Effectiveness of seasonal trivalent influenza vaccination against hospital-attended acute respiratory infections in pregnant women: A retrospective cohort study

BackgroundPregnant women are at risk of serious influenza infection. Although previous studies indicate maternal influenza vaccination can prevent hospitalisation in young infants, there is limited evidence of the effect in mothers.MethodsA cohort of 34,701 pregnant women delivering between 1 April 2012 and 31 December 2013 was created using birth records. Principal diagnosis codes from hospital emergency department (ED) and inpatient records were used to identify episodes of acute respiratory illness (ARI) during the 2012 and 2013 southern hemisphere influenza seasons. Cox regression models were used to calculate adjusted hazard ratios (aHRs) by maternal vaccination status, controlling for Indigenous status, socioeconomic level, medical conditions, and week of delivery.Results3,007 (8.7%) women received a seasonal influenza vaccine during pregnancy. Vaccinated women were less likely to visit an ED during pregnancy for an ARI (9.7 visits per 10,000 person-days vs. 35.5 visits per 10,000 person-days; aHR: 0.19, 95% CI: 0.05−0.68). Vaccinated women were also less likely to be hospitalised with an ARI compared to unvaccinated women (16.2 hospitalisations per 10,000 person-days vs. 34.0 hospitalisations per 10,000 person-days; aHR: 0.35, 95% CI: 0.13−0.97).ConclusionsInfluenza vaccination during pregnancy was associated with significantly fewer hospital attendances for ARI in pregnant women.     

儿童急性呼吸道感染病毒病原检测741例分析

目的了解当前沧州地区儿童急性呼吸道病毒感染(acute respiratory infection,ARI)病原学的状况,为临床儿童急性呼吸道感染提供病毒病原学诊断依据。方法选择2012年5月-2013年7月于河北省沧州市中心医院确诊的ARI住院患儿共74l例,取其鼻咽分泌物采用直接免疫荧光法检测7种病毒即呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒Ⅰ、Ⅱ、Ⅲ((PIV 1、PIV 2、PIV 3)、流感病毒A、B(IFV A、IFV B)。结果 741例患儿中阳性212例,总阳性率28.6%。不同性别患儿间阳性率比较差异无统计学意义(P=0.753)。RSV是住院ARI患儿最主要病原,其次是PIV3;冬季病毒阳性检出率最高,为45%,秋季最低,为15%。年龄≤3岁组检测阳性率明显高于4~7岁组和≥8岁组,差异均有统计学意义。结论 RSV是导致沧州地区儿童呼吸道感染的主要病原体;病毒感染流行性有明显的季节特征,冬春季高发;不同年龄儿童对各种病毒存在不同的易感性。     

儿童急性呼吸道感染578例病毒检测分析

目的 了解三门峡地区儿童急性呼吸道感染(ARI)的病毒病原学构成,指导临床诊断与治疗。方法 采集578例ARI住院患儿的鼻咽拭子,采用直接免疫荧光法检测7种病毒即呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒Ⅰ、Ⅱ、Ⅲ(PIVⅠ～Ⅲ)、流感病毒A、B型(IVA、IVB)。结果 儿童ARI的病毒总检出率为61.59%,混合感染占45.22%。病毒总检出率冬季最高(77.35%)、夏季最低(25.00%)。下呼吸道感染的病毒总检出率高于上呼吸道感染。RSV、PIVⅢ、IVA的检出率位居前三位,分别为30.62%、28.89%、21.97%。RSV及PIVⅢ在秋冬季、下呼吸道感染、3岁以下患儿中检出率较高;IVA在冬季、上呼吸道感染患儿中检出率较高。结论 RSV 、PIVⅢ、IVA是三门峡地区儿童急性呼吸道感染的主要病毒病原。RSV 、PIVⅢ是秋冬季节婴幼儿下呼吸道感染的主要病原;IVA是冬季各年龄患儿上呼吸道感染的主要病原。通过检测儿童ARI的病毒病原,对尽早明确病毒病原,避免滥用抗生素具有重要意义。     

苏州地区急性呼吸道感染住院患儿病毒感染状况分析

目的 了解苏州地区儿童急性呼吸道感染(acute respiratory infection,ARI)的病毒病原情况,指导临床进行诊断与治疗.方法 对苏州大学附属儿童医院2005年11月-2007年5月间住院的2492例ARI患儿采用无菌负压吸引法采集新鲜痰液,采用直接免疫荧光法检测7种病毒,即呼吸道合胞病毒(respirations syncytial virus,RSV),腺病毒(adenovirus,ADV),流感病毒A、B型(influenza virus-A,Inf-A;influenza virus-B,Inf-B),副流感病毒1、2、3型(parainfluenze viru-1,Pinf-1;parainfluenze viru-2,Pinf-2;parainfluenze viru-3,Pinf-3).同时用逆转录聚合酶链反应(RT-PCR)法进行人偏肺病毒(human metapneumovirus,hMPV)检测.结果 送检标本2492例,总病毒阳性率38.6%(961/2492),总阳性检出率与年龄、季节及病种有关[年龄:各年龄组总病毒检出阳性率分别为:50.0%(412/824),43.4%(190/438),30.5%(207/679)和27.6%(152/551),x~2=96.5002,P<0.01;季节:春夏秋冬四季总病毒检出阳性率分别为:46.7%(366/784),13.8%(66/478),13.8%(59/428)和58.6%(470/802),x~2=392.3279,P<0.01;病种:各种临床疾病(上呼吸道感染、急性喉炎、喉-气管-支气管炎、支气管肺炎、大叶性肺炎、毛细支气管炎、支气管哮喘)总病毒检出阳性率分别为:21.4%(30/140),73.7%(14/19),32.0%(8/25),36.9%(598/1620),13.1%(8/61),66.1%(216/327)和29.0%(87/300),x~2=162.1276,P<0.01],与性别无关[男女总病毒阳性率分别为:39.0%(588/1508)和37.9%(373/984),x~2=0.2962,P>0.05],其次为hMPV 20.6%(198/961).RSV流行高峰主要集中在12-3月份,以毛细支气管炎感染率50.2%(164/327)最高,hMPV全年均可检出,冬季检出率13.2%(106/802)最高.结论 RSV和hMPV是苏州地区ARI患儿的主要病毒病原,通过检测儿童呼吸道感染疾病的病毒病原,可对临床提供快速、准确的诊断依据,防止滥用抗生素.     

Early effectiveness of BNT162b2 Covid-19 vaccine in preventing SARS-CoV-2 infection in healthcare personnel in six Israeli hospitals (CoVEHPI)

BackgroundMethodologically rigorous studies on Covid-19 vaccine effectiveness (VE) in preventing SARS-CoV-2 infection are critically needed to inform national and global policy on Covid-19 vaccine use. In Israel, healthcare personnel (HCP) were initially prioritized for Covid-19 vaccination, creating an ideal setting to evaluate early real-world VE in a closely monitored population.MethodsWe conducted a prospective study among HCP in 6 hospitals to estimate the effectiveness of the BNT162b2 mRNA Covid-19 vaccine in preventing SARS-CoV-2 infection. Participants filled out weekly symptom questionnaires, provided weekly nasal specimens, and three serology samples – at enrollment, 30 days and 90 days. We estimated VE against PCR-confirmed SARS-CoV-2 infection using the Cox Proportional Hazards model and against a combined PCR/serology endpoint using Fisher’s exact test.ResultsOf the 1567 HCP enrolled between December 27, 2020 and February 15, 2021, 1250 previously uninfected participants were included in the primary analysis; 998 (79.8%) were vaccinated with their first dose prior to or at enrollment, all with Pfizer BNT162b2 mRNA vaccine. There were four PCR-positive events among vaccinated participants, and nine among unvaccinated participants. Adjusted two-dose VE against any PCR-confirmed infection was 94.5% (95% CI: 82.6%-98.2%); adjusted two-dose VE against a combined endpoint of PCR and seroconversion for a 60-day follow-up period was 94.5% (95% CI: 63.0%-99.0%). Five PCR-positive samples from study participants were sequenced; all were alpha variant.ConclusionsOur prospective VE study of HCP in Israel with rigorous weekly surveillance found very high VE for two doses of Pfizer BNT162b2 mRNA vaccine against SARS-CoV-2 infection in recently vaccinated HCP during a period of predominant alpha variant circulation.FundingClalit Health Services.     

Mild and asymptomatic influenza B virus infection among unvaccinated pregnant persons: Implication for effectiveness of non-pharmaceutical intervention and vaccination to prevent influenza

BackgroundWe estimated symptomatic and asymptomatic influenza infection frequency in community-dwelling unvaccinated pregnant persons to inform risk communication.MethodsWe collected residue sera from multiple antenatal-care blood draws during October 2016–April 2017. We determined influenza infection as seroconversion with ≥ 4-fold rise in antibody titers between any two serum samples by improved hemagglutinin-inhibition assay including ether-treated B antigens. The serology data were linked to the results of nuclei acid testing (rRT-PCR) based on acute respiratory illness (ARI) surveillance.ResultsAmong all participants, 43 %(602/1384) demonstrated serology and/or rRT-PCR evidenced infection, and 44 %(265/602) of all infections were asymptomatic. ARI-associated rRT-PCR testing identified only 10 %(61/602) of total infections. Only 1 %(5/420) of the B Victoria cases reported ARI and had a rRT-PCR positive result, compared with 33 %(54/165) of the H3N2 cases. Among influenza ARI cases with multiple serum samples, 19 %(11/58) had seroconversion to a different subtype prior to the illness.ConclusionsThe incidence of influenza B infection in unvaccinated pregnant persons is under-estimated substantially. Non-pharmaceutical intervention may have suboptimal effectiveness in preventing influenza B transmission due to the less clinical manifestation compared to influenza A. The findings support maternal influenza vaccination to protect pregnant persons and reduce consequent household transmission.     

2006—2009年广州急性呼吸道感染患者病毒病原学调查

目的 了解广州地区2006—2009年急性呼吸道感染(ARI)患者各病毒病原体的感染状况。方法 于2006年9月至2009年9月在广州医学院附属第二医院收集1554例ARI患者发病1～3d内的咽拭子和鼻拭子各1根,共收集1554份。应用荧光定量PCR方法检测标本中流感病毒A型和B型( FluA、FluB)、腺病毒(ADV)、鼻病毒(HRV)、呼吸道合胞病毒(RsV)、副流感病毒1、2、3型( HPIV1、HPIV2、HPIV3)、偏肺病毒(MPV)、冠状病毒(HCoV) 229E型(229E)、HCoV OC43感染等1 1种病毒的核酸。分析各病原体感染的流行病学特征及主要临床症状。结果 1554份标本的病毒总检出率为65.9％ (1024/1554),RSV检出率最高,为16.8％ (261/1554),其他病毒的检出率从高到低依次为HRV[13.9％ (216/1554)]、FluA[11.6％ (181/1554)]、MPV [6.5％ (101/1554)]、FluB[6.4％ (99/1554)]、HPIV[4.9％( 76/1554)]、ADV[3.5％( 55/1554)]、HCoV[2.3％( 35/1554)]。HPIV和HCoV在各年龄组人群中的感染率相近;FluA和FluB感染率在15 ～24岁人群中最高,分别为16.5％(29/176)、7.4％(13/176);MPV、RSV和HRV在4岁以下儿童中的感染率最高,分别为9.7％ (49/503)、21.7％( 109/503)、18.9％ (95/503);ADV的感染率在5～ 14岁人群中感染率最高,为6.0％(19/318)。HPIV和HRV的发病率无明显季节特征,FluA、FluB、RSV、ADV、MPV和HCoV的流行有一定的季节特征。ARI患者中存在22.2％( 227/1024)的患者合并感染其他呼吸道病毒。FluA、FluB、ADV感染患者出现高热症状的比例较高,分别为90.1％( 163/181)、88.9％( 88/99)、92.7％(51/55)。结论RSV是引起ARI的主要病毒病原体,新发现的病原体如MPV也是引起ARI的重要病原体;部分病原体的感染与年龄和季节有一定的关联;ARI患者中部分合并感染其他呼吸道病毒。     

冬春季住院患儿急性下呼吸道感染病毒学分析

目的:了解冬春季住院患儿急性下呼吸道感染(ARI)的病毒感染状况,为临床儿童急性呼吸道感染提供病毒病原学诊断依据。方法:选择2008年11月～2009年4月在九江市妇幼保健院呼吸内科住院的急性下呼吸道感染患儿,取其入院当天的静脉血,进行呼吸道病毒IgM检测,包括呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感病毒(IV)、副流感病毒(PIV),并对检测标本阳性的病例进行统计分析。结果:在151例患儿送检标本中,阳性37例,占24.5%(37/151)。阳性标本中呼吸道合胞病毒32例(86.5%),腺病毒1例(2.7%),流感病毒2例(5.4%),副流感病毒2例(5.4%)。RSV的发病高峰在12月至次年的1、2月份,RSV感染多见于3岁以下儿童,发病高峰年龄为6个月以下儿童,男、女发病比例为1.9∶1。结论:九江市妇幼保健院2008年11月～2009年4月住院患儿中,引起急性下呼吸道感染的病毒病原体以RSV为主,IV和PIV次之。     

儿童急性呼吸道病毒感染1200例的抗原检测及分析

目的了解急性呼吸道感染(acute respiratory tract infection,ARI)患儿病毒感染病原分布状况,掌握浙江金华儿童病毒感染的病原学流行趋势,为儿童呼吸道病毒感染诊断提供帮助及临床治疗提供参考。方法收集2013年2月-2014年1月本院住院确诊为急性呼吸道感染的1 200例患儿鼻咽分泌物,采用直接免疫荧光法(DFA)进行七项呼吸道病毒抗原检测,包括流感病毒A(FluA)和流感病毒B(FluB)、呼吸道合胞病毒(RSV)、腺病毒(ADV)及副流感病毒(PIV)1、2、3型,并进行统计学分析。结果 1 200例患儿送检标本,阳性424例(占35.33%)。阳性标本中RSV检出最高为290例(占68.40%)、FluA 26例(占6.13%)、FluB 10例(占2.36%)、ADV 12例(占2.83%)、PIV1 25例(占5.90%)、PIV2 6例(占1.42%)、PIV3 55例(占12.97%)。儿童呼吸道病毒感染第一至四季度检出率分别为41.27%、11.56%、12.74%及33.96%,第一与第四季度检出率较高且与第二、三季度相比有统计学差异(P0.05)。随着患儿年龄增长,呼吸道病毒感染率逐渐下降,0~6月龄婴幼儿病毒检出率最高(50.85%),3岁以上儿童病毒检出率最低(16.92%),且各年龄组间比较差异有统计学意义(P0.05)。结论病毒是儿童急性呼吸道感染的主要病原,直接免疫荧光法检测不仅可以对临床提供快速、准确的诊断依据,还能及时为临床提供病原学资料,指导合理用药,防止抗生素滥用。     

广州地区儿童呼吸道病毒感染流行情况及混合感染调查

目的:了解广州地区儿童呼吸道感染的病毒流行特征及病毒混合感染的病原学构成。方法:2006年9月～2009年8月共收集720例起病3天内的呼吸道感染患儿鼻、咽拭子,应用荧光定量PCR方法检测标本中流感病毒(Flu)、副流感病毒(HPIV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、鼻病毒(HRV)、偏肺病毒(MPV)及冠状病毒(HCoV)等7种病毒的核酸。结果:①病毒总检出率为69.7%(502/720),检出率最高的前3种病毒为RSV(19.4%)、Flu(16.9%)和HRV(14.2%)。不同年龄组患儿同种病毒检出率比较差异有统计学意义(P<0.05)。②502例阳性标本中,83例(16.5%)检出两种病毒混合感染,7例(1.4%)检出3种病毒混合感染。不同年龄组患儿混合感染发生率比较差异有统计学意义(P<0.05)。③病毒混合感染高峰季节是春季和夏季,其中春季以RSV、HRV、Flu和MPV混合感染为主,夏季则以Flu、HRV和ADV混合感染为主。结论:RSV、Flu和HRV是广州地区儿童呼吸道感染的主要病原体,病毒混合感染以RSV和Flu最为常见,随不同年龄、不同季节有一定变化规律。     

Potential impact of a maternal vaccine for RSV: A mathematical modelling study

Respiratory syncytial virus (RSV) is a major cause of respiratory morbidity and one of the main causes of hospitalisation in young children. While there is currently no licensed vaccine for RSV, a vaccine candidate for pregnant women is undergoing phase 3 trials. We developed a compartmental age-structured model for RSV transmission, validated using linked laboratory-confirmed RSV hospitalisation records for metropolitan Western Australia. We adapted the model to incorporate a maternal RSV vaccine, and estimated the expected reduction in RSV hospitalisations arising from such a program. The introduction of a vaccine was estimated to reduce RSV hospitalisations in Western Australia by 6–37% for 0–2 month old children, and 30–46% for 3–5 month old children, for a range of vaccine effectiveness levels. Our model shows that, provided a vaccine is demonstrated to extend protection against RSV disease beyond the first three months of life, a policy using a maternal RSV vaccine could be effective in reducing RSV hospitalisations in children up to six months of age, meeting the objective of a maternal vaccine in delaying an infant’s first RSV infection to an age at which severe disease is less likely.     

Potential impact of maternal vaccination on life-threatening respiratory syncytial virus infection during infancy

BackgroundRespiratory syncytial virus (RSV) infection is an important cause of infant mortality. Here, we estimated the potential impact of maternal vaccination against RSV on life-threatening RSV infection in infants.MethodsWe developed a mathematical model for maternal vaccine-induced antibody dynamics and used characteristics of a maternal RSV vaccine currently in phase 3 of clinical development. The model was applied to data from two cohorts of children younger than 12 months with RSV-related paediatric intensive care unit (PICU) admission in the United Kingdom (n = 370) and the Netherlands (n = 167), and a cohort of 211 children younger than 12 months with RSV-related in-hospital death from 20 countries worldwide.ResultsOur model predicted that, depending on vaccine efficiency, maternal vaccination at 30 weeks’ gestational age could have prevented 62–75% of RSV-related PICU admissions in the United Kingdom and 76–87% in the Netherlands. For the global mortality cohort, the model predicted that maternal vaccination could have prevented 29–48% of RSV-related in-hospital deaths. Preterm children and children with comorbidities were predicted to benefit less than (healthy) term children.ConclusionsMaternal vaccination against RSV may substantially decrease life-threatening RSV infections in infants.     

Socioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur,Malaysia

BackgroundAcute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia.MethodsChildren < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), non-medical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture.Results200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140–258), representing a median 16.4% (10.4–22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564–987), meaning that government subsidies covered a median 75.2% (70.2–78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653–1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus.ConclusionThese comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines.     

Respiratory syncytial virus infection in children with acute respiratory infections in Zambia.

Epidemiological research on respiratory syncytial virus (RSV) infections in children was carried out at the Virology Laboratory, University Teaching Hospital (UTH), in Lusaka, Zambia, from January-December 1996. Specimens including 736 nasal washings and 2424 throat swabs were collected from children with acute respiratory infections (ARI) and tested for RSV by enzyme immunoassay and by virus isolation. RSV was isolated in 62 (4.1%) of 1496 throat swabs collected from March to September and was detected in 99 (16.3%) of 609 nasal washings from March to November. The average RSV isolation rate was 2.6% and the average RSV detection rate was 13.5%. The highest RSV isolation (8.1%) and detection (30.5%) rates were in June 1996. RSV antibody in the 278 serum specimens collected from Zambian children, who were hospitalized in the paediatric ward, UTH, was detected using a standard neutralization test. The antibody positive rate was 60-80% in children > 4 years. It is evident that RSV is one of the main causal agents of ARI in children in Zambia.     

Relationships Between Community Virus Activity and Cardiorespiratory Rehospitalizations From Post-Acute Care

ObjectivesQuantify the relationship between increasing influenza and respiratory syncytial virus (RSV) community viral activity and cardiorespiratory rehospitalizations among older adults discharged to skilled nursing facilities (SNFs).DesignRetrospective cohort.Setting and ParticipantsAdults aged ≥65 years who were hospitalized and then discharged to a US SNF between 2012 and 2015.MethodsWe linked Medicare Provider Analysis and Review claims to Minimum Data Set version 3.0 assessments, PRISM Climate Group data, and the Centers for Disease Control and Prevention viral testing data. All data were aggregated to US Department of Health and Human Services regions. Negative binomial regression models quantified the relationship between increasing viral activity for RSV and 3 influenza strains (H1N1pdm09, H3N2, and B) and cardiorespiratory rehospitalizations from SNFs. Incidence rate ratios described the relationship between a 5% increase in circulating virus and the rates of rehospitalization for cardiorespiratory outcomes. Analyses were repeated using the same model, but influenza and RSV were considered “in season” or “out of season” based on a 10% positive testing threshold.ResultsCardiorespiratory rehospitalization rates increased by approximately 1% for every 5% increase in circulating influenza A(H3N2), influenza B, and RSV, but decreased by 1% for every 5% increase in circulating influenza A(H1N1pdm09). When respiratory viruses were in season (vs out of season), cardiorespiratory rehospitalization rates increased by approximately 6% for influenza A(H3N2), 3% for influenza B, and 5% for RSV, but decreased by 6% for influenza A(H1N1pdm09).Conclusions and ImplicationsThe respiratory season is a particularly important period to implement interventions that reduce cardiorespiratory hospitalizations among SNF residents. Decreasing viral transmission in SNFs through practices such as influenza vaccination for residents and staff, use of personal protective equipment, improved environmental cleaning measures, screening and testing of residents and staff, surveillance of viral activity, and quarantining infected individuals may be potential strategies to limit viral infections and associated cardiorespiratory rehospitalizations.     

苏州市2015-2018年孕产妇季节性流感病毒感染的影响因素研究

目的 探讨2015-2018年苏州市孕产妇季节性流感病毒感染的影响因素。方法 基于2015-2018年在苏州市开展的孕产妇人群流感随访队列资料，描述队列人群的基本情况和流感病毒感染后的临床特征，采用非条件logistic回归分析孕产妇实验室确诊流感病毒感染的影响因素。结果 共招募19 006名孕产妇，其中实验室确诊流感病例479名，A（H3N2）（42.8%）为主要的病毒亚型。在有流感流行期暴露风险的人群中，非条件单因素logistic回归分析结果显示，孕产妇或者其丈夫户籍在苏州市、职业为保育员及保姆、除本人外家中常住人口>2人、在苏州市有医疗保险、在苏州有生育险、纳入时为孕晚期、近一个月有过咳嗽、第一次怀孕、已有孩子、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变均与孕产妇流感病毒感染有关，其中第一次怀孕、怀孕前后户外时间比以前多、怀孕前后戴口罩频率比以前多、怀孕前后聚会频率有改变为保护因素；非条件多因素logistic回归分析结果显示，家中常住人口>2人（aOR=1.24，95%CI：1.01~1.52）、孕晚期（aOR=1.56，95%CI：1.26~1.91）是孕产妇感染流感病毒的危险因素。结论 家中常住人口数较多及孕晚期的孕产妇更要注意预防季节性流感。     

北京地区儿童ARI的鼻咽分泌物的病毒免疫荧光检测结果分析

目的 分析1997年3月－1999年3月两年间北京地区儿童急性呼吸道感染（ARI）的鼻咽分泌物病毒免疫荧光学检测结果。方法 选择1997年3月－1999年3月因急性呼吸道感染而在北京市儿童医院住院治疗的患儿,取其鼻咽分泌物做免疫荧光检测筛查七种呼吸道病毒抗原,阳性病例入选,分析其病历资料。结果 所有794例病人送检标本共796份,阳性228份（28．6％）,其中RSV196例（24．6％）、IA20(2．5％）、IB1例（0．12％）、ADV4例（0．5％）、PIV3 2例（0．25％）、RSV和PIV3 2例（0．25％）,RSV和IA3例 （0．38％）。RSV 和IA感染呈季节性分布。RSV组和IA组病人之间喘息症状并无差异。小年龄组病人与大年龄儿相当,呼吸快、更多存在低氧血症和二氧化碳潴留,病情重、吸氧者多。结论 北京地区两年以来儿童呼吸道感染的病毒学病因可能为呼吸道合胞病毒（RSV）、流感病毒（IA）、腺病毒（ADV）和副流感病毒3型（PIV3）,以RSV为主。RSV和IA有一定的季节变化。     

Pregnant women’s attitudes toward Zika virus vaccine trial participation

IntroductionAs Zika virus infection during pregnancy can cause a range of congenital anomalies, pregnant women may be a target population for vaccination in future outbreaks. Their inclusion in vaccine trials is critical to ensure safe and effective vaccines in pregnancy. Though many vaccine candidates are in development, pregnant women’s willingness to participate in Zika virus vaccine research is unknown. This study aims to describe pregnant women’s attitudes toward Zika virus vaccine research participation, as well as perceived barriers to and facilitators of enrollment.MethodsPregnant and recently postpartum women (n = 128) attending prenatal care at Massachusetts General Hospital completed surveys querying their willingness to participate in four hypothetical Zika virus vaccine trials and their motivations for participation. Demographics, information on prior Zika virus exposure, and vaccine acceptance were collected.ResultsMost women (77%) accepted participation in at least one hypothetical Zika virus vaccine trial, and women were significantly more likely to accept prospective enrollment in an inactivated vaccine trial compared to a live-attenuated vaccine trial (p-value <0.0001) or a nucleic acid-based vaccine trial (p-value <0.0444). Important motivators for participation included evidence from research with pregnant and non-pregnant people, a desire to protect the baby from Zika, perceptions of vaccine safety, and provider recommendation.ConclusionsA majority of women in this cohort were willing to participate in a Zika virus vaccine trial while pregnant, however, differences in acceptance exist between vaccine platforms. The high value placed on evidence by participants highlights the importance of gathering and communicating pregnancy-specific data to potential research participants and their providers. Women’s motivations for accepting research participation during pregnancy are important to inform the Zika virus vaccine research agenda, candidate prioritization, and trial design.     

Maternal immunization with respiratory syncytial virus fusion protein formulated with a novel combination adjuvant provides protection from RSV in newborn lambs

Respiratory syncytial virus (RSV) is the causative agent of serious upper and lower respiratory tract infections in newborns and infants. Protection from RSV is crucial for neonates, and maternal immunization is one approach that holds promise for providing immediate protection to young infants against severe RSV infection. We previously reported efficacy of a subunit vaccine consisting of the fusion (F) protein formulated with a novel adjuvant (ΔF/TriAdj) in neonates. The goal of the current study was to evaluate the ΔF/TriAdj as a maternal vaccine. Pregnant ewes were vaccinated intramuscularly with ΔF/TriAdj or PBS six weeks prior to lambing, and re-vaccinated four weeks later, which resulted in transfer of maternal antibodies (MatAbs) to the newborn lambs through the colostrum. Significantly higher levels of RSV ΔF-specific serum IgG were detected in vaccinated pregnant ewes and their lambs when compared to control animals, which revealed that MatAbs were passively transferred to the offspring. All newborn lambs were challenged with RSV at three days of age. After RSV challenge, virus production and lung pathology were significantly lower in lambs that had received passively transferred antibodies than in control animals. These results indicate that maternal immunization with ΔF/TriAdj might be an alternative, safe and effective approach to provide protection against RSV in newborn and young infants.     

Influenza vaccine effectiveness against influenza-associated hospitalization in 2015/16 season,Beijing, China

BackgroundVaccination is recommended to prevent influenza virus infection and associated complications. This study aimed to estimate the influenza vaccine effectiveness (VE) against hospitalization in the 2015/16 season in Beijing.MethodsPatients who were hospitalized in the 5 study hospitals between 1 Oct 2015 and 15 May 2016 were recruited. Influenza vaccination status was obtained for PCR-confirmed influenza patients and the selected controls who tested negative for the virus. Conditional logistic regression was used to estimate the influenza VE matching by calendar week, and adjusting for age, study sites, underlying medical conditions, smoking status, and hospital admissions over the past 12 months.ResultsThe overall VE was −37.9% (95% CI: −103.3, 6.5) against laboratory-confirmed influenza-associated hospitalization. The 2015–16 seasonal vaccine was had −61.9% (95% CI: −211.9, 15.9), −5.4% (95% CI: −108.1, 46.6) and −45.2% (95% CI: −152.6, 16.5) effectiveness to prevent infection from A(H1N1)pdm09, A(H3N2) and influenza B, respectively.ConclusionsInfluenza vaccination did not show effective protection against hospitalization with influenza in 2015/16 season in Beijing.