En el 2019 la mayoría de los casos ocurrieron en invierno, la causa de la internación fue la infeccción respiratoria aguda baja (IRAB) en el 79 % y se detectó influenza A en el 92 % de los casos. En el 2022, la mayoría de los casos ocurrieron en primavera, el 62 % presentó IRAB y en el 56 % se detectó influenza A. Ambos períodos tuvieron similares frecuencias de vacunación y de comorbilidades. Conclusiones. En el 2022 se registraron más internaciones por influenza, lo que podría corresponder a que se realizaron métodos diagnósticos moleculares, que son más sensibles, y se observó un cambio en la estacionalidad con más casos en primavera. En 2019 predominó influenza A en infecciones del tracto respiratorio inferior, mientras que en el 2022 influenza A y B fueron similares, y hubo más formas extrapulmonares.
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COVID-19 , Influenza Humana , Infecções Respiratórias , Criança , Humanos , Lactente , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Estudos Retrospectivos , Argentina/epidemiologia , Pandemias , COVID-19/diagnóstico , COVID-19/epidemiologia , Hospitalização , Infecções Respiratórias/epidemiologia , HospitaisRESUMO
Influenza affects approximately 10% of the world's population annually. It is associated with high morbidity and mortality rates due to its propensity to progress to severe acute respiratory infection, leading to 10-40% of hospitalized patients needing intensive care. Characterizing the multifactorial predictors of poor prognosis is essential for developing strategies against this disease. This study aimed to identify predictors of disease severity in influenza A-infected (IFA-infected) patients and to propose a prognostic score. A retrospective cross-sectional study was conducted with 142 IFA-infected out- and inpatients treated at a tertiary hospital between 2010 and 2018. The viral subtypes, hemagglutinin mutations, viral load, IL-28B SNPs, and clinical risk factors were evaluated according to the patient's ICU admission. Multivariate analysis identified the following risk factors for disease severity: neuromuscular diseases (OR = 7.02; 95% CI = 1.18-41.75; p = 0.032), cardiovascular diseases (OR = 5.47; 95% CI = 1.96-15.27; p = 0.001), subtype (H1N1) pdm09 infection (OR = 2.29; 95% CI = 1.02-5.15; p = 0.046), and viral load (OR = 1.43; 95% CI = 1.09-1.88; p = 0.009). The prognosis score for ICU admission is based on these predictors of severity presented and ROC curve AUC = 0.812 (p < 0.0001). Our results identified viral and host predictors of disease severity in IFA-infected patients, yielding a prognostic score that had a high performance in predicting the IFA patients' ICU admission and better results than a viral load value alone. However, its implementation in health services needs to be validated in a broader population.
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Vírus da Influenza A Subtipo H1N1 , Influenza Humana , Humanos , Influenza Humana/complicações , Influenza Humana/epidemiologia , Estudos Retrospectivos , Vírus da Influenza A Subtipo H1N1/genética , Estudos Transversais , Gravidade do Paciente , Unidades de Terapia IntensivaRESUMO
ABSTRACT OBJECTIVE To identify risk factors for death from influenza A(H1N1), including the effectiveness of the vaccine against influenza A(H1N1) concerning mortality. METHODS A case-control of incident cases of influenza A(H1N1) reported in the epidemiological information systems of the states of São Paulo, Paraná, Pará, Amazonas, and Rio Grande do Sul was conducted. RESULTS 305 participants were included, 70 of them cases and 235 controls, distributed as follows: Amazonas, 9 cases/10 controls; Pará, 22 cases/77 controls, São Paulo, 19 cases/49 controls; Paraná, 10 cases/54 controls; Rio Grande do Sul, 10 cases/45 controls. These participants had a mean age of 30 years, with 33 years among cases and 25 years among controls. There was a predominance of females both among the cases and controls. Biological (age), pre-existing diseases (congestive heart failure, respiratory disease, and diabetes mellitus), and care factors (ICU admission) associated with death from influenza A(H1N1) were identified. CONCLUSION The risk factors identified in this investigation not only allowed subsidizing the elaboration of clinical conducts but also indicate important aspects for facing "new" influenza epidemics that are likely to occur in our country.
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Humanos , Masculino , Feminino , Mortalidade , Estudos de Casos e Controles , Surtos de Doenças , Vírus da Influenza A Subtipo H1N1RESUMO
ABSTRACT Objective To review the long-term outcomes (functional status and psychological sequelae) of survivors of critical illnesses due to epidemic viral pneumonia before the COVID-19 pandemic and to establish a benchmark for comparison of the COVID-19 long-term outcomes. Methods This systematic review of clinical studies reported the long-term outcomes in adults admitted to intensive care units who were diagnosed with viral epidemic pneumonia. An electronic search was performed using databases: MEDLINE®, Web of Science™, LILACS/IBECS, and EMBASE. Additionally, complementary searches were conducted on the reference lists of eligible studies. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The results were grouped into tables and textual descriptions. Results The final analysis included 15 studies from a total of 243 studies. This review included 771 patients with Influenza A, Middle East Respiratory Syndrome, and Severe Acute Respiratory Syndrome. It analyzed the quality of life, functionality, lung function, mortality, rate of return to work, rehospitalization, and psychiatric symptoms. The follow-up periods ranged from 1 to 144 months. We found that the quality of life, functional capacity, and pulmonary function were below expected standards. Conclusion This review revealed great heterogeneity between studies attributed to different scales, follow-up time points, and methodologies. However, this systematic review identified negative long-term effects on patient outcomes. Given the possibility of future pandemics, it is essential to identify the long-term effects of viral pneumonia outbreaks. This review was not funded. Prospero database registration: (www.crd.york.ac.uk/prospero) under registration ID CRD42021190296.
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Worldwide, the COVID-19 pandemic caused by SARS-CoV-2 has enormously impacted healthcare systems, especially in low and middle-income countries. Coinfections with respiratory pathogens in COVID-19 patients may contribute to worse outcomes. This study identified the presence of 12 viral coinfections and pneumococcal carriers among individuals with SARS-CoV-2 infection in outpatient and community settings in Ecuador. From January 2020 to November 2021, 215 nasopharyngeal and nasal swabs were taken from individuals who reported symptoms of COVID-19 or had known exposure to someone with confirmed or suspected COVID-19. One hundred fifty-eight tested positive for SARS-CoV-2 by RT-qPCR and coinfections were detected in 12% (19/158) of SARS-CoV-2-positive patients; the most frequent coinfection was with influenza A virus at 4.4% (7/158; 95% CI: 1.2-7.6), followed by respiratory syncytial virus with 3.1% (5/158; 95% CI: 0.4-5.8), and finally rhinovirus and human coronavirus NL63 with 1.2% (2/158). Pneumococcal carriage was detected in 3.7% (6/158; 95% CI: 0.76-6.64) of SARS-CoV-2 cases. Influenza B, adenovirus, human metapneumovirus (HMPV), parainfluenza virus types 1, 2, and 3, and human coronavirus HKU1 were undetected. To our knowledge, this is the first study of coinfection of SARS-CoV-2 and respiratory pathogens performed on outpatients in Latin America. The high proportion of outpatients with viral coinfections reported in our cohort allows us to suggest that testing for SARS-CoV-2 and other common respiratory pathogens should be carried out to ensure accurate diagnoses, prompt patient treatment, and appropriate isolation.
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COVID-19 , Coinfecção , Humanos , SARS-CoV-2 , COVID-19/epidemiologia , Pacientes Ambulatoriais , Coinfecção/epidemiologia , Pandemias , Equador/epidemiologiaRESUMO
The prompt and accurate identification of the etiological agents of viral respiratory infections is a critical measure in mitigating outbreaks. In this study, we developed and clinically evaluated a novel melting-curve-based multiplex real-time PCR (M-m-qPCR) assay targeting the RNA-dependent RNA polymerase (RdRp) and nucleocapsid phosphoprotein N of SARS-CoV-2, the Matrix protein 2 of the Influenza A virus, the RdRp domain of the L protein from the Human Respiratory Syncytial Virus, and the polyprotein from Rhinovirus B genes. The analytical performance of the M-m-qPCR underwent assessment using in silico analysis and a panel of reference and clinical strains, encompassing viral, bacterial, and fungal pathogens, exhibiting 100% specificity. Moreover, the assay showed a detection limit of 10 copies per reaction for all targeted pathogens using the positive controls. To validate its applicability, the assay was further tested in simulated nasal fluid spiked with the viruses mentioned above, followed by validation on nasopharyngeal swabs collected from 811 individuals. Among them, 13.4% (109/811) tested positive for SARS-CoV-2, and 1.1% (9/811) tested positive for Influenza A. Notably, these results showed 100% concordance with those obtained using a commercial kit. Therefore, the M-m-qPCR exhibits great potential for the routine screening of these respiratory viral pathogens.
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We identified highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b in wild birds, poultry, and a lion in Peru during November 2022-February 2023 and markers associated with transmission adaptation and antiviral drug resistance. Continuous genomic surveillance is needed to inform public health measures and avoid mass animal deaths.