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Immunogenicity of inactivated influenza vaccine in residential homes for elderly people.

Nicholson KG, Baker DJ, Chakraverty P, Farquhar A, Hurd D, Kent J, Litton PA, Smith SH.

Infectious Diseases Unit, Groby Road Hospital, Leicester.

One hundred and seventy residents of 11 Leicester City Council homes for the elderly, with a total of 515 beds, were studied during a 30-week period from September 1988 to March 1989 to determine the use of influenza vaccine, the levels of influenza antibody, the incidence of influenza, and the protection afforded by vaccination. The study group of 133 women and 37 men had a mean age of 85 years and 59% had one or more chronic medical conditions. The immunization rates by home for the 170 symptomatic residents ranged from 8% to 90% (mean 45%). Seventy-one sera, 36 from vaccinated and 35 from non-vaccinated residents were collected between 1 December 1988 and 24 March 1989 and were assayed for antibody to A/Taiwan/1/86 (H1N1), A Sichuan/2/87 (H3N2) and B/Beijing/1/87. Analysis revealed no statistically significant differences between the antibody profiles of vaccinated and unvaccinated subjects. Six influenza A and 6 influenza B infections were confirmed among the 170 subjects with upper respiratory tract infections. Influenza vaccination was not associated with significant levels of protection against influenza A or B. Studies of the haemagglutinins of the vaccine strains and influenza isolates during 1988/89 showed that they were closely related.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1615780&dopt=Abstract flu, influenza



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Effects of 4-ipomeanol on bovine parainfluenza type 3 virus-induced pneumonia in calves.

Li X, Castleman WL.

Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison.

Previous research has demonstrated that 4-ipomeanol toxicosis can enhance the severity of para-influenza virus-induced pneumonia in mice. The objectives of this study were to determine whether calves are susceptible to 4-ipomeanol-induced enhancement of parainfluenza type 3 viral pneumonia and to determine whether 4-ipomeanol alters pulmonary replication of parainfluenza virus. Male Holstein calves were injected with either 4-ipomeanol (3 mg/kg) or vehicle (polyethylene glycol) 3 days prior to intratracheal inoculation with either parainfluenza virus or sham inoculum of culture medium. Calves in the four treatment groups (ipomeanol-parainfluenza, ipomeanol-medium, vehicle-parainfluenza, and vehicle-medium) were necropsied at 5 days after inoculation with parainfluenza virus or medium. The lungs were studied by correlated methods of light and electron microscopy, digitizing morphometry and pulmonary lavage to quantitate the severity of pneumonia. Pulmonary viral titers were determined, and viral antigen was identified in the lung by immunoperoxidase technique. The calves in the ipomeanol-virus treatment group had over a 9-fold higher (P less than 0.05) volume density of virus-induced interstitial pneumonia than did the calves in the other three treatment groups. This 4-ipomeanol-enhanced viral pneumonia was associated with significantly greater (P less than 0.05) numbers of pulmonary macrophages and neutrophils in the lavage fluid and higher (P less than 0.05) pulmonary titers of pulmonary infectious parainfluenza virus. Four-ipomeanol-enhanced viral pneumonia was characterized in part by extensive hyperplasia of type II alveolar epithelial cells and by dense aggregates of macrophages and neutrophils in alveolar spaces and interalveolar septa. The results indicate that 4-ipomeanol exacerbates interstitial pneumonia in calves induced by bovine parainfluenza type 3 virus.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1661042&dopt=Abstract flu, influenza



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Longitudinal study of acute respiratory diseases in Rio de Janeiro: occurrence of respiratory viruses during four consecutive years.

Nascimento JP, Siqueira MM, Sutmoller F, Krawczuk MM, de Farias V, Ferreira V, Rodrigues MJ.

Departamento de Virologia, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.

The occurrence of different viruses in nasopharyngeal secretions from children less than 5 years old with acute respiratory infections (ARI) was investigated over a period of 4 years (1982-1985) in Rio de Janeiro. Of the viruses known to be associated with ARI, all but influenza C and parainfluenza types 1, 2 and 4 were found. Viruses were found more frequently in children attending emergency or pediatric wards than in outpatients. This was clearly related to the high incidence of respiratory syncytial virus (RSV) in the more severe cases of ARI. RSV positive specimens appeared mainly during the fall, over four consecutive years, showing a clear seasonal occurrence of this virus. Emergency wards provide the best source of data for RSV surveillance, showing sharp increase in the number of positive cases coinciding with increased incidence of ARI cases. Adenovirus were the second most frequent viruses isolated and among these serotypes 1, 2 and 7 were predominant. Influenza virus and parainfluenza virus type 3 were next in frequency. Influenza A virus were isolated with equal frequency in outpatient departments, emergency and pediatric wards. Influenza B was more frequent among outpatients. Parainfluenza type 3 caused outbreaks in the shanty-town population annually during the late winter or spring and were isolated mainly from outpatients. Herpesvirus, enterovirus and rhinovirus were found less frequently. Other viruses than RSV and parainfluenza type 3 did not show a clear seasonal incidence.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1668974&dopt=Abstract flu, influenza



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Clinical manifestations of influenza in HIV-infected individuals.

Skiest DJ, Kaplan P, Machala T, Boney L, Luby J.

Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9113, USA. daniels.skies UTSouthwestern.edu

Although influenza vaccination is recommended for individuals with HIV infection, there are no data indicating an increased incidence or severity of influenza in this population. We sought to describe the clinical manifestations and morbidity of influenza in HIV-infected patients. All cases of influenza occurring in HIV-infected individuals over 3 years at a large county hospital were reviewed. Forty-three cases of influenza were diagnosed. Most patients presented with typical signs and symptoms of influenza, including cough (90%), myalgias (64%), and fever (52%). Sore throat and headache occurred in less than half of patients. The mean CD4 cell count and HIV viral load in patients with influenza was 340 cells/mm(3) and 3.34 log copies/ml, respectively. No significant differences in CD4 counts or viral loads were noted in patients with pneumonia (n=7) compared with patients without pneumonia (n=36), P>0.5. Six patients were hospitalized. One patient each had encephalitis and renal failure, although the relationship to influenza was not clear. No new or unusual clinical manifestations were observed. The rate of pulmonary complications was similar to other studies in HIV-negative patients; however, the hospitalization rate was higher than commonly seen in HIV-negative individuals.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11564331&dopt=Abstract flu, influenza



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Influenza virus activity in Papua New Guinea.

Sungu M, Sanders R.

Papua New Guinea Institute of Medical Research, Goroka.

Influenza viruses remain a major cause of respiratory disease in both developed and developing countries. A great deal of information concerning the structure, pathology and modes of transmission of these viruses has been accumulated, but no means of successfully combating them have, as yet, been devised. The most appropriate strategy for limiting the effects of influenza is to monitor the emergence and spread of new strains carefully and warn the public and at-risk groups of impending epidemics. In Papua New Guinea, as in most other developing countries, the major at-risk groups are the very young and the elderly. In the past, influenza epidemics were rare and affected the whole community, but with modern development and increased mobility the transmission dynamics of influenza have changed. The only influenza surveillance centre in Papua New Guinea is at the Papua New Guinea Institute of Medical Research in Goroka, and the surveillance activities of this centre are limited to the immediately surrounding areas. There is a need to establish a national influenza surveillance network, to provide nation-wide monitoring of influenza activity, and to provide a central repository of current information on influenza infections in the country.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1750264&dopt=Abstract flu, influenza



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Influenza: relation of mortality to morbidity parameters--Netherlands, 1970-1989.

Sprenger MJ, Mulder PG, Beyer WE, Masurel N.

Department of Virology, Erasmus University, Rotterdam, The Netherlands.

The purpose of this study is to investigate the relationship between the number of influenza-like illness (ILI), weekly registered by the general practitioners (sentinel stations), and the monthly overall influenza mortality in people over 60 years of age, provided by the Dutch Statistical Bureau during the period July 1970 to June 1989. The quantitative impact of influenza-morbidity is expressed by three summary parameters, calculated from the 52 (53) weekly ILI-figures per season-year, (i) their sum (i.e. global extent of an epidemic), (ii) their standard deviation, and (iii) their maximum (i.e. peak number of ILI during an epidemic). In the analysis influenza A subtype is also included. These four parameters are mutually compared with respect to their predictability for yearly total influenza mortality in the 19 season-years available. In most cases, the standard deviation and the peak number of ILI are more powerful for prediction of mortality, than the global extent of the epidemic. The peak number of ILI is of special interest. It is particularly useful for estimating the effect on current influenza mortality during an ongoing epidemic. From the model it is possible to calculate a threshold (of weekly ILI) beyond which mortality increases proportionately more than the number of illness episodes. By using the peak value of morbidity it is possible to calculate the minimal impact of epidemic mortality. This study indicates that the weekly number of influenza-like illnesses has a certain prognostic value for the real impact of influenza. An electronic surveillance system could detect immediately the threshold above which influenza mortality increases more than proportionally.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1800412&dopt=Abstract flu, influenza



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[The effect of different factors on the reproduction of influenza viruses and reassortants in cell cultures]

[Article in Russian]

Podcherniaeva RIa, Danlybaeva GA.

The influence of the maintenance medium, polyethylene glycol (PEG), DEAE-dextran, and low temperature on reproduction of influenza A, B, and C viruses and their reassortants in diploid and continuous cell cultures was determined. Lowering of pH in the maintenance medium to 6.5 was found to decrease reproduction of influenza A (H1N1) and A (H3N2) viruses and increase that of influenza B viruses. Treatment of cells with PEG solution increased the yield of influenza B and C but not A viruses. However, influenza A virus strains proved to be capable of producing infectious progeny in nonpermissive cell lines treated with PEG. Addition of DEAE-dextran to the medium exerted no effect on the infectivity of influenza A and B reassortants. Moreover, infection of MDCK cells after a "cold shock" led to an increase in hemagglutinin titres in influenza A reassortants.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1803770&dopt=Abstract flu, influenza



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Influenza vaccination in the prevention of acute otitis media in children.

Heikkinen T, Ruuskanen O, Waris M, Ziegler T, Arola M, Halonen P.

Department of Pediatrics, University of Turku, Finland.

We studied a new approach to the prevention of acute otitis media through the administration of influenza vaccine to 187 day-care center children aged 1 to 3 years before the influenza A epidemic of 1988-1989. The control group consisted of 187 unvaccinated children of similar age and background. During the 6-week study period, influenza A infection was diagnosed in five (3%) of 187 vaccinees and in 29 (16%) of 187 controls. Acute otitis media developed in three (60%) of five vaccinees with an influenza A infection compared with 18 (67%) of 27 controls (excluded were two children with a double viral infection). The incidence of acute otitis media associated with influenza A was reduced by 83% in the vaccinees. The total number of children with acute otitis media in the vaccine group was 35, compared with 55 in the control group, disclosing a 36% reduction among the vaccinees. We conclude that influenza vaccination decreases the incidence of acute otitis media in children during an influenza A epidemic, suggesting also that other vaccines against respiratory viruses may be an effective way to reduce the incidence of acute otitis media.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1849344&dopt=Abstract flu, influenza



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[Rapid diagnosis of influenza virus infections from nasopharyngeal secretions]

[Article in German]

Doller G, Tjhen KY, Schuy W, Gerth HJ.

Abteilung fur Medizinische Virologie und Epidemiologie, Universitat Tubingen.

Since virus isolation consumes a lot of work and time, and virus specific antibodies are not detectable before several days after the onset of illness we developed an enzyme immunoassay (ELISA) for the detection of influenza A and influenza B virus antigen in nasopharyngeal specimens (NPS). This test permits antigen detection within four hours. This ELISA was tested with 119 NPS from children, most of these between 1-12 years old. Virus isolation in MDCK-cells served as control. A total of 67 influenza A/H3N2-, 10 influenza A/H1N1, and 2 influenza B viruses were isolated from cell cultures. 68 (88.3%) of the NPS reacted positive in influenza A virus antigen ELISA, 2 in influenza B virus antigen ELISA, and 9 reacted falsely-negative. The failure to detect antigen could not be solely due to low antigen concentration in the NPS because in 5 materials high concentrations of infectious virus were shown in cell culture. The test allows the rapid diagnosis of influenza virus infections with high efficacy also for laboratories without the facility to perform tissue culture. For accelerating the diagnosis by isolation of viruses in cell cultures, ELISA is useful as cell culture confirmation test, because influenza virus antigen is detectable before a cytopathogenic effect appears.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1870599&dopt=Abstract flu, influenza



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Impact of influenza on morbidity in children with cystic fibrosis.

Ferson MJ, Morton JR, Robertson PW.

Public Health Unit, Eastern Sydney Area Health Service, Randwick, New South Wales, Australia.

Recommendations concerning annual influenza vaccination in children suffering from cystic fibrosis (CF) are not uniform. Previous studies have shown that influenza causes a small proportion of episodes of acute respiratory deterioration in CF patients. During the 1989 Australian winter, we studied the association between serologically proven influenza infection and acute respiratory morbidity in 20 children with CF. Six children were shown to have influenza infection, four with type A and two with type B. Four of five children requiring hospital admission were shown to have influenza, but only 2 of 15 did not need admission (P less than or equal to 0.025). As well, influenza was diagnosed in 6 of 12 children who suffered acute respiratory illness leading to school absenteeism (including hospitalization), but diagnosed in no children without this degree of illness (P less than or equal to 0.025). Influenza significantly increases the incidence of hospitalization and of less serious respiratory illness in children with CF, a finding which suggests that influenza vaccine efficacy studies are necessary in this group.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1931225&dopt=Abstract flu, influenza



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Detection and identification of human influenza viruses by the polymerase chain reaction.

Zhang WD, Evans DH.

Department of Molecular Biology & Genetics, University of Guelph, Ontario, Canada.

A series of oligonucleotide primers are described which hybridize to conserved regions of influenza virus cDNA and prime DNA synthesis in Taq polymerase catalyzed amplification reactions (PCR). Primers were designed to hybridize as nested pairs and, following a two-step amplification, produce uniquely sized DNA fragments diagnostic for viral type and subtype. Influenza A and B matrix-protein genes and the influenza C haemagglutinin gene were targets for the type-specific primers. Subtype-specific primers targeted conserved sequences within the three haemagglutinin or two neuraminidase subtypes of different human influenza isolates. The utility of this method was demonstrated using computer search methods and by accurately amplifying DNA from a variety of influenza A, B, and C strains. Type-specific primer sets showed a broad type specificity and amplified DNA from viral strains of unknown sequence. Restriction mapping and DNA sequencing showed that fragments amplified in this manner derived from the input template, confirming the accuracy of the method and demonstrating how PCR can be used to quickly derive sufficient sequence information for analysis of viral relatedness. Subtyping primers were able to distinguish accurately between the three haemagglutinin (H1, H2, H3) and two neuraminidase (N1, N2) alleles of human influenza A isolates. Again DNA was amplified from viruses of unknown sequence confirming that most of these primer sets may prove useful as broad range subtyping reagents. In order to simplify the work associated with analysis of many samples, we have also devised a rapid method for the isolation of viral RNA and synthesis of cDNA. Using this 'mini-prep' technique, it is possible to detect, amplify, and identify picogram quantities of influenza virus in a single day, confirming that PCR provides a useful alternative to existing methods of influenza detection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1939505&dopt=Abstract flu, influenza