Influenza and other respiratory viruses
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Influenza Other Respi Viruses · Jan 2013
Mucosal antibody responses are directed by viral burden in children with acute influenza infection.
Influenza infection causes excess hospitalizations and deaths in younger patients, but susceptibility to severe disease is poorly understood. While mucosal antibodies can limit influenza-associated infection and disease, little is known about acute mucosal antibody responses to influenza infection. ⋯ B lymphocytes were abundant in lung tissue of infants with fatal acute influenza LRI. Among surviving children with H1N1 infection, only a small subset (11%) demonstrated H1N1 neutralizing activity in NPS. H1N1 neutralizing activity coincided with high local levels of antiviral IgM, IgG and IgA, greater detection of inflammatory mediators, and higher viral burden (P = 0·016). Patients with mucosal antiviral antibody responses demonstrated more severe respiratory symptoms including greater hypoxia (P = 0·0018) and pneumonia (P = 0·038). These patients also trended toward younger age, longer duration of illness and longer hospital stays. Prophylaxis strategies that heighten neutralizing antibody production in the mucosa are likely to benefit both older and younger children.
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Influenza Other Respi Viruses · Jan 2013
Impact of viral infections in children with community-acquired pneumonia: results of a study of 17 respiratory viruses.
Little is known about the prevalence of viral infections in children with community-acquired pneumonia (CAP). ⋯ The findings of this study highlight the importance of respiratory viruses (mainly RSV and rhinovirus) in children with CAP and show the characteristics of both the single infections and co-infections associated with the disease.
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Influenza Other Respi Viruses · Nov 2012
Patterns in influenza antiviral medication use before and during the 2009 H1N1 pandemic, Vaccine Safety Datalink Project, 2000-2010.
U.S. recommendations for using influenza antiviral medications changed in response to viral resistance (to reduce adamantane use) and during the 2009 H1N1 pandemic (to focus on protecting high-risk patients). Little information is available on clinician adherence to these recommendations. We characterized population-based outpatient antiviral medication usage, including diagnosis and testing practices, before and during the pandemic. ⋯ Antiviral medication usage patterns suggest that clinicians followed recommendations to change antiviral prescribing based on resistance and to focus on high-risk patients during the pandemic. Medications were commonly dispensed to patients without influenza diagnoses and tests, suggesting that antiviral dispensings may offer useful supplemental data for monitoring influenza incidence.
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Influenza Other Respi Viruses · Nov 2012
Intensive care unit patients with 2009 pandemic influenza A (H1N1pdm09) virus infection - United States, 2009.
The influenza A (H1N1pdm09) [pH1N1] virus resulted in intensive care unit (ICU) admissions, acute respiratory distress syndrome (ARDS), and death. ⋯ Among patients hospitalized in an ICU with pH1N1 virus infection, ARDS was a common complication, and one-quarter of patients died. Patients with asthma had less severe outcomes. Early treatment with influenza antiviral agents was likely beneficial, especially when initiated ≤ 2 days after illness onset.