Major Issues and Challenges of Influenza Pandemic Preparedness in Developing Countries

Summary line: A pandemic is a global issue, and pandemic preparedness should be considered from a global perspective

Origin of measles virus: divergence from rinderpest virus between the 11th and 12th centuries

Measles, caused by measles virus (MeV), is a common infection in children. MeV is a member of the genus Morbillivirus and is most closely related to rinderpest virus (RPV), which is a pathogen of cattle. MeV is thought to have evolved in an environment where cattle and humans lived in close proximity. Understanding the evolutionary history of MeV could answer questions related to divergence times of MeV and RPV

Evolution of the M gene of the influenza A virus in different host species: large-scale sequence analysis

<p>Abstract</p> <p>Background</p> <p>Influenza A virus infects not only humans, but also other species including avian and swine. If a novel influenza A subtype acquires the ability to spread between humans efficiently, it could cause the next pandemic. Therefore it is necessary to understand the evolutionary processes of influenza A viruses in various hosts in order to gain better knowledge about the emergence of pandemic virus. The virus has segmented RNA genome and 7th segment, M gene, encodes 2 proteins. M1 is a matrix protein and M2 is a membrane protein. The M gene may be involved in determining host tropism. Besides, novel vaccines targeting M1 or M2 protein to confer cross subtype protection have been under development. We conducted the present study to investigate the evolution of the M gene by analyzing its sequence in different species.</p> <p>Results</p> <p>Phylogenetic tree revealed host-specific lineages and evolution rates were different among species. Selective pressure on M2 was stronger than that on M1. Selective pressure on M1 for human influenza was stronger than that for avian influenza, as well as M2. Site-by-site analyses identified one site (amino acid position 219) in M1 as positively selected in human. Positions 115 and 121 in M1, at which consensus amino acids were different between human and avian, were under negative selection in both hosts. As to M2, 10 sites were under positive selection in human. Seven sites locate in extracellular domain. That might be due to host's immune pressure. One site (position 27) positively selected in transmembrane domain is known to be associated with drug resistance. And, two sites (positions 57 and 89) locate in cytoplasmic domain. The sites are involved in several functions.</p> <p>Conclusion</p> <p>The M gene of influenza A virus has evolved independently, under different selective pressure on M1 and M2 among different hosts. We found potentially important sites that may be related to host tropism and immune responses. These sites may be important for evolutional process in different hosts and host adaptation.</p

Desenvolvimento de competências comunicacionais como factor de integração: reconstruindo uma intervenção com uma criança com paralisia cerebral

Trabalho apresentado para obtenção do título de especialista na área de formação de professores. Instituto Politécnico de Beja. Escola Superior de Educação, 2010.Resumo Este trabalho decorre da actividade profissional da autora na área da Educação Especial. Nele se aborda uma intervenção visando a estimulação da Comunicação Aumentativa numa criança com Paralisia Cerebral e todo o processo de Intervenção Precoce, de integração da criança em Jardim de Infância e em meio escolar e, ainda, o dispositivo formativo conduzido pela autora em relação aos actores envolvidos na acção educativa com esta criança. O trabalho consta de duas partes, cujos textos correspondem a dois momentos de (re)construção desta intervenção: um primeiro momento, a quente, aquando da apresentação de uma comunicação, por parte da autora num evento de natureza científica; um segundo momento, decorrido um lapso de tempo dilatado após a realização desta comunicação, em que a autora faz uma releitura da intervenção que conduziu, à luz dos desenvolvimentos ocorridos em vários domínios (tecnológico, literatura sobre comunicação aumentativa, conceitos e práticas em Educação Especial, legislação, formação de adultos).Abstract This work results from the professional activity of the author in the area of Special Education. It addresses an intervention aimed at the stimulation of Augmentative Communication in a child with Cerebral Palsy and the whole process of Early Intervention, the integration of the child in kindergarten and at school, and also the training device conducted by the author regarding the actors involved in educational activities with this child. The work consists of two parts, whose texts represent two moments of (re)construction of this intervention: a first moment, in an impulsive manner, upon the presentation of a communication, by the author, in a scientific event, a second moment, after an extended period of time after this communication, in which the author makes a rereading of the conducted intervention in the light of developments in various areas that in the meanwhile had occurred (technological, literature on augmentative communication, concepts and practices in Special Education, legislation, training of adults)

Respiratory syncytial virus: time for surveillance across all ages, with a focus on adults

Human respiratory syncytial virus (RSV), a leading cause of serious respiratory illness, can affect individuals of all ages, especially children below two years of age and adults 60 years of age and above, as well as individuals with chronic comorbidities, such as chronic pulmonary or cardiovascular conditions, and immunocompromised individuals [1,2]. In adults, clinical outcomes of RSV infection vary from mild, cold-like symptoms to more serious complications, including pneumonia, exacerbations of chronic medical conditions (e.g. asthma, chronic obstructive pulmonary disease, congestive heart failure), and can lead to death [3]. The RSV-related hospitalisation burden is especially high in older adults. A meta-analysis conducted on data from high-income countries across different continents (based on literature published between 1 January 2000 and 3 November 2021) estimated that approximately 470 000 individuals 60 years of age and above were hospitalised in 2019 due to RSV, of whom approximately 33 000 died. The pooled estimate for RSV acute respiratory infection (ARI) attack rate was 1.62% (95% CI = 0.84–3.08%), corresponding to an estimated 5.2 million RSV-associated ARI cases [2]. As RSV symptoms in adults resemble those of other common respiratory viruses (e.g. influenza), clinical diagnosis of RSV may be challenging.Circulation of the two major RSV antigenic groups (A and B) is seasonal in temperate climates, with a peak during the winter months, but has a more variable pattern in tropical climates. In addition, RSV circulation overlaps with the influenza season but usually lasts longer (16–22 vs. 6–8 weeks, respectively) [1]. Human respiratory syncytial virus circulation was impacted during the first two years of the coronavirus disease 2019 (COVID-19) pandemic, with RSV cases substantially declining after the widespread implementation of public health and social measures and re-emerging out of season when measures were gradually lifted [4].Human respiratory syncytial virus surveillance is limited, geographically heterogeneous, and does not systematically include all age groups. While the burden of RSV is highest among very young children, adults 60 years of age and above, and individuals with underlying health conditions, other populations also contribute to RSV transmission. Therefore, improved RSV surveillance systems are needed to better understand the epidemiology of RSV and inform public health measures. To identify the current challenges in RSV surveillance in adults and the ways to expand RSV surveillance systems, an advisory board among seven experts with national and international expertise in infectious diseases and surveillance was held in August 2022. The main points discussed by the group are summarised in plain language in Figure 1.<br/

Rumor Surveillance and Avian Influenza H5N1

We describe the enhanced rumor surveillance during the avian influenza H5N1 outbreak in 2004. The World Health Organization’s Western Pacific Regional Office identified 40 rumors; 9 were verified to be true. Rumor surveillance informed immediate public health action and prevented unnecessary and costly responses

Influenza Transmission in a Community during a Seasonal Influenza A(H3N2) Outbreak (2010–2011) in Mongolia: A Community-Based Prospective Cohort Study

BACKGROUND: Knowledge of how influenza viruses spread in a community is important for planning and implementation of effective interventions, including social distancing measures. Households and schools are implicated as the major sites for influenza virus transmission. However, the overall picture of community transmission is not well defined during actual outbreaks. We conducted a community-based prospective cohort study to describe the transmission characteristics of influenza in Mongolia. METHODS AND FINDINGS: A total of 5,655 residents in 1,343 households were included in this cohort study. An active search for cases of influenza-like illness (ILI) was performed between October 2010 and April 2011. Data collected during a community outbreak of influenza A(H3N2) were analyzed. Total 282 ILI cases occurred during this period, and 73% of the subjects were aged <15 years. The highest attack rate (20.4%) was in those aged 1-4 years, whereas the attack rate in those aged 5-9 years was 10.8%. Fifty-one secondary cases occurred among 900 household contacts from 43 households (43 index cases), giving an overall crude household secondary attack rate (SAR) of 5.7%. SAR was significantly higher in younger household contacts (relative risk for those aged <1 year: 9.90, 1-4 years: 5.59, and 5-9 years: 6.43). We analyzed the transmission patterns among households and a community and repeated transmissions were detected between households, preschools, and schools. Children aged 1-4 years played an important role in influenza transmission in households and in the community at large. Working-age adults were also a source of influenza in households, whereas elderly cases (aged ≥ 65 years) had no link with household transmission. CONCLUSIONS: Repeated transmissions between households, preschools, and schools were observed during an influenza A(H3N2) outbreak period in Mongolia, where subjects aged 1-4 years played an important role in influenza transmission

Impact of the Tohoku Earthquake and Tsunami on Pneumonia Hospitalisations and Mortality Among Adults in Northern Miyagi, Japan: A Multicentre Observational Study

Background On 11 March 2011, the Tohoku earthquake and tsunami struck off the coast of northeastern Japan. Within 3 weeks, an increased number of pneumonia admissions and deaths occurred in local hospitals. Methods A multicentre survey was conducted at three hospitals in Kesennuma City (population 74000), northern Miyagi Prefecture. All adults aged ≥18 years hospitalised between March 2010 and June 2011 with community-acquired pneumonia were identified using hospital databases and medical records. Segmented regression analyses were used to quantify changes in the incidence of pneumonia. Results A total of 550 pneumonia hospitalisations were identified, including 325 during the pre-disaster period and 225 cases during the post-disaster period. The majority (90%) of the post-disaster pneumonia patients were aged ≥65 years, and only eight cases (3.6%) were associated with near-drowning in the tsunami waters. The clinical pattern and causative pathogens were almost identical among the pre-disaster and post-disaster pneumonia patients. A marked increase in the incidence of pneumonia was observed during the 3-month period following the disaster; the weekly incidence rates of pneumonia hospitalisations and pneumonia-associated deaths increased by 5.7 times (95% CI 3.9 to 8.4) and 8.9 times (95% CI 4.4 to 17.8), respectively. The increases were largest among residents in nursing homes followed by those in evacuation shelters. Conclusions A substantial increase in the pneumonia burden was observed among adults after the Tohoku earthquake and tsunami. Although the exact cause remains unresolved, multiple factors including population aging and stressful living conditions likely contributed to this pneumonia outbreak