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1.
Denise R. Silva Vinícius P. Viana Alice M. Müller Fernando P. Livi Paulo de Tarso R. Dalcin 《Influenza and other respiratory viruses》2014,8(1):42-52
Background
Respiratory viral infections (RVIs) are the most common causes of respiratory infections. The prevalence of respiratory viruses in adults is underestimated. Meteorological variations and air pollution are likely to play a role in these infections.Objectives
The objectives of this study were to determine the number of emergency visits for influenza-like illness (ILI) and severe acute respiratory infection (SARI) and to evaluate the association between ILI/SARI, RVI prevalence, and meteorological factors/air pollution, in the city of Porto Alegre, Brazil, from November 2008 to October 2010.Methods
Eleven thousand nine hundred and fifty-three hospitalizations (adults and children) for respiratory symptoms were correlated with meteorological parameters and air pollutants. In a subset of adults, nasopharyngeal aspirates were collected and analyzed through IFI test. The data were analyzed using time-series analysis.Results
Influenza-like illness and SARI were diagnosed in 3698 (30·9%) and 2063 (17·7%) patients, respectively. Thirty-seven (9·0%) samples were positive by IFI and 93 of 410 (22·7%) were IFI and/or PCR positive. In a multivariate logistic regression model, IFI positivity was statistically associated with absolute humidity, use of air conditioning, and presence of mold in home. Sunshine duration was significantly associated with the frequency of ILI cases. For SARI cases, the variables mean temperature, sunshine duration, relative humidity, and mean concentration of pollutants were singnificant.Conclusions
At least 22% of infections in adult patients admitted to ER with respiratory complaints were caused by RVI. The correlations among meteorological variables, air pollution, ILI/SARI cases, and respiratory viruses demonstrated the relevance of climate factors as significant underlying contributors to the prevalence of RVI. 相似文献2.
Factors associated with transmission of influenza‐like illness in a cohort of households containing multiple children
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Chelsea R. Brown James M. McCaw Emily J. Fairmaid Lorena E. Brown Karin Leder Martha Sinclair Jodie McVernon 《Influenza and other respiratory viruses》2015,9(5):247-254
Background
Household studies of influenza-like illness (ILI) afford opportunities to study determinants of respiratory virus transmission.Objectives
We examined predictors of ILI transmission within households containing at least two children.Methods
A prospective cohort study recorded ILI symptoms daily for 2712 adult and child participants during the 1998 influenza season in Victoria, Australia. Logistic and Poisson regressions were used to explore predictors of household transmission of ILI and the secondary household attack proportion (SHAP). A date of illness onset during the influenza season was used as a proxy indicator of ILI associated with influenza infection (as opposed to other aetiological causes).Results
A total of 1009 ILI episodes were reported by 781 of 2712 (29%) participants residing in 157 households. Transmission, defined as detection of ILI in one or more household members following identification of an index case, was observed in 206 of 705 (29%) household introductions. Transmission of ILI was significantly associated with the onset of ILI in the index case during the peak influenza season compared with the remainder of the observation period (37% versus 27%, odds ratio = 1·59, 95% CI 1·09, 2·31, P = 0·017). The SHAP was 0·12, higher if the index case was of secondary school age [incidence risk ratio (IRR) = 1·80, 95% CI 1·08, 2·98, P = 0·022].Conclusions
Risk of household transmission of ILI was increased during the peak influenza season, indicating an increased burden of disease during the period of influenza circulation. In this cohort, secondary-school-aged children and adults were important transmitters of ILI. 相似文献3.
Scott A. McDonald Anne M. Presanis Daniela De Angelis Wim van der Hoek Mariette Hooiveld Gé Donker Mirjam E. Kretzschmar 《Influenza and other respiratory viruses》2014,8(1):33-41
Objectives
To estimate, using Bayesian evidence synthesis, the age-group-specific annual incidence of symptomatic infection with seasonal influenza in the Netherlands over the period 2005–2007.Methods
The Netherlands population and age group distribution for 2006 defined the base population. The number of influenza-like illness (ILI) cases was estimated from sentinel surveillance data and adjusted for underascertainment using the estimated proportion of ILI cases that do not consult a general practitioner. The estimated number of symptomatic influenza (SI) cases was based on indirect evidence from the surveillance of ILI cases and the proportions of laboratory-confirmed influenza cases in the 2004/5, 2005/6 and 2006/7 respiratory years. In scenario analysis, the number of SI cases prevented by increasing vaccination uptake within the 65 + age group was estimated.Results
The overall symptomatic infection attack rate (SIAR) over the period 2005–2007 was estimated at 2·5% (95% credible interval [CI]: 2·1–3·2%); 410 200 SI cases (95% CI: 338 500–518 600) were estimated to occur annually. Age-group-specific SIARs were estimated for <5 years at 4·9% (2·1–13·7%), for 5–14 years at 3·0% (2·0–4·7%), for 15–44 years at 2·6% (2·1–3·2%), for 45–64 years at 1·9% (1·4–2·5%) and for 65 + years at 1·7% (1·0–3·0%). Under assumed vaccination uptake increases of 5% and 15%, 1970 and 5310 SI cases would be averted.Conclusions
By synthesising the available information on seasonal influenza and ILI from diverse sources, the annual extent of symptomatic infection can be derived. These estimates are useful for assessing the burden of seasonal influenza and for guiding vaccination policy. 相似文献4.
Elevated transmission of upper respiratory illness among new recruits in military barracks in Thailand
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Jens W. Levy Piraya Bhoomiboonchoo Sriluck Simasathien Henrik Salje Angkana Huang Ram Rangsin Richard G. Jarman Stefan Fernandez Chonticha Klungthong Kittinun Hussem Robert V. Gibbons In‐Kyu Yoon 《Influenza and other respiratory viruses》2015,9(6):308-314
Background
New recruits within military barracks present conditions favorable for the spread of respiratory pathogens. However, respiratory pathogen transmission in such confined settings in the tropics has not been well studied.Methods
Recruits in four successive Royal Thai Army basic training classes living in military barracks were monitored for the symptoms of influenza-like illness (ILI) or upper respiratory illness (URI). Classes 1 and 2 were also monitored after basic training. Nasal/throat swabs from acute illnesses were collected and tested by influenza RT-PCR (all four classes). In addition, class 1 had multiplex PCR performed along with the analysis of bed locations within the barracks.Results
Influenza-like illness/upper respiratory illness rates ranged from 4·7 to 6·9 per 100 recruit-weeks in the four classes and generally decreased during the course of basic training (P < 0·05 in three of four classes). Rates during basic training were 1·7 (95% CI: 1·29, 2·29) and 2·5 (95% CI: 1·5, 4·1) times higher than after basic training (classes 1 and 2, respectively). In class 1, coronavirus, parainfluenza virus, and rhinovirus were the most commonly identified respiratory pathogens; only one influenza PCR-positive infection was detected in all four classes. Bed locations of URI/ILI cases in class 1 tended to be in closer proximity to each other.Conclusion
Basic training recruits in military barracks in the tropics had high rates of acute respiratory illnesses with illness patterns consistent with external seeding followed by substantial internal transmission. Our findings may contribute to control measures in similar confined settings both within and outside the military. 相似文献5.
Alexa Dierig Leon G. Heron Stephen B. Lambert Jiehui Kevin Yin Julie Leask Maria Yui Kwan Chow Theo P. Sloots Michael D. Nissen Iman Ridda Robert Booy 《Influenza and other respiratory viruses》2014,8(3):293-301
Background
Influenza-like illness (ILI) confers a high annual morbidity in young children. We report the epidemiology of ILIs in children who participated in an influenza vaccine effectiveness study during the 2010 Southern Hemisphere influenza season in Sydney, Australia.Methods
Children aged 0·5–3 years were prospectively recruited from child care centres (CCCs). We classified them as fully vaccinated, partially vaccinated and unvaccinated according to their receipt of unadjuvanted vaccines containing influenza A (H1N1)pdm09. For 13 weeks commencing 30 July 2010, parents reported when their children developed an ILI (fever ≥37·8°C/feverishness plus ≥1 respiratory symptom) and collected nose and/or throat swabs for multiplex respiratory virus polymerase chain reaction (PCR) testing. Health impacts were assessed by telephone interview at enrolment and two weeks after each ILI.Results
There were 124 ILIs reported in 105 of 381 enrolled children. Swabs were taken in 117 ILIs: 175 viruses were identified from 103 swabs. Adeno- and rhinoviruses were most frequently identified; 44% of swabs yielded multiple viruses. No virus was associated with more severe symptoms, although rhinovirus-related ILIs lasted longer. Nose swabs had a higher virus detection rate than throat swabs. Influenza-vaccinated children were 1·6 times (P = 0·001) more likely than unvaccinated children to have a non-influenza ILI.Conclusion
Adeno- and rhinoviruses were the most common viruses causing ILI. Swabs taken by parents are an effective method for sample collection. Influenza-like illness was more common in children vaccinated against influenza in this observational study, but prior health-seeking behaviour may have contributed to this difference. 相似文献6.
Laurentiu Zolotusca Pernille Jorgensen Odette Popovici Adriana Pistol Florin Popovici Marc‐Alain Widdowson Viorel Alexandrescu Alina Ivanciuc Po‐Yung Cheng Diane Gross Caroline S. Brown Joshua A. Mott 《Influenza and other respiratory viruses》2014,8(1):8-12
Background
Limited data are available from Central and Eastern Europe on risk factors for severe complications of influenza. Such data are essential to prioritize prevention and treatment resources and to adapt influenza vaccination recommendations.Objectives
To use sentinel surveillance data to identify risk factors for fatal outcomes among hospitalized patients with severe acute respiratory infections (SARI) and among hospitalized patients with laboratory-confirmed influenza.Methods
Retrospective analysis of case-based surveillance data collected from sentinel hospitals in Romania during the 2009/2010 and 2010/2011 winter influenza seasons was performed to evaluate risk factors for fatal outcomes using multivariate logistic regression.Results
During 2009/2010 and 2010/2011, sentinel hospitals reported 661 SARI patients of which 230 (35%) tested positive for influenza. In the multivariate analyses, infection with influenza A(H1N1)pdm09 was the strongest risk factor for death among hospitalized SARI patients (OR: 6·6; 95% CI: 3·3–13·1). Among patients positive for influenza A(H1N1)pdm09 virus infection (n = 148), being pregnant (OR: 7·1; 95% CI: 1·6–31·2), clinically obese (OR: 2·9;95% CI: 1·6–31·2), and having an immunocompromising condition (OR: 3·7;95% CI: 1·1–13·4) were significantly associated with fatal outcomes.Conclusion
These findings are consistent with several other investigations of risk factors associated with influenza A(H1N1)pdm09 virus infections. They also support the more recent 2012 recommendations by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) that pregnant women are an important risk group for influenza vaccination. Ongoing sentinel surveillance can be useful tool to monitor risk factors for complications of influenza virus infections during each influenza season, and pandemics as well. 相似文献7.
Noelle M. Cocoros Timothy L. Lash Alfred DeMaria Jr Michael Klompas 《Influenza and other respiratory viruses》2014,8(1):25-32
Background
Obesity was recognized as in independent risk factor for influenza during the 2009 H1N1 influenza pandemic.Objectives
We evaluated the association between body mass index (BMI) and influenza-like illness (ILI) during two non-pandemic influenza seasons (2003–2004 and 2004–2005) and during the spring and fall waves of the 2009 H1N1 pandemic.Methods
Adults with severe (inpatient) and mild (outpatient) ILI were compared to those without ILI using a case-cohort design. The study was nested among those insured by a single health insurance company, receiving care from a large multispecialty practice. Data were collected from insurance claims and the electronic health record. The primary exposure was obesity (BMI ≥ 30·0 kg/m2).Results
Across three seasons, the crude and adjusted ORs for obesity and severe ILI were 1·65 (95% CI 1·31, 2·08) and 1·23 (95% CI 0·97, 1·57), respectively. An association was observed for those aged 20–59 years (adjusted OR 1·92, 95% CI 1·26, 2·90), but not for those 60 and older (adjusted OR 1·08, 95% CI 0·80, 1·46). The adjusted ORs for obesity and severe ILI in 2003–2004, 2004–2005, and during H1N1 were 1·14 (95% CI 0·80, 1·64), 1·24 (95% CI 0·86, 1·79), and 1·76 (95% CI 0·91, 3·42), respectively. Among those with a Charlson Comorbidity Index score of zero, the adjusted ORs for 2003–2004, 2004–2005, and H1N1 were 1·60 (95% CI 0·93, 2·76), 1·43 (95% CI 0·80, 2·56), and 1·90 (95% CI 0·68, 5·27), respectively.Conclusions
Our results suggest a small to moderate association between obesity and hospitalized ILI among adults. 相似文献8.
Veronica L. Tallo Taro Kamigaki Alvin G. Tan Rochelle R. Pamaran Portia P. Alday Edelwisa S. Mercado Jenaline B. Javier Hitoshi Oshitani Remigio M. Olveda 《Influenza and other respiratory viruses》2014,8(2):159-168
Objectives
Although the public health significance of influenza in regions with a temperate climate has been widely recognized, information on influenza burden in tropical countries, including the Philippines, remains limited. We aimed to estimate influenza incidence rates for both outpatients and inpatients then characterized their demographic features.Design
An enhanced surveillance was performed from January 2009 to December 2011 in an urbanized highland city. The influenza-like illness (ILI) surveillance involved all city health centers and an outpatient department of a tertiary government hospital. The severe acute respiratory infection (sARI) surveillance was also conducted with one government and four private hospitals since April 2009. Nasal and/or oropharyngeal swabs were collected and tested for influenza A, influenza B, and respiratory syncytial virus.Results and Conclusions
We obtained 5915 specimens from 13 002 ILI cases and 2656 specimens from 10 726 sARI cases throughout the study period. We observed year-round influenza activity with two possible peaks each year. The overall influenza detection rate was 23% in the ILI surveillance and 9% in the sARI surveillance. The mean annual outpatient incidence rate of influenza was 5·4 per 1000 individuals [95% confidence interval (CI), 1·83–12·7], and the mean annual incidence of influenza-associated sARI was 1·0 per 1000 individuals (95% CI, 0·03–5·57). The highest incidence rates were observed among children aged <5 years, particularly those aged 6–23 months. Influenza posed a certain disease burden among inpatients and outpatients, particularly children aged <5 years, in an urbanized tropical city of the Philippines. 相似文献9.
Ing‐Kit Lee Kuo‐Shu Tang Chung‐Chen Li Hock‐Liew Eng Huey‐Ling You Kuender D. Yang 《Influenza and other respiratory viruses》2014,8(1):91-98
Background
The sensitivity of rapid influenza diagnostic test (RIDT) of children with influenza-like illness (ILI) remains low.Objective
We compare the parameters between pandemic A(H1N1) 2009 influenza with negative RIDT and ILI not H1N1 for improving the low sensitivity of RIDT for children with ILI.Methods
In a cohort of consecutive laboratory-confirmed H1N1 influenza, we identified 150 H1N1 children with positive RIDT, 152 H1N1 children with negative RIDT, and 75 children with ILI not H1N1. Viral load in throat, complete blood count (CBC), and C-reactive protein (CRP) levels between H1N1 children with negative RIDT and children with ILI not H1N1 were assessed.Results
The diagnostic sensitivity of the RIDT was 45·5%. An analysis of CBC and CRP levels indicated that H1N1 children with negative RIDT had lower total leukocyte, neutrophil, lymphocyte, and basophil counts, and serum CRP levels (P < 0·01). Lymphocyte counts less than 1500 cells/mm3 and CRP levels <15 mg/l, determined by a receiver operating characteristic curve, showed a diagnostic sensitivity of 52·5% and 80·7%, respectively. Combining the lymphocyte counts and CRP levels provided a diagnostic sensitivity of 91·5%. Moreover, H1N1 children with negative RIDT had a lower viral load than those with positive RIDT (3·33 versus 4·48 log10 copies/ml, P < 0·001); the viral load was negatively correlated to the lymphocyte count (P < 0·001).Conclusions
A combination of a low lymphocyte count and a low CRP level could, in the early disease phase, provide a useful screening for H1N1 children with false-negative RIDT, potentially facilitating differential diagnoses. 相似文献10.
11.
Kaitlin Rainwater‐Lovett Kevin Chun Justin Lessler 《Influenza and other respiratory viruses》2014,8(1):74-82
Background
Evaluation of influenza control measures frequently focuses on the efficacy of chemoprophylaxis and vaccination, while the effectiveness of non-pharmaceutical interventions (NPI) receives less emphasis. While influenza control measures are frequently reported for individual outbreaks, there have been few efforts to characterize the real-world effectiveness of these interventions across outbreaks.Objectives
To characterize influenza case and outbreak definitions and control measures reported by long-term care facilities (LTCFs) of elderly adults and estimate the reduction in influenza-like illness (ILI) attack rates due to chemoprophylaxis and NPI.Methods
We conducted a literature search in PubMed including English-language studies reporting influenza outbreaks among elderly individuals in LTCFs. A Bayesian hierarchical logistic regression model estimated the effects of control measures on ILI attack rates.Results
Of 654 articles identified in the literature review, 37 articles describing 60 influenza outbreaks met the inclusion criteria. Individuals in facilities where chemoprophylaxis was used were significantly less likely to develop influenza A or B than those in facilities with no interventions [odds ratio (OR) 0·48, 95% CI: 0·28, 0·84]. Considered by drug class, adamantanes significantly reduced infection risk (OR 0·22, 95% CI: 0·12, 0·42), while neuraminidase inhibitors did not show a significant effect. Although NPI showed no significant effect, the results suggest that personal protective equipment may produce modest protective effects.Conclusions
Our results indicate pharmaceutical control measures have the clearest reported protective effect in LTCFs. Non-pharmaceutical approaches may be useful; however, most data were from observational studies and standardized reporting or well-conducted clinical trials of NPI are needed to more precisely measure these effects. 相似文献12.
John Klena Shali Liu Youxing Peng Hui Yang Jun Luo Jiandong Zheng Maoyi Chen Zhibin Peng Nijuan Xiang Xixiang Huo Lin Xiao Hui Jiang Hui Chen Yuzhi Zhang Xuesen Xing Zhen Xu Zijian Feng Faxian Zhan Weizhong Yang Timothy M. Uyeki Yu Wang Jay K. Varma 《Influenza and other respiratory viruses》2014,8(1):53-65
13.
Zékiba Tarnagda Issaka Yougbaré Abdoul K. Ilboudo Thérèse Kagoné Armel M. Sanou Assana Cissé Isaïe Médah Denis Yelbéogo Ndahwouh Talla Nzussouo 《Influenza and other respiratory viruses》2014,8(5):524-529
Background
Although influenza surveillance has recently been improved in some sub-Saharan African countries, no information is yet available from Burkina Faso.Objectives
Our study was the first to determine the prevalence of influenza viruses circulating in Burkina Faso through a sentinel surveillance system.Methods
We conducted sentinel surveillance with oropharyngeal (OP) swabs collected from outpatients (1 month to 83 years) from six sites in Bobo-Dioulasso and Ouagadougou, among patients meeting the WHO/CDC case definition for influenza-like illness (ILI; fever ≥38°C, and cough and/or sore throat in the absence of other diagnosis) from July 2010 to May 2012. Influenza viruses were detected by real-time RT-PCR using CDC primers, probes, and protocols.Results
The first three ILI cases were enrolled each day; of 881 outpatients with ILI enrolled and sampled, 58 (6·6%) tested positive for influenza viruses (29 influenza A and 29 influenza B). Among the influenza A viruses, 55·2% (16/29) were influenza A (H1N1)pdm09 and 44·8% (13/29) were seasonal A (H3N2). No cases of seasonal A/H1N1 were detected. Patients within 0–5 years and 6–14 years were the most affected, comprising 41·4% and 22·4% laboratory-confirmed influenza cases, respectively. Influenza infections occurred during both the dry, dusty Harmattan months from November to March and the rainy season from June to October with peaks in January and August.Conclusions
This surveillance was the first confirming the circulation of influenza A (H1N1)pdm09, A/H3N2, and influenza B viruses in humans in Burkina Faso. 相似文献14.
Anne C. B. Perdigão Fernanda M. C. Araújo Maria E. L. Melo Daniele R. Q. Lemos Luciano P. Cavalcanti Izabel L. C. Ramalho Lia C. Araújo Deborah M. Sousa Marilda M. Siqueira Maria I. F. Guedes 《Influenza and other respiratory viruses》2015,9(6):293-297
Objective
The aim of this study was to present results of the post-pandemic phase of A(H1N1)pdm09 virus infection in pregnant women in Ceará, Brazil, during the January–June 2012 influenza season.Results
One hundred and fifty-four nasopharyngeal swab samples were collected from pregnant women admitted to hospitals with suspected severe acute respiratory infection (SARI). Fifty-three (34·4%) had laboratory-confirmed A(H1N1)pdm09 virus infection with 15 (28·3%) outpatients and 38 (71·7%) hospitalized. Five (9·4%) women were in the first trimester of pregnancy, 20 (37·7%) in the second trimester of pregnancy, and 24 (45·2%) in the third trimester of pregnancy. Three had no information about the time of pregnancy. Six samples from newborns were also analyzed, of which three were nasopharyngeal swab positive for A(H1N1)pdm09. These swabs were collected immediately after birth, with the exception of one that was collected on the day after birth.Conclusion
Our findings suggest that transplacental transfer of influenza viruses could occur as a result of severe illness in pregnancy. It is therefore important to encourage women to be vaccinated against influenza in order to avoid pregnancy complications. 相似文献15.
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18.
Manuel V. Villaran Josefina García Jorge Gomez Ana E. Arango Marina Gonzales Wilson Chicaiza Washington Alemán Ivette Lorenzana de Rivera Felix Sanchez Nicolas Aguayo Tadeusz J. Kochel Eric S. Halsey 《Influenza and other respiratory viruses》2014,8(2):217-227
Background
Human parainfluenza viruses (HPIVs) are common viral causes of community-acquired pneumonia, particularly in children. The four types of HPIV have world-wide distribution; however, limited information exists about the epidemiological profile of HPIV in Latin-America.Objective
Provide epidemiologic and phylogenetic information about HPIVs that circulated in Latin America between 2006 and 2010 to better characterize the extent and variability of this respiratory virus in the region.Methods
Oropharyngeal swabs, demographic data and clinical characteristics were obtained from individuals with influenza-like illness in 10 Latin-American countries between 2006–2010. Specimens were analyzed with culture and molecular methods.Results
A total of 30 561 individuals were enrolled; 991 (3·2%) were HPIV positive. Most infected participants were male (53·7%) and under 5 years of age (68·7%). The HPIV type most frequently isolated was HPIV-3 (403, 40·7%). In 66/2007 (3·3%) hospitalized individuals, HPIV was identified. The most frequent symptoms at enrollment were cough and rhinorrhea. We identified certain patterns for HPIV-1, -2 and -3 in specific cities. Phylogenetic analysis revealed a homogeneous distribution in the region.Conclusions
In the current scenario, no vaccine or treatment is available for this pathogen. Our results contribute to the scarce epidemiologic and phylogenetic information of HPIV in the region that could support the development of specific management. 相似文献19.
Results of a pilot study using self‐collected mid‐turbinate nasal swabs for detection of influenza virus infection among pregnant women
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Mark G. Thompson Jeannette R. Ferber Roxana Odouli Donna David Pat Shifflett Jennifer K. Meece Allison L. Naleway Sam Bozeman Sarah M. Spencer Alicia M. Fry De‐Kun Li 《Influenza and other respiratory viruses》2015,9(3):155-160
Background
We evaluated the feasibility of asking pregnant women to self-collect and ship respiratory specimens.Methods
In a preliminary laboratory study, we compared the RT-PCR cycle threshold (CT) values of influenza A and B viruses incubated at 4 storage temperatures (from 4 to 35°C) for 6 time periods (8, 24, 48, 72, and 168 hours and 30 days), resulting in 24 conditions that were compared to an aliquot tested after standard freezing (−20°C) (baseline condition). In a subsequent pilot study, during January–February, 2014, we delivered respiratory specimen collection kits to 53 pregnant women with a medically attended acute respiratory illness using three delivery methods.Results
CT values were stable after storage at temperatures <27°C for up to 72 hours for influenza A viruses and 48 hours for influenza B viruses. Of 53 women who received kits during the pilot, 89% collected and shipped nasal swabs as requested. However, 30% (14/47) of the women took over 2 days to collect and ship their specimen. The human control gene, ribonuclease P (RNase P), was detected in 100% of nasal swab specimens. However, the mean CT values for RNase P (26·5, 95% confidence interval [CI] = 26·0–27·1) and for the 8 influenza A virus positives in our pilot (32·2, 95% CI = 28·9–35·5) were significantly higher than the CTs observed in our 2010–2012 study using staff-collected nasal pharyngeal swabs (P-values < 0·01).Discussion
Self-collection of respiratory specimens is a promising research method, but further research is needed to quantify the sensitivity and specificity of the approach. 相似文献20.
Nomenclature updates resulting from the evolution of avian influenza A(H5) virus clades 2.1.3.2a, 2.2.1, and 2.3.4 during 2013–2014
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Gavin J. D. Smith Ruben O. Donis World Health Organization/World Organisation for Animal Health/Food Agriculture Organization H Evolution Working Group 《Influenza and other respiratory viruses》2015,9(5):271-276