总结本地区7个月甲型H1N1流感病毒传播的特点

目的检测7个月疑是甲型H1N1流感病毒特异片断,分析本地区H1N1流感病毒的流行病学特点。方法采用实时荧光定量（Real Time RT-PCR）法,对2039例可疑病例的咽拭子、鼻拭子进行检测。结果检测出甲流患者791例,检出率为38.79%（791/2039）;甲流H1N1157例,检出率为7.7%（157/2039）,各月检出率均有不同。结论本地区甲型流感是在8月开始多发,以普通甲流感染为主,甲型H1N1流感混在其中,本地区的传播高峰是在10月。     

某中学甲型H1N1流感暴发疫情调查

目的 描述洪雅县某中学甲型H1N1流感暴发疫情的流行病学特征,为学校甲型H1N1流感暴发防控提供参考.方法 应用现场流行病学方法开展调查,用RT - PCR检测病例标本,用Epidata录入数据,用Excel、Epiinfo软件进行结果分析.结果 该校共发现流感病例151例,罹患率6.31％,学生病例149例,首发病例为高一学生,高一年级罹患率最高(11.19％),住校生罹患率9.1％,走读生为2.83％.病原学检测,采集25例病例的咽拭子标本,甲型H1N1流感病毒阳性率20％.结论 此次疫情是为甲型H1N1流感暴发疫情,住校学生罹患率较高,住宿条件较差和学生接触密切是此次疫情的危险因素.     

2009年甲型H1N1流感患者临床特点的研究

目的调查2009年甲型H1N1流感患者的临床特点。方法通过调查2009年11月至2010年2月符合流感疑似病例收治入院的136例患者,明确2009甲型H1N1流感组,季节性甲型流感组和非流感组的人口学情况,肺炎发生的差异,危重症发生的差异,以及实验室检测参数的差异,筛选出需要住院的流感疑似患者发生肺炎的危险因素。结果 2009甲型H1N1流感发病年龄更年轻（36±17岁）;孕妇的构成比（42.2%）高于其他组;发生肺炎的构成比（51.11%）高于其他组;病死1例。D-二聚体、AST、LDH异常增加的构成比明显大于其他发热患者。结论甲型H1N1流感的易感人群是年轻人和孕妇。甲型H1N1流感是发生肺炎的危险因素,容易并发肺炎和呼吸衰竭,及引起血凝系统、骨骼肌、心肌的损害。     

Acute systemic inflammation induced by influenza A (H1N1) vaccination causes a deterioration in endothelial function in HIV-infected patients

Objectives

Vaccination of HIV‐infected patients against the influenza A/H1N1 subtype was proposed as a mandatory precautionary measure during the 2009 pandemic. The immediate cardiovascular effects of the novel vaccine have been largely unexplored. We investigated the impact of vaccination on indices of endothelial function in a cohort of HIV‐infected patients.

Methods

We included 24 HIV‐infected patients in a study with a randomized, sham procedure‐controlled design. A monovalent, adjuvanted vaccine against influenza A/H1N1 was used in the vaccine arm (n=16); patients in the control group (n=8) were subjected to a sham procedure. Endothelial function, as assessed by flow‐mediated dilatation (FMD), and inflammatory markers were assessed prior to and 8 and 48 h post vaccination.

Results

FMD deteriorated following vaccination (baseline, 6.5 ± 1.1%; 8 h, 1.1 ± 1.5%; 48 h, 2.0 ± 1.4%; P=0.04). The white blood cell count increased at 8 h and remained elevated at 48 h. Soluble intercellular adhesion molecule‐1 levels decreased after vaccination; the maximum decrease was noted at 48 h. Conversely, the sham procedure did not induce changes in endothelial function or inflammatory markers, apart from a reduction in the white blood cell count at 48 h.

Conclusions

Acute systemic inflammation induced by vaccination against the influenza A/H1N1 virus resulted in a deterioration in endothelial function in HIV‐infected patients, and this effect was sustained for at least 48 h. Our findings may have important implications in view of the high cardiovascular risk that HIV infection carries. The effect of the novel vaccine on endothelial function should be weighed against the immunological protection that it confers.     

Influenza disease burden in adults by subtypes following the initial epidemic of pandemic H1N1 in Singapore

Peaks of influenza activity in July 2009 and January 2010 were >90% pandemic H1N1 (pH1N1), but by May 2010, H3N2 predominated in hospital attendances (46·5%, versus 38·9% pH1N1); H3N2 hospital attendances were older (72·9% aged ≥60 years versus 13·5% for pH1N1), but the age-stratified proportions admitted for pneumonia ]were similar. As at the end of the third epidemic wave in Singapore, pH1N1 cases in hospital attendances were still markedly younger than cases of H3N2 or influenza B, with little evidence for any changes in severity.     

Genotypic Variants of Pandemic H1N1 Influenza A Viruses Isolated from Severe Acute Respiratory Infections in Ukraine during the 2015/16 Influenza Season

Human type A influenza viruses A(H1N1)pdm09 have caused seasonal epidemics of influenza since the 2009–2010 pandemic. A(H1N1)pdm09 viruses had a leading role in the severe epidemic season of 2015/16 in the Northern Hemisphere and caused a high incidence of acute respiratory infection (ARI) in Ukraine. Serious complications of influenza-associated severe ARI (SARI) were observed in the very young and individuals at increased risk, and 391 fatal cases occurred in the 2015/16 epidemic season. We analyzed the genetic changes in the genomes of A(H1N1)pdm09 influenza viruses isolated from SARI cases in Ukraine during the 2015/16 season. The viral hemagglutinin (HA) fell in H1 group 6B.1 for all but four isolates, with known mutations affecting glycosylation, the Sa antigenic site (S162N in all 6B.1 isolates), or virulence (D222G/N in two isolates). Other mutations occurred in antigenic site Ca (A141P and S236P), and a subgroup of four strains were in group 6B.2, with potential alterations to antigenicity in A(H1N1)pdm09 viruses circulating in 2015/16 in Ukraine. A cluster of Ukrainian isolates exhibited novel D2E and N48S mutations in the RNA binding domain, and E125D in the effector domain, of immune evasion nonstructural protein 1 (NS1). The diverse spectrum of amino-acid substitutions in HA, NS1, and other viral proteins including nucleoprotein (NP) and the polymerase complex suggested the concurrent circulation of multiple lineages of A(H1N1)pdm09 influenza viruses in the human population in Ukraine, a country with low vaccination coverage, complicating public health measures against influenza.     

Development of Live-Attenuated Influenza Vaccines against Outbreaks of H5N1 Influenza

Several global outbreaks of highly pathogenic avian influenza (HPAI) H5N1 virus have increased the urgency of developing effective and safe vaccines against H5N1. Compared with H5N1 inactivated vaccines used widely, H5N1 live-attenuated influenza vaccines (LAIVs) have advantages in vaccine efficacy, dose-saving formula, long-lasting effect, ease of administration and some cross-protective immunity. Furthermore, H5N1 LAIVs induce both humoral and cellular immune responses, especially including improved IgA production at the mucosa. The current trend of H5N1 LAIVs development is toward cold-adapted, temperature-sensitive or replication-defective vaccines, and moreover, H5N1 LAIVs plus mucosal adjuvants are promising candidates. This review provides an update on the advantages and development of H5N1 live-attenuated influenza vaccines.     

HIV/AIDS病人中甲型H1N1流行性感冒感染情况

目的了解艾滋病病毒（HIV）感染者／艾滋病（AIDS）病人（HIV／AIDS病人）中,甲型H1N1流行性感冒（流感）感染状况,分析研究HIV／AIDS病人的CD4^＋T淋巴细胞（简称CD4细胞）水平,对甲型H1N1流感病毒抗体水平的影响,为评价甲型H1N1流感、HIV／AIDS病人现有防控策略和措施提供技术支持。方法对252例HIV／AIDS病人进行问卷调查,并采集静脉血2～5mL检测流感抗体。对问卷调查结果及实验室检测结果以Excel为基础建立数据库,应用SPSS17．0软件对资料进行分析。结果252例HIV／AIDS病人中,甲型H1N1流感抗体阳性40例,阳性率15．9％,阴性212例（84．1％）。流感抗体阳性与阴性者比较显示,CD4细胞水平、有无接种甲型流感疫苗的差异有统计学意义,年龄、性别、婚姻状况、教育程度等情况差异无统计学意义。HIV／AIDS病人与健康人群甲型H1NI流感的抗体阳性率差异有统计学意义。结论HIV／AIDS病人因免疫力低下可优先考虑接种流感疫苗。低CD。细胞水平是感染甲型H1N1流感的危险因素。     

A Novel Duplex Real-Time Reverse-Transcription PCR Assay for the Detection of Influenza A and the Novel Influenza A(H1N1) Strain

Timely implementation of antiviral treatment and other public health based responses are dependent on accurate and rapid diagnosis of the novel pandemic influenza A(H1N1) strain. In this study we developed a duplex real-time PCR (RT-PCR) (dFLU-TM) assay for the simultaneous detection of a broad range of influenza A subtypes and specific detection of the novel H1N1 2009 pandemic strain. The assay was compared to the combined results of two previously described monoplex RT-PCR assays using 183 clinical samples and 10 seasonal influenza A isolates. Overall, the results showed that the dFLU-TM RT-PCR method is suitable for detection of influenza A, including the novel H1N1 pandemic strain, in clinical samples.     

Live attenuated H5N1 vaccine with H9N2 internal genes protects chickens from infections by both Highly Pathogenic H5N1 and H9N2 Influenza Viruses

Please cite this paper as: Nang et al. (2013) Live attenuated H5N1 vaccine with H9N2 internal genes protects chickens from infections by both Highly Pathogenic H5N1 and H9N2 Influenza Viruses. Influenza and Other Respiratory Viruses 7(2) 120–131. Background The highly pathogenic H5N1 and H9N2 influenza viruses are endemic in many countries around the world and have caused considerable economic loss to the poultry industry. Objectives We aimed to study whether a live attenuated H5N1 vaccine comprising internal genes from a cold‐adapted H9N2 influenza virus could protect chickens from infection by both H5N1 and H9N2 viruses. Methods We developed a cold‐adapted H9N2 vaccine virus expressing hemagglutinin and neuraminidase derived from the highly pathogenic H5N1 influenza virus using reverse genetics. Results and Conclusions Chickens immunized with the vaccine were protected from lethal infections with homologous and heterologous H5N1 or H9N2 influenza viruses. Specific antibody against H5N1 virus was detected up to 11 weeks after vaccination (the endpoint of this study). In vaccinated chickens, IgA and IgG antibody subtypes were induced in lung and intestinal tissue, and CD4+ and CD8+ T lymphocytes expressing interferon‐gamma were induced in the splenocytes. These data suggest that a live attenuated H5N1 vaccine with cold‐adapted H9N2 internal genes can protect chickens from infection with H5N1 and H9N2 influenza viruses by eliciting humoral and cellular immunity.     

Temporal Dynamics of Influenza A(H5N1) Subtype before and after the Emergence of H5N8

Highly pathogenic avian influenza (HPAI) viruses continue to circulate worldwide, causing numerous outbreaks among bird species and severe public health concerns. H5N1 and H5N8 are the two most fundamental HPAI subtypes detected in birds in the last two decades. The two viruses may compete with each other while sharing the same host population and, thus, suppress the spread of one of the viruses. In this study, we performed a statistical analysis to investigate the temporal correlation of the HPAI H5N1 and HPAI H5N8 subtypes using globally reported data in 2015–2020. This was joined with an in-depth analysis using data generated via our national surveillance program in Egypt. A total of 6412 outbreaks were reported worldwide during this period, with 39% (2529) as H5N1 and 61% (3883) as H5N8. In Egypt, 65% of positive cases were found in backyards, while only 12% were found in farms and 23% in live bird markets. Overall, our findings depict a trade-off between the number of positive H5N1 and H5N8 samples around early 2017, which is suggestive of the potential replacement between the two subtypes. Further research is still required to elucidate the underpinning mechanisms of this competitive dynamic. This, in turn, will implicate the design of effective strategies for disease control.     

上海最初10例新型甲型H1N1流感确诊病例临床特点

目的探讨上海地区今年甲型H1N1流感确诊病例的临床特点。方法2009年5月24日～2009年6月15日上海市(复旦大学附属)公共卫生临床中心收治的甲型H1N1流感最初10例确诊病例的流行病学及临床资料。结果甲型H1N1流感病例的临床特点:①10例患者平均年龄为30.1岁(18～47岁);全部为输入性病例,感染地区为美国(70%),澳大利亚(30%)。②起病急、发病到住院时间平均为2.7天;潜伏期平均为4.3天;首发症状多为发热(70%),大多数为中低热、持续1～4天。主要症状和体征为发热(100%)、咳嗽(80%)、咽痛(50%),咽部充血(100%)和扁桃体肿大(50%)等,症状持续时间为1～7天。少数患者可出现病毒性肺炎(20%),无重症病例。③WBC多数正常,没有显著的中性粒细胞和淋巴细胞计数上升或下降;C反应蛋白升高和CD4+下降比较常见。④全部病例给予奥司他韦治疗,流感病毒转阴时间1～6天,中位时间4天。结论上海出现的甲型H1N1流感能在人与人之间传播,感染者大多表现出轻微的症状,很快痊愈。     

Influenza surveillance from November 2008 to 2011; including pandemic influenza A(H1N1)pdm09 in Bhutan

Objective Describe the influenza A(H1N1) pandemic in Bhutan. Design Observational study from sentinel surveillance sites. Setting Bhutan remains isolated, with only one to two flights a day at the lone airport, no trains, and only three major roads that enter from India. Main outcome measures PCR positive human respiratory samples Results The first case of A(H1N1)pdm09 infection was detected in Bhutan in July 2009, 3 months after the virus was first reported in Mexico in April 2009. During the official WHO pandemic period (11 June 2009 to 8 August 2010), a total of 2149 samples were collected and tested by RT‐PCR of which 22.7% (487) were confirmed A(H1N1)pdm09; H3N2, H1N1, and B were positive in 2.2%, 1.1%, and 7.2%, respectively. The highest rate of A(H1N1)pdm09 cases (57.4%) was detected in the 6‐20 year‐old age group. Importantly, Bhutan increased from 3 sentinel sites in April 2009 to 11 a year later, and in April 2010 established PCR capability for influenza. Conclusions Despite relative isolation, the A(H1N1)pdm09 reached Bhutan within 3 months of identification in Mexico. The H1N1 pandemic has made Bhutan more prepared for epidemics in the future.     

Influenza A/H5N1 infection: Other treatment options and issues

Abstract:   Antiviral therapy and vaccination are important strategies for the control of human influenza/H5N1 disease, but the efficacy of these modalities is limited by timing of administration and shortage of supply. Lung protective ventilation strategy with a low tidal volume and low pressure, in addition to a conservative fluid management approach, is recommended when treating patients with ARDS. Low-dose steroids may be considered in the treatment of refractory septic shock. Non-invasive positive pressure ventilation (NPPV) may play a limited supportive role for early ARDS/acute lung injury, but it is contra-indicated in critically ill patients with multi-organ failure and haemodynamic instability. NPPV and oxygen therapy should be applied in healthcare facilities with good ventilation and respiratory protection as substantial exposure to exhaled air occurs within a 0.5 m and 0.4 m radius of patients receiving NPPV and oxygen via a simple mask, respectively. Intravenous gammaglobulin should be used with caution for treatment of reactive haemo-phagocytosis due to its thrombogenic effects, whereas the role of etoposide needs evaluation with animal models. Passive immunotherapy in the form of convalescent plasma may be useful as rescue therapy. More data are needed to explore the potential role of other drugs with immuno-modulating properties such as statins. Healthcare workers currently must apply strict standards, contact and droplet precautions when dealing with suspected cases, and upgrade to airborne precautions when performing aerosol-generating procedures. Non-pharmacological measures such as early case isolation, household quarantine, school/workplace closure, good community hygiene and restrictions on travel are useful measures in controlling a pandemic.     

15例甲型H1N1流感重症病例临床分析

目的总结我院收治甲型H1N1流感重症病例15例的治疗经验。方法 15例甲型H1N1流感重症病例都使用奥司他韦进行治疗,起病4 d以上使用仍然有效。2例使用激素,抗生素使用都是早期、联合、广谱。每天有两名市级专家组成员进行查房,专家值班。结果所有病人经过治疗,病情好转,治愈出院。结论一旦出现流感症状要及时去医院治疗,以免发展成重症病例。重症病例不主张使用激素,抗生素使用要求早期、联合、广谱。每天有专家进行查房。