Respiratory Syncytial Virus Coinfections With Rhinovirus and Human Bocavirus in Hospitalized Children

It is not clearly established if coinfections are more severe than single viral respiratory infections.The aim of the study was to study and to compare simple infections and viral coinfections of respiratory syncytial virus (RSV) in hospitalized children.From September 2005 to August 2013, a prospective study was conducted on children younger than 14 years of age, admitted with respiratory infection to the Pediatric Department of the Severo Ochoa Hospital, in Spain. Specimens of nasopharyngeal aspirate were taken for virological study by using polymerase chain reaction, and clinical data were recorded. Simple RSV infections were selected and compared with double infections of RSV with rhinovirus (RV) or with human bocavirus (HBoV).In this study, 2993 episodes corresponding to 2525 children were analyzed. At least 1 virus was detected in 77% (2312) of the episodes. Single infections (599 RSV, 513 RV, and 81 HBoV) were compared with 120 RSV-RV and 60 RSV-HBoV double infections. The RSV-RV coinfections had fever (63% vs 43%; P < 0.001) and hypoxia (70% vs 43%; P < 0.001) more often than RV infections. Hypoxia was similar between single or dual infections (71%). Bronchiolitis was more frequent in the RSV simple group (P < 0.001). Pediatric intensive care unit admission was more common in RSV simple or RSV-RV groups than in the RV monoinfection (P = 0.042).Hospitalization was longer for both RSV simple group and RSV-HBoV coinfection, lasting about 1 day (4.7 vs 3.8 days; P < 0.001) longer than in simple HBoV infections. There were no differences in PICU admission. RSV single group was of a younger age than the other groups.Coinfections between RSV-RV and RSV-HBoV are frequent. Overall viral coinfections do not present greater severity, but have mixed clinical features.This study has been partially supported by FIS (Fondo de Investigaciones Sanitarias – Spanish Health Research Fund) Grants No.: PI06/0532, PI09/00246, and PI12/01291.S

Nutritional Supplementation to Increase Influenza Vaccine Response in Children Living With HIV: A Pilot Clinical Trial

Final results of this work have been presented at the following meetings: 36rd Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID 2018), Malmö, Sweden, 28th May-June 2nd, 2018. (Ref. ESP18-0517).Aims: Vaccine response is poor among children living with HIV. The gut microbiota has been identified as a potential target to improve vaccine immunogenicity, but data are scarce in the context of HIV infection. Methods: Pilot, double-blind, randomized placebo-controlled trial in which 24 HIV-infected children were randomized to receive a mixture of symbiotics, omega-3/6 fatty acids, and amino acids or placebo for 4 weeks, each in combination with ART, and were then immunized against influenza. Vaccine response and safety of the nutritional supplementation were the primary outcomes. Results: Eighteen HIV-infected children completed the follow-up period (mean age 11.5 ± 4.14 years, 61% female). The nutritional supplement was safe but did not enhance the response to the influenza vaccine. A 4-fold rise in antibody titers was obtained in only 37.5% of participants in the intervention arm vs. 40% in the placebo. No immunological or inflammatory predictors of vaccine response were identified. Conclusions: In this exploratory study, a 4-week course of symbiotics did not increase influenza vaccine immunogenicity in HIV-infected children. Larger studies are warranted to address the potential of modulating the microbiome in children living with HIV.This work was funded by the Instituto de Salud Carlos III-Fondos FEDER (grant number CB21/17/00025), Acción Estratégica en Salud (PI13/0422, PI17/01283, PI18/00154, and PI18CIII/00009). TS and SS-V have been funded by the Instituto de Salud Carlos III-Fondos FEDER (BA21/00022 and BA21/00017). The funding bodies did not have a role in the design or conduct of the study, the analysis and interpretation of the results, and the writing of the report or the decision to publish. The authors would like to particularly acknowledge all the children and adolescents as well as their families for their participation in this study. They acknowledge the Spanish Pediatric HIV infection Group CORISPE and the Pediatric HIV BioBank integrated in the Spanish AIDS Research Network and collaborating Centers [supported by the Instituto de Salud Carlos III, Spanish Health Ministry (Grant n◦ RD06/0006/0035)] for its collaboration and cession of clinical information and samples used in this work. Nutricion Médica S.L., manufactured and packaged the nutritional product under investigation. Final results of this work have been presented at the following meetings: 36rd Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID 2018), Malmö, Sweden, 28th May-June 2nd, 2018. (Ref. ESP18-0517).S

Nutritional Supplementation to Increase Influenza Vaccine Response in Children Living With HIV: A Pilot Clinical Trial

AimsVaccine response is poor among children living with HIV. The gut microbiota has been identified as a potential target to improve vaccine immunogenicity, but data are scarce in the context of HIV infection.MethodsPilot, double-blind, randomized placebo-controlled trial in which 24 HIV-infected children were randomized to receive a mixture of symbiotics, omega-3/6 fatty acids, and amino acids or placebo for 4 weeks, each in combination with ART, and were then immunized against influenza. Vaccine response and safety of the nutritional supplementation were the primary outcomes.ResultsEighteen HIV-infected children completed the follow-up period (mean age 11.5 ± 4.14 years, 61% female). The nutritional supplement was safe but did not enhance the response to the influenza vaccine. A 4-fold rise in antibody titers was obtained in only 37.5% of participants in the intervention arm vs. 40% in the placebo. No immunological or inflammatory predictors of vaccine response were identified.ConclusionsIn this exploratory study, a 4-week course of symbiotics did not increase influenza vaccine immunogenicity in HIV-infected children. Larger studies are warranted to address the potential of modulating the microbiome in children living with HIV

Self-reported cases of influenza among Spanish healthcare workers during the 2009 influenza A(H1N1) pandemic

[ES] Objetivos: Describir la prevalencia de síndrome gripal en el invierno de 2009 y los factores asociados a su ocurrencia. Método: Estudio transversal en 18 hospitales españoles. Los voluntarios respondieron un cuestionario de salud, informando sobre si habían sufrido síndrome gripal y su estado vacunal. Resultados: Participaron 1289 trabajadores sanitarios, y de ellos, 72 (5,6%) refirieron gripe en su familia, 195 (15,1%) se vacunaron frente al virus /California/7/2009/H1N1 y 75 (5,8%, intervalo de confianza del 95% [IC95%]: 4,5-7,1) sufrieron síndrome gripal. Hubo diferencias entre comunidades autónomas. En el análisis de regresión logística, se asoció a síndrome gripal trabajar en la Comunidad de Madrid (odds ratio [OR] = 8,31, IC95%: 1.05-65.39), tener casos de gripe en la familia (OR = 2,84, IC95%: 1,41-5,73) y no estar vacunado frente a la gripe A (OR = 2,68, IC95%: 1,05-6,82). Conclusiones: La presencia de casos en la familia y la comunidad donde se trabaja determinaron una diferente prevalencia de síndrome gripal. La vacuna se asoció a una menor prevalencia de la enfermedad. [EN] Objectives: To describe the prevalence of influenza-like syndrome in winter 2009 and the factors asso ciated with its occurrence. Methods: A cross-sectional study was carried out in 18 hospitals in Spain. Volunteers completed a health questionnaire in which they reported the occurrence of influenza-like syndrome and vaccination and demographic status. Results: A total of 1,289 healthcare workers participated. Of these, 72 (5.6%) reported influenza in their family, 195 (15.1%) had been vaccinated against the A/California/7/2009/H1N1 virus and 75 (5.8%, 95%CI: 4.5-7.1%) had been diagnosed with influenza like-syndrome. There were differences among regions. In logistic regression analysis, the following factors were associated with a higher prevalence of influenza like syndrome: working in Madrid (OR = 8.31, 95%CI: 1.05-65.39), the occurrence of cases of influenza in the family (OR = 2.84, 95%CI: 1.41-5.73) and not having been vaccinated against influenza A (H1N1) (OR = 2.68, 95% CI: 1.05-6.82). Conclusions: Differences in the prevalence of influenza-like syndrome were due to the occurrence of familiar cases and region. Vaccination againstinfluenza A (H1N1) was associated with a lower prevalence of the disease.Proyecto financiado por el Instituto de Salud Carlos III a través del CIBER de Epidemiología y Salud Pública. Código del proyecto GR09/0038S