RESUMO
ABSTRACT: To investigate the epidemiology and factors associated with the severity of viral acute lower respiratory infection (ALRI) in children hospitalized in Manaus, Amazonas, in 2017 to 2018.Retrospective cohort study of children hospitalized at the Hospital and Emergency Room Delphina Rinaldi Abdel Aziz, in Manaus, from April 01, 2017 to August 31, 2018, with a clinical diagnosis of ALRI and nasopharyngeal aspirates positive for at least 1 respiratory virus.One hundred forty-six children aged 0.2 to 66âmonths (median 7âmonths) were included. Patients were divided into 2 groups according to the disease severity classified by an adapted Walsh et al score: moderate disease, score 0-4, nâ=â66 (45.2%) and severe disease, score 5-7, nâ=â80 (54.8%). A greater number of viral ALRI cases were observed in the rainiest months. Respiratory syncytial virus was the most prevalent (nâ=â103, 70.3%), followed by metapneumovirus (nâ=â24, 16.4%), influenza virus (nâ=â17, 11.6%), parainfluenza virus (nâ=â11, 7.5%), and adenovirus (nâ=â4, 2.7%). Co-detections of 2 to 3 viruses were found in 12 (8.2%) patients. The presence of viral coinfection was an independent risk factor for disease severity (adjusted relative risk [RR] 1.53; 95% CI 1.10-2.14). Twelve patients (8.2%) died, all with severe disease. Risk factors for death were shock (adjusted RR 10.09; 95% CI 2.31-43.90) and need for vasoactive drugs (adjusted RR 10.63; 95% CI 2.44-46.31).There was a higher incidence of viral ALRI in Manaus in the rainy season. Respiratory syncytial virus was the most prevalent virus. The presence of viral coinfection was an independent risk factor for disease severity.
Assuntos
Infecções por Adenovirus Humanos/epidemiologia , Coinfecção/epidemiologia , Influenza Humana/epidemiologia , Infecções por Paramyxoviridae/epidemiologia , Infecções por Vírus Respiratório Sincicial/epidemiologia , Adenoviridae/isolamento & purificação , Infecções por Adenovirus Humanos/diagnóstico , Infecções por Adenovirus Humanos/virologia , Brasil/epidemiologia , Pré-Escolar , Coinfecção/diagnóstico , Coinfecção/virologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Alphainfluenzavirus/isolamento & purificação , Betainfluenzavirus/isolamento & purificação , Masculino , Metapneumovirus/isolamento & purificação , Infecções por Paramyxoviridae/diagnóstico , Infecções por Paramyxoviridae/virologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/isolamento & purificação , Respirovirus/isolamento & purificação , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
BACKGROUND: We used data from the Sentinel Enhanced Dengue Surveillance System (SEDSS) to describe influenza trends in southern Puerto Rico during 2012-2018 and compare them to trends in the United States. METHODS: Patients with fever onset ≤ 7 days presenting were enrolled. Nasal/oropharyngeal swabs were tested for influenza A and B viruses by PCR. Virologic data were obtained from the US World Health Organization (WHO) Collaborating Laboratories System and the National Respiratory and Enteric Virus Surveillance System (NREVSS). We compared influenza A and B infections identified from SEDSS and WHO/NREVSS laboratories reported by US Department of Health and Human Services (HHS) region using time series decomposition methods, and analysed coherence of climate and influenza trends by region. RESULTS: Among 23,124 participants, 9% were positive for influenza A and 5% for influenza B. Influenza A and B viruses were identified year-round, with no clear seasonal patterns from 2012 to 2015 and peaks in December-January in 2016-2017 and 2017-2018 seasons. Influenza seasons in HHS regions were relatively synchronized in recent years with the seasons in Puerto Rico. We observed high coherence between absolute humidity and influenza A and B virus in HHS regions. In Puerto Rico, coherence was much lower in the early years but increased to similar levels to HHS regions by 2017-2018. CONCLUSIONS: Influenza seasons in Puerto Rico have recently become synchronized with seasons in US HHS regions. Current US recommendations are for everyone 6 months and older to receive influenza vaccination by the end of October seem appropriate for Puerto Rico.
Assuntos
Influenza Humana/epidemiologia , Clima Tropical , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Vírus da Influenza A/isolamento & purificação , Influenza Humana/virologia , Betainfluenzavirus/isolamento & purificação , Masculino , Vigilância da População , Porto Rico/epidemiologia , Estações do Ano , Estados Unidos/epidemiologiaRESUMO
Indivíduos infectados pelo HIV têm um risco mais elevado de serem afetados por doenças graves, tais como infecções por vírus respiratórios, incluindo o vírus da influenza. A imunossupressão desses indivíduos pode afetar a sua capacidade de resposta à imunização ativa. A vacinação contra o vírus influenza ainda representa a principal forma de reduzir o impacto deste vírus. Devido à circulação em 2009 do vírus influenza pandêmico A (H1N1) pdm09 e influenza sazonal A (H3N2) e vírus B, a composição atual vacina incluem antígenos destes três agentes em sua formulação. Assim, a análise do impacto da vacina trivalente inativada contra influenza (TIV) em indivíduos infectados pelo HIV merece mais estudos. Uma coorte de 131 indivíduos HIV- 1 positivos, com viremia controlada recebeu duas doses únicas de TIV com 21 dias de intervalo. Os títulos de anti- hemaglutinantes (HA) de seus soros foi avaliada em diferentes pontos de tempo (dias zero, 21 e 42, bem como seis meses pós- vacinação). No que diz respeito à resposta imune ao vírus A(H1N1) pdm09 , observouse que um ano depois de ter recebido a vacina monovalente contra este antígeno , 62,6 por cento dos indivíduos permaneceram soroprotegidos, uma queda de 20 por cento em relação à 6 meses pós vacinação monovalente no ano de 2010. Além disso, após a primeira dose de TIV, títulos soroprotetores foram encontrados em todos os indivíduosA soroproteção de baseline para os antígenos H3N2 e influenza B foi de 67,9 por cento e 27,5 por cento, respectivamente. Em relação à soroconversão, observamos que 19,8 por cento e 21 por cento dos indivíduos apresentavam títulos antihemaglutinantes para o vírus A(H1N1)pdm09, 21 e 42 dias pós-vacinação com TIV, respectivamente...
HIV-infected individuals have a higher risk of being affected by serious illnesses , such as infections by respiratory viruses, including influenza virus . Immunosuppression of theseindividuals can affect their ability to respond to active immunization. Vaccination againstinfluenza is still the main way to reduce the impact of this virus. Due to the movement in2009 pandemic influenza A (H1N1)pdm09 and seasonal influenza A (H3N2) and B viruses,the current vaccine composition include antigens of these three agents in their formulation.Thus, analysis of the impact of trivalent inactivated influenza vaccine (TIV) in HIV-infectedindividuals deserves further study. A cohort of 131 HIV-1 positive individuals with controlledviremia received two single doses of TIV 21 days apart. The titers of anti-hemagglutinant(HA) of their sera was assessed at different time points (zero, 21, 42 days and six monthspost- vaccination). With regard to immune to the virus A (H1N1)pdm09 response , it wasnoted that a year after having received the monovalent vaccine against this antigen , 62.6 percent ofsubjects remained seroprotection , a decrease of 20 percent compared to 6 monovalent monthspost-vaccination in 2010 . Moreover, after the first dose of TIV, seroprotective titers werefound in all individuals. The seroprotection baseline for H3N2 and influenza B antigens was67.9 percent and 27.5 percent , respectively. Regarding to seroconversion, we found that 19.8 percent and 21percent of subjects had anti -hemagglutinin titles for the A (H1N1)pdm09, 21 and 42 days postvaccinationwith TIV, respectively...
Assuntos
Humanos , HIV-1 , Influenza Aviária , Betainfluenzavirus , Influenza Humana/classificação , Influenza Humana/epidemiologia , Vacinas contra Influenza/administração & dosagem , Hepatite A , Hepatite BRESUMO
To better understand the significant variability displayed by influenza viruses, we need to be aware not only of its genetic characteristics, but also of the effect this genetic makeup has on proteins associated with viral replication and antigenicity. The origin of such diversity is due first and foremost to its segmented genome that allows segment reassortment (antigenic shift) and second to the error prone viral polymerase (antigenic drift) responsible of copying the genes enclosed in these segments. These two combined mechanisms confer a genetic plasticity that often leads to the emergence of new influenza viruses in nature.
Assuntos
Farmacorresistência Viral/genética , Variação Genética , Orthomyxoviridae/genética , Tropismo Viral , Animais , Variação Antigênica , Genoma Viral , Humanos , Alphainfluenzavirus/efeitos dos fármacos , Alphainfluenzavirus/genética , Betainfluenzavirus/genética , Gammainfluenzavirus/genética , Mutação , Replicação Viral , Eliminação de Partículas ViraisRESUMO
Globalmente, as infecções causadas pelos vírus Influenza constituem um importante desafio a Saúde Pública. Os vírus Influenza B pertencem à família Orthomyxoviridae, o genoma viral é constituído por um RNA de fita simples e polaridade negativa. O processo de drift antigênico favorece o contínuo aparecimento de novas variantes virais, o que demanda a reformulação anual da vacina. No início década de 80, foi observada a divergência do vírus Influenza B em duas linhagens antigênica e filogeneticamente distintas: B/Victoria/2/87-like (Vic87) e B/yamagata/16/88-like (Yam88), que têm co-circulado em diferentes países. O objetivo deste estudo consiste na identificação e caracterização molecular das linhagens de Influenza B circulantes em diferentes regiões brasileiras durante as epidemias de 2004 a 2008, com base no sequenciamento dos genes Hemaglutinina (HA) e Neuraminidase (NA). Ainda, padronizamos o protocolo de Eletroforese em Gel com Gradientes Desnaturantes (DGGE), visando à rápida tipagem dos vírus B. Diferentes substituições nos genes da HA e NA foram encontradas, e evidenciamos a co-circulação de ambas as linhagens no período estudado. Contudo, não observamos a ocorrência de rearranjo gênico, e nem a emergência de cepas resistentes aos inibidores de neuraminidase, com base nos genes investigados. No período 2006-2008, observamos a adequada concordância entre as cepas circulantes e as cepas vacinas preconizadas para o uso no Hemisfério Sul. Entretanto, o mesmo não foi verdadeiro para o período 2004-2005. Finalmente, o protocolo de DGGE desenvolvido pode ser eficientemente utilizado para fins de rápida...
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Humanos , Genoma Viral , Hemaglutininas , Betainfluenzavirus , Neuraminidase , Vírus da Influenza B/genética , Brasil/epidemiologia , Eletroforese em Gel de Campo PulsadoRESUMO
Las infecciones respiratorias agudas de etiología viral ocupan el primer lugar de morbilidad en la población pediátrica a nivel mundial. El propósito de este estudio fue identificar los virus respiratorios como agentes etiológicos de estas infecciones en los niños que consultaron al Servicio de Pediatría del Hospital Universitario de Caracas. Se incluyeron pacientes entre 0 y 11 años que consultaron por infecciones respiratorias agudas. Se realizó encuesta epidemiológica y clínica y se tomaron las muestras (hisopado nasofaríngeo) para identificación y aislamiento de los virus respiratorios (influenza A y B, para influenza 1, 2, y 3, adenovirus y virus sincitial respiratorio) por inmunofluorescencia y cultivo. Durante 7 años se evaluaron 583 niños, el estudio virológico fue positivo en 83 pacientes (14,2 por ciento) correspondiendo 72,3 por ciento al virus para influenza 1,15,7 por ciento virus influenza A, 6 por ciento influenza B, 4,8 por ciento adenovirus y 1,2 por ciento al virus para influenza 3. Los hallazgos coinciden con la epidemiología en el país para el período del estudio. Se demostró la circulación de los virus para influenza 1 y 3,influenza A y B y adenovirus.
Respiratory viral infections are the first cause of morbidity in children worldwide. The purpose of this study was to know the viral etiology of acute respiratory infections in the Pediatric Department of the Hospital Universitario de Caracas. We investigated children 0-11 years with acute respiratory infections for viral etiology. The diagnosis was made by identification of respiratory viruses from nasopharyngeal swab (influenza A and B, parainfluenza 1,2, and 3, adenovirus and respiratory sincitial virus) by inmunofluorescence and culture. 583 patients were investigated. Respiratory viruses were detected in 14,2% cases, with parainfluenza type 1 virus the most commonly detected (72,3%), followed by influenza A 15,7%, influenza B 6%, adenovirus 4,8% and parainfluenza 31,2%. The virology results were similar to the epidemiological reports of the Health Services during the period of the investigation. It was demonstrated the circulation of parainfluenza viruses 1-3, influenza A and B and adenoviruses.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Doenças Respiratórias/etiologia , Influenza Humana/epidemiologia , Alphainfluenzavirus/imunologia , Betainfluenzavirus/imunologia , Sistema Respiratório/lesões , Vírus Sincicial Respiratório Humano/isolamento & purificação , Bronquiolite/patologia , Infecções/epidemiologia , Infecções/imunologia , Pneumonia/patologiaRESUMO
Several studies conducted all over the world have reported that the influenza virus is associated with great morbidity and mortality rates. In this study, we analyzed the incidence of the influenza virus between 2000 and 2003 in Curitiba. We studied 1621 samples obtained from outpatients and hospitalized patients of both sexes and all ages. The study was conducted at the local primary care health units (outpatients) and at the tertiary care unit (hospitalized) of the General Hospital of the Federal University in the state of Paraná, Brazil. Nasopharyngeal aspirates and, eventually, bronchoalveolar lavage were assayed for the presence of viral antigens, either by indirect immunofluorescence or cell culture. Of the samples studied, 135 (8.3%) were positive for influenza virus, and of those, 103 (76.3%) were positive for type A and 32 (23.7%) for type B. Additionally, positive samples were analyzed by reverse transcription followed by polymerase chain reaction and subtypes H1 and H3 were identified from this group. A high incidence of positive samples was observed mainly in the months with lower temperatures. Furthermore, outpatients showed a higher incidence of influenza viruses than hospitalized patients.
Assuntos
Alphainfluenzavirus/imunologia , Antígenos Virais/sangue , Betainfluenzavirus/imunologia , Influenza Humana/epidemiologia , Brasil/epidemiologia , Líquido da Lavagem Broncoalveolar/virologia , Técnicas de Cultura de Células , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Incidência , Influenza Humana/diagnóstico , Influenza Humana/virologia , Alphainfluenzavirus/genética , Betainfluenzavirus/genética , Masculino , Líquido da Lavagem Nasal/virologia , Vigilância da População , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do AnoRESUMO
Several studies conducted all over the world have reported that the influenza virus is associated with great morbidity and mortality rates. In this study, we analyzed the incidence of the influenza virus between 2000 and 2003 in Curitiba. We studied 1621 samples obtained from outpatients and hospitalized patients of both sexes and all ages. The study was conducted at the local primary care health units (outpatients) and at the tertiary care unit (hospitalized) of the General Hospital of the Federal University in the state of Paraná, Brazil. Nasopharyngeal aspirates and, eventually, bronchoalveolar lavage were assayed for the presence of viral antigens, either by indirect immunofluorescence or cell culture. Of the samples studied, 135 (8.3 percent) were positive for influenza virus, and of those, 103 (76.3 percent) were positive for type A and 32 (23.7 percent) for type B. Additionally, positive samples were analyzed by reverse transcription followed by polymerase chain reaction and subtypes H1 and H3 were identified from this group. A high incidence of positive samples was observed mainly in the months with lower temperatures. Furthermore, outpatients showed a higher incidence of influenza viruses than hospitalized patients.
Assuntos
Feminino , Humanos , Masculino , Antígenos Virais/sangue , Influenza Humana/epidemiologia , Alphainfluenzavirus/imunologia , Betainfluenzavirus/imunologia , Brasil/epidemiologia , Líquido da Lavagem Broncoalveolar/virologia , Técnicas de Cultura de Células , Técnica Indireta de Fluorescência para Anticorpo , Incidência , Influenza Humana/diagnóstico , Influenza Humana/virologia , Alphainfluenzavirus/genética , Betainfluenzavirus/genética , Líquido da Lavagem Nasal/virologia , Vigilância da População , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do AnoRESUMO
The objective of the present study was to determine the impact of influenza virus on pediatric hospitalized patients. We retrospectively reviewed records of children with laboratory diagnoses, by cell culture and/or indirect immunofluorescence assay, of influenza virus seen in a period of 6 years. A total of 1,033 samples were analyzed, 45 (4.3%) of them being reactive to influenza virus. Thirty-one samples were positive to influenza A virus and 14 to influenza B. The frequency of hospitalization in intensive care and medical emergency was found to be high. Three (8.6%) patients died, two of them due to respiratory failure. Low frequency of influenza virus infection was observed in the study. The data suggest the need of more efficient epidemiological surveillance measures in order to obtain reliable information to better assess the impact of the virus on our region and determine the need of preventive measures, such as immunization.
Assuntos
Alphainfluenzavirus/isolamento & purificação , Betainfluenzavirus/isolamento & purificação , Influenza Humana/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Feminino , Humanos , Lactente , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Prevalência , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
The objective of the present study was to determine the impact of influenza virus on pediatric hospitalized patients. We retrospectively reviewed records of children with laboratory diagnoses, by cell culture and/or indirect immunofluorescence assay, of influenza virus seen in a period of 6 years. A total of 1,033 samples were analyzed, 45 (4.3 percent) of them being reactive to influenza virus. Thirty-one samples were positive to influenza A virus and 14 to influenza B. The frequency of hospitalization in intensive care and medical emergency was found to be high. Three (8.6 percent) patients died, two of them due to respiratory failure. Low frequency of influenza virus infection was observed in the study. The data suggest the need of more efficient epidemiological surveillance measures in order to obtain reliable information to better assess the impact of the virus on our region and determine the need of preventive measures, such as immunization.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Influenza Humana/epidemiologia , Alphainfluenzavirus/isolamento & purificação , Betainfluenzavirus/isolamento & purificação , Brasil/epidemiologia , Influenza Humana/diagnóstico , Influenza Humana/virologia , Prevalência , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
The objective was to study Orthomyxovirus in heterothermic animals. Blood samples from snakes (genus Bothrops and Crotalus) and from toads and frogs (genus Bufo and Rana) were collected to evaluate the red cell receptors and antibodies specific to influenza virus by the hemagglutination and hemagglutination inhibition tests, respectively. Both snakes and toads kept in captivity presented receptors in their red cells and antibodies specific to either influenza virus type A (human and equine origin) or influenza type B. The same was observed with recently captured snakes. Concerning the influenza hemagglutination inhibition antibodies protective levels were observed in the reptiles' serum, against influenza type A and type B. Unlike the toads, 83.3% of the frogs presented mean levels of Ab 40HIU for some influenza strains. It was concluded that heterothermic animals could offer host conditions to the influenza virus and also susceptibility to the infection.
Assuntos
Alphainfluenzavirus/isolamento & purificação , Anticorpos Antivirais/sangue , Anuros/virologia , Betainfluenzavirus/isolamento & purificação , Viperidae/virologia , Animais , Testes de Inibição da Hemaglutinação , Alphainfluenzavirus/imunologia , Betainfluenzavirus/imunologiaRESUMO
Influenza infection can be severe in bone marrow transplant (BMT) recipients. Although yearly epidemics occur worldwide, and a higher risk of complication is expected in these patients, few studies have addressed the impact of the new neuraminidase inhibitors in the prognosis of influenza after BMT. Influenza A or B infections were found in 39 of the 66 patients (59%) showing a positive nasal wash by DFA. Influenza A was diagnosed in 18 patients and influenza B in 23 patients; two patients were infected by influenza A and B with 84- and 90-day intervals between episodes, respectively. Of the 41 episodes (61%) of influenza A or B, 25 infections occurred during the spring and summer months. Oseltamivir was introduced within 48 h of symptoms appearing. Only two patients (5.1%) developed influenza pneumonia, and no patient died of influenza. A total of 22 patients (56.4%) acquired influenza before day +180 when preventive vaccination strategies are precluded owing to poor immunogenicity of the vaccine during this period. Oseltamivir proved to be safe and appears to have played an important role in the outcome of influenza infection in this population. The therapeutic and/or prophylactic benefits of Oseltamivir in BMT recipients remain to be demonstrated in randomized, prospective trials.
Assuntos
Acetamidas/uso terapêutico , Transplante de Medula Óssea/efeitos adversos , Influenza Humana/prevenção & controle , Antivirais/uso terapêutico , Seguimentos , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/terapia , Humanos , Influenza Humana/tratamento farmacológico , Influenza Humana/etiologia , Alphainfluenzavirus , Betainfluenzavirus , Líquido da Lavagem Nasal , Oseltamivir , Pré-Medicação , Estações do Ano , Resultado do TratamentoRESUMO
Desde os tempos mais remotos, os vírus influenza têm sido o agente causal de doenças respiratórias letais. O seu processo de replicação ocorre nas células epiteliais do trato respiratório, causando uma síndrome respiratória aguda, na qual as glicoproteínas hemaglutinina (HA) e hemaglutinina-esterase-fusão (HEF), ancoradas na superfície dos vírus influenza A e C, respectivamente, são responsáveis pelos processos de fusão durante o ciclo de replicação viral. Ao contrário dos processos de adsorção, sialidase e esterase, atividades inatas desempenhadas por estas mesmas estruturas, a fusão depende de uma glicosilação e clivagem protéica prévias, para que o vírus se torne infeccioso. A glicosilação das proteínas de superfície está associada principalmente com a antigenicidade e com a estabilidade das proteínas de fusão. O presente trabalho analisa a influência da de-glicosilação sobre a atividade de fusão, usando vírus influenza A e C como modelos de estudo. A de-glicosilação parcial provocou significativa redução da atividade fusogênica, induzindo uma redução de 51,0 por cento, 87,5 por cento, 95,5 por cento e 79,3 por cento em relação às amostras de vírus influenza A/Memphis/102/ 72, A/FM/1/47, C/Taylor/1233/47 e C/Paris/1/67, respectivamente, acarretando também eventuais aumentos desta atividade biológica para certas amostras: 10,15 por cento (pH 5,8), 59,47 por cento (pH 5,8), 32,55 por cento (pH 5,8) e 80,7 por cento (pH 5,4) com relação às amostras de vírus influenza A/Memphis/102/72, A/FM/1/ 47, C/Taylor/1233/47 e A/Paris/1/67, respectivamente. Os resultados permitem concluir que o nível de glicosilação mostra-se estreitamente relacionado com a estabilidade das proteínas, causando o processo deglicosilação uma influência significativa sobre a atividade fusogênica viral.