Posts filed under ‘Influenza’

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.

Clinical Infectious Diseases March 5, 2019 V.68 N.6 P.e1-e47.   

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.

Uyeki TM1, Bernstein HH2, Bradley JS3,4, Englund JA5, File TM6, Fry AM1, Gravenstein S7, Hayden FG8, Harper SA9, Hirshon JM10, Ison MG11, Johnston BL12, Knight SL13, McGeer A14, Riley LE15, Wolfe CR16, Alexander PE17,18, Pavia AT19.

Abstract

These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.

Published by Oxford University Press for the Infectious Diseases Society of America 2018.

FULL TEXT

https://academic.oup.com/cid/article/68/6/e1/5251935

PDF (CLIC en PDF)

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May 1, 2019 at 6:23 pm

Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England.

BMC Med. September 8, 2017 V.15 N.1 P.166.

Thorrington D1, van Leeuwen E2,3, Ramsay M4, Pebody R2, Baguelin M2,5.

Author information

1 Respiratory Diseases Department, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK. dominic.thorrington@phe.gov.uk

2 Respiratory Diseases Department, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.

3 Imperial College Faculty of Medicine, London, SW7 2AZ, UK.

4 Immunisation, Hepatitis & Blood Safety Department, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.

5 Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

Abstract

BACKGROUND:

As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccine (QLAIV), whilst children with contraindications receive the quadrivalent inactivated influenza vaccine (QIIV). Individuals aged younger than 65 years in the clinical risk populations and elderly individuals aged 65+ years receive either a trivalent inactivated influenza vaccine (TIIV) offering protection from two A strains and one B strain or the QIIV at the choice of their general practitioner. The cost-effectiveness of quadrivalent vaccine programmes is an open question. The original analysis that supported the paediatric programme only considered a trivalent live attenuated vaccine (LAIV). The cost-effectiveness of the QIIV to other patients has not been established. We sought to estimate the cost-effectiveness of these programmes, establishing a maximum incremental total cost per dose of quadrivalent vaccines over trivalent vaccines.

METHODS:

We used the same mathematical model as the analysis that recommended the introduction of the paediatric influenza vaccination programme. The incremental cost of the quadrivalent vaccine is the additional cost over that of the existing trivalent vaccine currently in use.

RESULTS:

Introducing quadrivalent vaccines can be cost-effective for all targeted groups. However, the cost-effectiveness of the programme is dependent on the choice of target cohort and the cost of the vaccines: the paediatric programme is cost-effective with an increased cost of £6.36 per dose, though an extension to clinical risk individuals younger than 65 years old and further to all elderly individuals means the maximum incremental cost is £1.84 and £0.20 per dose respectively.

CONCLUSIONS:

Quadrivalent influenza vaccines will bring substantial health benefits, as they are cost-effective in particular target groups.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590113/pdf/12916_2017_Article_932.pdf

April 13, 2019 at 12:58 pm

A review of the value of quadrivalent influenza vaccines and their potential contribution to influenza control.

Hum Vaccin Immunother. July 3, 2017 V.13 N.7 P.1640-1652.

Ray R1, Dos Santos G2, Buck PO3, Claeys C1, Matias G1, Innis BL3, Bekkat-Berkani R1.

Author information

1 a GSK , Wavre , Belgium.

2 b Business & Decision Life Sciences , Brussels , Belgium (on behalf of GSK).

3 c GSK , Philadelphia , PA , USA.

Abstract

The contribution of influenza B to the seasonal influenza burden varies from year-to-year. Although 2 antigenically distinct influenza B virus lineages have co-circulated since 2001, trivalent influenza vaccines (TIVs) contain antigens from only one influenza B virus. B-mismatch or co-circulation of both B lineages results in increased morbidity and mortality attributable to the B lineage absent from the vaccine. Quadrivalent vaccines (QIVs) contain both influenza B lineages. We reviewed currently licensed QIVs and their value by focusing on the preventable disease burden. Modeling studies support that QIVs are expected to prevent more influenza cases, hospitalisations and deaths than TIVs, although estimates of the case numbers prevented vary according to local specificities. The value of QIVs is demonstrated by their capacity to broaden the immune response and reduce the likelihood of a B-mismatched season. Some health authorities have preferentially recommended QIVs over TIVs in their influenza prevention programmes.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512791/pdf/khvi-13-07-1313375.pdf

 

April 13, 2019 at 12:57 pm

Safety and Immunogenicity of MF59-Adjuvanted Cell Culture-Derived A/H5N1 Subunit Influenza Virus Vaccine: Dose-Finding Clinical Trials in Adults and the Elderly.

 Open Forum Infect Dis. March 1, 2019 V.6 N.4 

Frey SE1, Shakib S2, Chanthavanich P3, Richmond P4, Smith T5, Tantawichien T6, Kittel C7, Jaehnig P7, Mojares Z8, Verma B9, Kanesa-Thasan N9, Hohenboken M10.

Author information

1 School of Medicine, Saint Louis University, St. Louis, Missouri.

2 CMAX Clinical Research Pty Ltd., Adelaide, SA, Australia.

3 Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

4 Division of Paediatrics, School of Medicine, University of Western Australia, and Vaccine Trials Group, Telethon Kids Institute, Subiaco, WA, Australia.

5 Mercy Health Research, St. Louis, Missouri.

6 Department of Medicine, Faculty of Medicine, Chulalongkorn University and Queen Saovabha Memorial Institute, Bangkok, Thailand.

7 GlaxoSmithKline Vaccines GmbH, Marburg, Germany.

8 GlaxoSmithKline Pte Ltd., Singapore, Singapore.

9 GlaxoSmithKline Vaccines LLC, Rockville, Maryland.

10 Seqirus Inc., Cambridge, Massachusetts.

Abstract

BACKGROUND:

A/H5N1 influenza viruses have high pandemic potential; consequently, vaccines need to be produced rapidly. MF59® adjuvant reduces the antigen required per dose, allowing for dose sparing and more rapid vaccine availability.

METHODS:

Two multicenter, phase II trials were conducted to evaluate the safety and immunogenicity of an MF59-adjuvanted, cell culture-derived, A/H5N1 vaccine (aH5N1c) among 979 adult (18-64 years old) and 1393 elderly (≥65 years old) subjects. Participants were equally randomized to receive 2 full-dose (7.5 μg of hemagglutinin antigen per dose) or 2 half-dose aH5N1c vaccinations 3 weeks apart. Outcomes were based on Center for Biologics Evaluation Research and Review (CBER) and Committee for Medicinal Products for Human Use (CHMP) licensure criteria (titers ≥1:40 and seroconversions on day 43). Solicited reactions and adverse events were assessed (www.clinicaltrials.gov: NCT01776541 and NCT01766921).

RESULTS:

CBER and CHMP criteria were met by both age groups. CBER criteria for hemagglutination titers were met for the full-dose formulation. Solicited reaction frequencies tended to be higher in the full-dose group and were of mild to moderate intensity. No vaccine-related serious adverse events occurred.

CONCLUSIONS:

In adult and elderly participants, the full-dose aH5N1c vaccine formulation was well tolerated and met US and European licensure criteria for pandemic vaccines.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446137/pdf/ofz107.pdf

April 13, 2019 at 12:56 pm

Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.

Clinical Infectious Diseases March 2019 V.68  N.6 e1–e47

Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM Jr, Fry AM, et al.

These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic.

This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza.

It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza.

The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.

FULL TEXT

https://academic.oup.com/cid/article/68/6/e1/5251935

PDF (CLIC en PDF)

March 20, 2019 at 3:42 pm

Infections in patients affected by rheumatologic diseases associated to glucocorticoid use or tumor necrosis factor-alpha inhibitors.

Rev Chilena Infectol. April 2014 V.31 N.2 P.181-95.

[Article in Spanish]

Fica A.

Abstract

A great diversity of infectious agents can affect patients that use steroids at immunosuppressive doses or tumor necrosis factor alpha (TNF-alpha) antagonists.

The list of participating microorganisms is more restricted in the case of anti TNF-alpha blockers.

Overlapping agents include intracellular bacteria, Mycobacterium tuberculosis, geographic fungal agents that have the ability to establish granulamotous infections, herpes zoster, and reactivation of chronic hepatitis B virus infection.

An important conceptual issue for these infections is the existence of a threshold prednisone daily dose for the emergence of opportunistic infections but higher levels of immunosuppression and cofactors are required in the case of Pneumocystis jiroveci and cytomegalovirus infections.

In order to prevent these threats, a detailed medical evaluation is needed before prescription to detect potential risks and manage them properly.

Prevention rules must be prescribed in every case, that include common sense behaviors, vaccines, and in selected cases, chemoprophylaxis for latent tuberculosis (TB) infection, P. jiroveci pneumonia (PCP) or other specific requirements.

Latent TB infection is probable and requires chemoprophylaxis in the case of remote or recent exposure to a patient with lung TB, a positive tuberculin or interferon-gamma release assay result or residual lung scars in a chest x-ray exam.

PCP prevention is suggested when the patient reaches a daily dose of prednisone of 30 mg but might be needed at lower doses in case of other concomitant immunosuppressive drugs or when lymphopenia arises shortly after prednisone initiation.

PDF

https://scielo.conicyt.cl/pdf/rci/v31n2/art09.pdf

 

November 19, 2018 at 11:12 am

Respiratory Virus Infection During Pregnancy: Does It Matter?

The Journal of Infectious Diseases August 15, 2018 V.218 N.4 P.512-515

EDITOR’S CHOICE

Janet A Englund; Helen Y Chu

FULL TEXT

https://academic.oup.com/jid/article/218/4/512/4993270

PDF (CLIC en PDF)

 

August 13, 2018 at 6:24 pm

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