Epidemiology of Influenza-like Illness during Pandemic (H1N1) 2009, New South Wales, Australia

To rapidly describe the epidemiology of influenza-like illness (ILI) during the 2009 winter epidemic of pandemic (H1N1) 2009 virus in New South Wales, Australia, we used results of a continuous population health survey. During July–September 2009, ILI was experienced by 23% of the population. Among these persons, 51% were unable to undertake normal duties for <3 days, 55% sought care at a general practice, and 5% went to a hospital. Factors independently associated with ILI were younger age, daily smoking, and obesity. Effectiveness of prepandemic seasonal vaccine was ≈20%. The high prevalence of risk factors associated with a substantially increased risk for ILI deserves greater recognition

The impact of COVID-19 and COVID vaccination on cardiovascular outcomes

COVID-19 is an independent risk factor for cardiovascular disease. COVID-19 vaccination may prevent this, but in some cases, COVID-19 vaccination may cause myocarditis or pericarditis. Patients with COVID-19 may present with non-specific symptoms that have a cardiac origin. This review examines the cardiovascular complications of COVID-19 infection and the impact of COVID-19 vaccination. COVID-19 cardiovascular complications include myocardial injury, pericarditis, coagulopathy, myocardial infarction, heart failure, arrhythmias, and persistent post-acute risk of adverse cardiovascular outcomes. Diagnostic and referral pathways for non-specific symptoms, such as dyspnoea and fatigue, remain unclear. COVID-19 vaccination is cardioprotective overall but is associated with myopericarditis in young males, though at a lower rate than following SARS-CoV-2 infection. Increased awareness among primary care physicians of potential cardiovascular causes of non-specific post-COVID-19 symptoms, including in younger adults, such as fatigue, dyspnoea, and chest pain, is essential. We recommend full vaccination with scheduled booster doses, optimal management of cardiovascular risk factors, rapid treatment of COVID-19, and clear diagnostic, referral, and management pathways for patients presenting with non-specific symptoms to rule out cardiac complications

Association of influenza infection and vaccination with cardiac biomarkers and left ventricular ejection fraction in patients with acute myocardial infarction

Aims: The aim of this study was to examine the association of influenza infection and vaccination with extent of cardiac damage during acute myocardial infarctions (AMIs) as measured by serum biomarkers and left ventricular ejection function (LVEF) in patients. Methods: Post-hoc analysis was performed on data from a prospective case-control study of influenza and AMI, conducted in a tertiary care hospital in Sydney, Australia. We included 275 cases of AMI, aged ≥ 40 years admitted to the cardiology during the study period. Results: Mean and median CK-MB levels were significantly higher among unvaccinated group compared to vaccinated group (p value < 0.05). Troponin levels were also higher among unvaccinated group compared to vaccinated group; although not statistically significant. Troponin and CKMB values were not statistically different among influenza positive cases and influenza negative cases. Large size infarcts were less frequent among vaccinated cases compared to unvaccinated cases (25% vs 35.5%) and were more frequent among influenza positive cases compared to influenza negative cases (35.3% vs 31.5%), however differences were not statistically significant. LVEF was lower among vaccinated cases compared to unvaccinated cases (62.5% vs. 52.8%) and influenza positive cases compared to influenza negative cases (58.8% vs 55.4), however differences were not significant. Conclusion: Lower CKMB levels among vaccinated groups showed that influenza vaccine may have a protective effect against large infarcts, therefore influenza vaccination should be recommended for high risk groups. The study suggests an association of larger infarcts with influenza infection, but larger studies are required to confirm this

Impairment of left atrial function and cryptogenic stroke : potential insights in the pathophysiology of stroke in the young

Background: Stroke is one of the leading causes of morbidity and mortality with a significant percentage classified as cryptogenic. Left atrial (LA) remodelling, a substrate for atrial fibrillation (AF) and stroke development, may play a role in identification of the aetiology of cryptogenic stroke. We aimed to examine LA function to gain mechanistic insights into the pathophysiology of cryptogenic stroke in young patients otherwise at low risk for cardiovascular disease. Methods: Patients aged &lt;60 years without traditional cardiovascular risk factors and who were diagnosed with ischaemic cryptogenic stroke or TIA were evaluated and compared to healthy controls and patients with paroxysmal AF with a CHA2DS2-VA score of 0. Conventional and novel left ventricular (LV) and LA echocardiographic parameters between the three groups were assessed. Results: Each group consisted of thirty patients. There were no significant differences in LV parameters (LVEF, LV endoGLS) between groups. LA strain in stroke patients was significantly lower compared to the controls (median 33%; interquartile range (IQ) [32/39] vs 31 [27/34]; p = 0.008). LA strain was significantly lower in AF patients compared to stroke patients (median 21% [19/22] vs 31% [27/34]; p &lt; 0.0001). Conclusion: A stepwise reduction in measures of LA function was appreciated between controls, young stroke and paroxysmal AF groups. This may indicate dynamic LA remodelling occurring in the young stroke population and suggest a shared causal mechanism for stroke development in this group. LA strain may further refine the risk for cardioembolic stroke