Preparing for an influenza season 2021/22 with a likely co-circulation of influenza virus and SARS-CoV-2

EditorialN

Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection

BackgroundDespite decreasing COVID-19 disease severity during the Omicron waves, a proportion of patients still require hospitalization and intensive care.ObjectiveTo compare demographic characteristics, comorbidities, vaccination status, and previous infections in patients hospitalized for community-associated COVID-19 (CAC) in predominantly Delta, Omicron BA.1 and BA.4/5 SARS-CoV-2 waves.MethodsData were extracted from three national databases—the National COVID-19 Database, National Vaccination Registry and National Registry of Hospitalizations.ResultsAmong the hospitalized CAC patients analyzed in this study, 5,512 were infected with Delta, 1,120 with Omicron BA.1, and 1,143 with the Omicron BA.4/5 variant. The age and sex structure changed from Delta to BA.4/5, with the proportion of women (9.5% increase), children and adolescents (10.4% increase), and octa- and nonagenarians increasing significantly (24.5% increase). Significantly more patients had comorbidities (measured by the Charlson Comorbidity Index), 30.3% in Delta and 43% in BA.4/5 period. The need for non-invasive ventilatory support (NiVS), ICU admission, mechanical ventilation (MV), and in-hospital mortality (IHM) decreased from Delta to Omicron BA.4/5 period for 12.6, 13.5, 11.5, and 6.3%, respectively. Multivariate analysis revealed significantly lower odds for ICU admission (OR 0.68, CI 0.54–0.84, p < 0.001) and IHM (OR 0.74, CI 0.58–0.93, p = 0.011) during the Delta period in patients who had been fully vaccinated or boosted with a COVID-19 vaccine within the previous 6 months. In the BA.1 variant period, patients who had less than 6 months elapsed between the last vaccine dose and SARS-CoV-2 positivity had lower odds for MV (OR 0.38, CI 0.18-0.72, p = 0.005) and IHM (OR 0.56, CI 0.37- 0.83, p = 0.005), but not for NIVS or ICU admission.ConclusionThe likelihood of developing severe CAC in hospitalized patients was higher in those with the Delta and Omicron BA.1 variant compared to BA.4/5

Epidemiološki i virološki nadzor influence i influenci slične bolesti u Sloveniji

The number of patients with acute respiratory infections rises sharply shortly after the influenza virus appears in population. Consequently, the hospitalization and mortality rates increase. Several indicators may be used to measure the burden-of-illness caused by the influenza virus: incidence rate of influenza-like illness (ILI) or acute respiratory illness (ARI), crude or cause-specific mortality rate, sick-live or monitoring the over the counter (OTC) medication sales. Two indicators have been measured in Slovenia since 1999: the ILI and ARI incidence rates in approximately 4% of the population. Multiplex Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was used as a screening method for the detection of influenza viruses, respiratory syncytial virus (RSV), adenoviruses and enteroviruses in nasal and/or throat swabs. All positive samples were further propagated in the corresponding cell culture line. RT-PCR was used for fast determination of hemaglutinins (H1, H3) and neuraminidases (N1, N2) of influenza A viruses. The antigenic subtype of the samples isolated on the cell culture was determined by means of a hemaglutination inhibition assay and confirmed in the WHO European Reference Centre for Influenza. In the 2004/2005 season, the ILI incidence rate was at highest in weeks 5, 6 and 7 of the year 2005, when it reached its peak value (392/100,000). The highest ARI incidence rate was recorded in the period from 31st January to 6th February, and remained elevated for the following two weeks. Samples were taken from 793 patients with clinical signs of ILI. The influenza A or B virus was detected in 15.2% of patients. One third of the influenza A cases were of the H1N1 subtype, while the others were H3N2. Enteroviral infection was relatively common in the past season (15.8% of patients). The influenza isolates in Slovenia were similar to those in other European countries and belonged to: A/H3N2/California/7/2004 (A/H3N2/Fujian/441/2002-like viruses), A/H1N1/New Caledonia/20/99 and B/Jiangsu/10/03 (B/Shaghai/361/2002-like viruses). The dominant influenza virus in Europe and the USA was influenza A H3N2. The ARI and/or ILI incidence rates were higher in most European countries (including Slovenia) compared to previous seasons.Broj pacijenata s akutnom dišnom zarazom naglo se povećava nakon što se u populaciji počinje javljati virus influence. Kao posljedica toga javlja se povećana stopa hospitalizacije i mortaliteta. Nekoliko pokazatelja može se rabiti za mjerenje pojave popratnih bolesti vezanih uz influencu: stopa pojavnosti influenci slične bolesti ili akutne dišne bolesti, stopa nespecifičnog i specifičnog mortaliteta, bolovanje ili promatranje povećane potrošnje lijekova. Dva su pokazate-lja mjerena u Sloveniji od 1999.: pojava bolesti slične influenci i stopa pojave akutne dišne bolesti na oko 4% populacije. Lančana reakcija polimerazom uz prethodnu reverznu transkripciju (RT-PCR) bila je rabljena kao pregledna metoda za dokaz virusa influence, respiratornog sincicijskog virusa, adenovirusa i enterovirusa u obriscima nosa i/ili žrijela. Svi pozitivni uzorci bili su zatim nacijepljeni na odgovarajuće stanične linije. RT-PCR je bio upotrijebljen za brzo određivanje hemaglutinina (H1, H3) i neuraminidaze (N1, N2) virusa influence A. Antigenski podtipovi izdvojenih virusa na staničnim kulturama određeni su pomoću testa inhibicije hemaglutinacije te potvrđeni u Europskom referentnom centru za influencu Svjetske zdravstvene organizacije. U sezoni 2004./2005. stopa pojavnosti bolesti slične influenci bila je najveća u 5., 6. i 7. tjednu 2005., kada je dostigla svoj vrhunac (392/100000). Najviša incidencija akutne dišne bolesti ustanovljena je u razdoblju od 31. siječnja do 6. veljače i na toj je razini ostala sljedeća dva tjedna. Uzorci su bili uzeti od 793 bolesnika s kliničkim znakovima bolesti slične influenci. Virus influence A i B bio je dokazan u 15,2% pacijenata. Trećina slučajeva influence bila je uzrokovana podtipom H1N1 dok su ostali bili uzrokovani podtipom H3N2. Enterovirusne infekcije bile su relativno česte u prošloj sezoni (u 15,8% pacijenata). Izolati virusa influence bili su slični onima izdvojenima u drugim europskim zemljama i pripadali su serotipovima A/H3N2/California/7/2004 (A/H3N2/Fujian/441/2002-slični virusi), A/H1N1/New Caledonia/20/99 and B/Jiangsu/10/03 (B/Shanghai/361/2002-slični virusi). Dominantni virus influence u Europi i SAD-u bio je podtip A H3N2. Pojavnost akutne dišne bolesti i/ili influenci slične bolesti bila je veća u usporedbi s prethodnom sezonom u većini europskih zemalja (uključujući i Sloveniju)

Sivi puh (Myoxus glis) kao domadar medicinski važnih mikroorganizama

The fat dormouse (Myoxus glis) was examined as a potential host of hantaviruses and rickettsiae. 98 animals were collected from three different regions in Slovenia (Godovic, Metlika, Sneznik). Serological methods were used for, the detection of specific viral and/or rickesttsial antibodies in animal sera samples. With the PCR method and restriction enzyme digestion, viral and rickettsial genomes were examined. Myoxus glis was confirmed as a host of Hantaan virus. The prevalence of hantaviral infection among the population of Myoxus glis was 13.3 %. It was established that animal age plays a role in the probability of infection with hantaviruses, but not sex. Rickettsial infection was not confirmed in Myoxus glis with any of the methods used.The fat dormouse (Myoxus glis) was examined as a potential host of hantaviruses and rickettsiae. 98 animals were collected from three different regions in Slovenia (Godovic, Metlika, Sneznik). Serological methods were used for, the detection of specific viral and/or rickesttsial antibodies in animal sera samples. With the PCR method and restriction enzyme digestion, viral and rickettsial genomes were examined. Myoxus glis was confirmed as a host of Hantaan virus. The prevalence of hantaviral infection among the population of Myoxus glis was 13.3 %. It was established that animal age plays a role in the probability of infection with hantaviruses, but not sex. Rickettsial infection was not confirmed in Myoxus glis with any of the methods used

Seasonality and Genotype Diversity of Human Rhinoviruses during an Eight-Year Period in Slovenia

Due to the high socioeconomic burden of rhinoviruses, the development of prevention and treatment strategies is of high importance. Understanding the epidemiological and clinical features of rhinoviruses is essential in order to address these issues. Our study aimed to define the seasonality and molecular epidemiology of rhinoviruses in Slovenia. Over a period of eight years, a total of 20,425 patients from sentinel primary healthcare settings and sentinel hospitals were examined for a panel of respiratory viruses in the national programme for the surveillance of influenza-like illnesses and acute respiratory infections. The patients were from all age groups and had respiratory infections of various severity. Infection with a rhinovirus was confirmed using an RT-rPCR in 1834 patients, and 1480 rhinoviruses were genotyped. The molecular analysis was linked to demographical and meteorological data. We confirmed the year-round circulation of rhinoviruses with clear seasonal cycles, resulting in two seasonal waves with peaks in spring and autumn. High levels of genotype variability and co-circulation were confirmed between and within seasons and were analysed in terms of patient age, the patient source reflecting disease severity, and meteorological factors. Our study provides missing scientific information on the genotype diversity of rhinoviruses in Slovenia. As most previous investigations focused on exclusive segments of the population, such as children or hospitalised patients, and for shorter study periods, our study, with its design, size and length, contributes complementary aspects and new evidence-based knowledge to the regional and global understanding of rhinovirus seasonality and molecular epidemiology

Predominance of influenza A(H1N1)pdm09 virus genetic subclade 6B.1 and influenza B/Victoria lineage viruses at the start of the 2015/16 influenza season in Europe

Influenza A(H1N1)pdm09 viruses predominated in the European influenza 2015/16 season. Most analysed viruses clustered in a new genetic subclade 6B.1, antigenically similar to the northern hemisphere vaccine component A/California/7/2009. The predominant influenza B lineage was Victoria compared with Yamagata in the previous season. It remains to be evaluated at the end of the season if these changes affected the effectiveness of the vaccine for the 2015/16 season

Sivi puh (Myoxus glis) kao domadar medicinski važnih mikroorganizama

The fat dormouse (Myoxus glis) was examined as a potential host of hantaviruses and rickettsiae. 98 animals were collected from three different regions in Slovenia (Godovic, Metlika, Sneznik). Serological methods were used for, the detection of specific viral and/or rickesttsial antibodies in animal sera samples. With the PCR method and restriction enzyme digestion, viral and rickettsial genomes were examined. Myoxus glis was confirmed as a host of Hantaan virus. The prevalence of hantaviral infection among the population of Myoxus glis was 13.3 %. It was established that animal age plays a role in the probability of infection with hantaviruses, but not sex. Rickettsial infection was not confirmed in Myoxus glis with any of the methods used.The fat dormouse (Myoxus glis) was examined as a potential host of hantaviruses and rickettsiae. 98 animals were collected from three different regions in Slovenia (Godovic, Metlika, Sneznik). Serological methods were used for, the detection of specific viral and/or rickesttsial antibodies in animal sera samples. With the PCR method and restriction enzyme digestion, viral and rickettsial genomes were examined. Myoxus glis was confirmed as a host of Hantaan virus. The prevalence of hantaviral infection among the population of Myoxus glis was 13.3 %. It was established that animal age plays a role in the probability of infection with hantaviruses, but not sex. Rickettsial infection was not confirmed in Myoxus glis with any of the methods used