Two years of experience in hospital surveillance for the severe influenza like illnesses in St. Petersburg: etiology, clinical characterization of diseases, antigenic and genetic properties of isolated influenza viruses

In this paper, we analyze the etiology of the diseases occurring during two consecutive influenza epidemic seasons in St. Petersburg, Russian Federation. The analysis is based on the results of the PCR diagnostics of the clinical samples collected from patients hospitalized in three St. Petersburg hospitals with influenza like illnesses (ILI). It was shown that the influenza virus A(H1N1)pdm09 was the dominant causative agent during the 2012-2013 epidemic season while, in the 2013-2014 season, A(H3N2) virus was predominant among adults and children. The influenza B virus activity was high in the 2012-2013 season and low in the 2013-2014 season. During both seasons, the main causative agent for the hospitalization of young children was respiratory syncytial virus (RSV), followed by rhinovirus and influenza virus. The rate of involvement of parainfluenza, adenovirus, metapneumovirus and coronavirus was low and was negligible for bocavirus. Children 0-2 and 3-6 years old formed the group of patients that was affected by acute respiratory infection agents the most. Children younger than 3 months old were the major group of the intensive care unit (ICUs) patients and only 27.5% of them were adults. RSV and rhinovirus were the leading cause of ILI among the children admitted to ICU. Among the adult patients admitted to the ICU, only influenza A(H1N1)pdm09, A(H3N2) and B viruses were detected during both influenza seasons.According to the results of the antigenic and genetic analysis, most influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in St. Petersburg matched the vaccine strains recommended by the WHO for vaccine composition in the 2012-2013 and 2013-2014 seasons.In this paper, we analyze the etiology of the diseases occurring during two consecutive influenza epidemic seasons in St. Petersburg, Russian Federation. The analysis is based on the results of the PCR diagnostics of the clinical samples collected from patients hospitalized in three St. Petersburg hospitals with influenza like illnesses (ILI). It was shown that the influenza virus A(H1N1)pdm09 was the dominant causative agent during the 2012-2013 epidemic season while, in the 2013-2014 season, A(H3N2) virus was predominant among adults and children. The influenza B virus activity was high in the 2012-2013 season and low in the 2013-2014 season. During both seasons, the main causative agent for the hospitalization of young children was respiratory syncytial virus (RSV), followed by rhinovirus and influenza virus. The rate of involvement of parainfluenza, adenovirus, metapneumovirus and coronavirus was low and was negligible for bocavirus. Children 0-2 and 3-6 years old formed the group of patients that was affected by acute respiratory infection agents the most. Children younger than 3 months old were the major group of the intensive care unit (ICUs) patients and only 27.5% of them were adults. RSV and rhinovirus were the leading cause of ILI among the children admitted to ICU. Among the adult patients admitted to the ICU, only influenza A(H1N1)pdm09, A(H3N2) and B viruses were detected during both influenza seasons. According to the results of the antigenic and genetic analysis, most influenza A(H1N1)pdm09 and A(H3N2) viruses circulating in St. Petersburg matched the vaccine strains recommended by the WHO for vaccine composition in the 2012-2013 and 2013-2014 seasons

ОСЕЛЬТАМИВИР — СРЕДСТВО ПРОТИВОВИРУСНОЙ ТЕРАПИИ ГРИППА A(H1N1)pdm09 У ДЕТЕЙ И ВЗРОСЛЫХ

In this article are presented the results of comparative of experimental (on cell cultures) study of the influenza virus strains sensitivity to neuraminidase  inhibitor — Oseltamivir and blocker of M-canal — Rimantadin аnd the results of study effectiveness of the inclusion in the complex therapy of 331 hospitalized patients (children and adults) rapy of А(Н1N1)pdm09 antiviral drug — inhibitor of neuraminidase Oseltamivir that occurred during the epidemic seasons 2009—2010 and 2015—2016  in terms of observational clinical studies.  It is shown that this drug, can be successfully used in the treatment of children and adults with influenza А(Н1N1)pdm09 during 8—9 years after beginning of pandemic cycle.Представлены  результаты сравнительного  исследования чувствительности  вирусов гриппа  к противовирусным препаратам, ингибитору нейраминидазы — осельтамивиру и блокатору М2 канала — римантадину, а также данные изучения лечебной эффективности осельтамивира в терапии 331 пациента (детей и взрослых) с верифицированным  гриппом А(H1N1)pdm/2009, госпитализированных в течение эпидсезонов 2009—2010  и 2015—2016  гг. в условиях наблюдательного клинического исследования. Показано, что препарат может успешно использоваться при лечении детей и взрослых с гриппом А(Н1N1)pdm09 и через 8—9 лет после начала пандемического цикла

OSELTAMIVIR AS ANTIVIRAL THERAPY OF INFLUENZA A(H1N1)pdm09 IN CHILDREN AND ADULTS

In this article are presented the results of comparative of experimental (on cell cultures) study of the influenza virus strains sensitivity to neuraminidase  inhibitor — Oseltamivir and blocker of M-canal — Rimantadin аnd the results of study effectiveness of the inclusion in the complex therapy of 331 hospitalized patients (children and adults) rapy of А(Н1N1)pdm09 antiviral drug — inhibitor of neuraminidase Oseltamivir that occurred during the epidemic seasons 2009—2010 and 2015—2016  in terms of observational clinical studies.  It is shown that this drug, can be successfully used in the treatment of children and adults with influenza А(Н1N1)pdm09 during 8—9 years after beginning of pandemic cycle

ОСЕЛЬТАМИВИР — СРЕДСТВО ПРОТИВОВИРУСНОЙ ТЕРАПИИ ГРИППА A(H1N1)pdm09 У ДЕТЕЙ И ВЗРОСЛЫХ

In this article are presented the results of comparative of experimental (on cell cultures) study of the influenza virus strains sensitivity to neuraminidase  inhibitor — Oseltamivir and blocker of M-canal — Rimantadin аnd the results of study effectiveness of the inclusion in the complex therapy of 331 hospitalized patients (children and adults) rapy of А(Н1N1)pdm09 antiviral drug — inhibitor of neuraminidase Oseltamivir that occurred during the epidemic seasons 2009—2010 and 2015—2016  in terms of observational clinical studies.  It is shown that this drug, can be successfully used in the treatment of children and adults with influenza А(Н1N1)pdm09 during 8—9 years after beginning of pandemic cycle.Представлены  результаты сравнительного  исследования чувствительности  вирусов гриппа  к противовирусным препаратам, ингибитору нейраминидазы — осельтамивиру и блокатору М2 канала — римантадину, а также данные изучения лечебной эффективности осельтамивира в терапии 331 пациента (детей и взрослых) с верифицированным  гриппом А(H1N1)pdm/2009, госпитализированных в течение эпидсезонов 2009—2010  и 2015—2016  гг. в условиях наблюдательного клинического исследования. Показано, что препарат может успешно использоваться при лечении детей и взрослых с гриппом А(Н1N1)pdm09 и через 8—9 лет после начала пандемического цикла.</p

Influenza Epidemiology And Influenza Vaccine Effectiveness During The 2016-2017 Season In The Global Influenza Hospital Surveillance Network (Gihsn)

BackgroundThe Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hospital-based epidemiological study to collect epidemiological data in the GIHSN. In the 2016-2017 influenza season, 15 sites in 14 countries participated in the GIHSN, although the analyses could not be performed in 2 sites. A common core protocol was used in order to make results comparable. Here we present the results of the GIHSN 2016-2017 influenza season.MethodsA RT-PCR test was performed to all patients that accomplished the requirements detailed on a common core protocol. Patients admitted were included in the study after signing the informed consent, if they were residents, not institutionalised, not discharged in the previous 30days from other hospitalisation with symptoms onset within the 7days prior to admission. Patients 5years old or more must also complied the Influenza-Like Illness definition. A test negative-design was implemented to perform IVE analysis. IVE was estimated using a logistic regression model, with the formula IVE=(1-aOR)x100, where aOR is the adjusted Odds Ratio comparing cases and controls.ResultsAmong 21,967 screened patients, 10,140 (46.16%) were included, as they accomplished the inclusion criteria, and tested, and therefore 11,827 (53.84%) patients were excluded. Around 60% of all patients included with laboratory results were recruited at 3 sites. The predominant strain was A(H3N2), detected in 63.6% of the cases (1840 patients), followed by B/Victoria, in 21.3% of the cases (618 patients). There were 2895 influenza positive patients (28.6% of the included patients). A(H1N1)pdm09 strain was mainly found in Mexico. IVE could only be performed in 6 sites separately. Overall IVE was 27.24 (95% CI 15.62-37.27. Vaccination seemed to confer better protection against influenza B and in people 2-4years, or 85years old or older. The aOR for hospitalized and testing positive for influenza was 3.02 (95% CI 1.59-5.76) comparing pregnant with non-pregnant women.ConclusionsVaccination prevented around 1 in 4 hospitalisations with influenza. Sparse numbers didn't allow estimating IVE in all sites separately. Pregnancy was found a risk factor for influenza, having 3 times more risk of being admitted with influenza for pregnant women.Wo