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OBJECTIVE: Estimates of the burden of influenza are needed to inform prevention and control activities for seasonal influenza, including to support the development of appropriate vaccination policies. We used sentinel surveillance data on severe acute respiratory infection (SARI) to estimate the burden of influenza-associated hospitalizations in the Lao Peoples Democratic Republic. METHODS: Using methods developed by the World Health Organization, we combined data from hospital logbook reviews with epidemiological and virological data from influenza surveillance from 1 January to 31 December 2016 in defined catchment areas for two sentinel sites (Champasack and Luang Prabang provincial hospitals) to derive population-based estimates of influenza-associated SARI hospitalization rates. Hospitalization rates by age group were then applied to national age-specific population estimates using 2015 census data. RESULTS: We estimated the overall influenza-associated SARI hospitalization rate to be 48/100 000 population (95% confidence interval [CI]: 44-51) or 3097 admissions (95% CI: 2881-3313). SARI hospitalization rates were estimated to be as low as 40/100 000 population (95% CI: 37-43) and as high as 92/100 000 population (95% CI: 87-98) after accounting for SARI patient underascertainment in hospital logbooks. Influenza-associated SARI hospitalization rates were highest in children aged

Background: Surveillance programmes for influenza and other respiratory pathogens are important to generate vaccine effectiveness (VE) estimates and to inform vaccine composition. We aimed to explore the feasibility and acceptability of home‐based testing. Methods: In three out of nine provinces in South Africa, we established a self‐referral system for individuals aged ≥ 18 years with respiratory symptoms of ≤ 10 days duration. Following consent, swab collection material was delivered to participants who also completed a questionnaire including self‐reported vaccination status. Swabs were tested by PCR for influenza, respiratory syncytial virus (RSV) and SARS‐CoV‐2. A test‐negative methodology was used to estimate influenza VE. Results: Of 1456 samples collected between 19 November 2021 and 3 September 2022, 73 (5%) tested positive for influenza, 38 (3%) tested positive for RSV and 394 (27%) for SARS‐CoV‐2. We subtyped 55% (40/73) of the influenza positive specimens; 16/40 (40%) were influenza A(H1N1)pdm09; 10/40 (25%)A(H3N2)) and all 14/40(35%) influenza B were B/Victoria. Only 20% (279/1451) of participants reported influenza‐like illness case definition symptoms of fever and cough. Influenza vaccine coverage was 11% (157/1454). The overall influenza VE was 26% (95% confidence interval: −73%, 69%). Of the completed acceptability questionnaires, 123/127 (97%) participants would make use of the service again; 90% (1306) were recruited via the COVID‐19 testing centre (call in, social media, webpage), and 7% (99/1306) through CoughWatchSA. Conclusions: Home‐based swabbing was feasible and acceptable. We were able to calculate an influenza VE, although a larger sample size and verification of vaccine status may improve the VE estimates in the future. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The burden of influenza in Cambodia is not well known, but it would be useful for understanding the impact of seasonal epidemics and pandemics and to design appropriate policies for influenza prevention and control. The severe acute respiratory infection (SARI) surveillance system in Cambodia was used to estimate the national burden of SARI hospitalizations in Cambodia. METHODS: We estimated age-specific influenza-associated SARI hospitalization rates in three sentinel sites in Svay Rieng, Siem Reap and Kampong Cham provinces. We used influenza-associated SARI surveillance data for one year to estimate the numerator and hospital admission surveys to estimate the population denominator for each site. A national influenza-associated SARI hospitalization rate was calculated using the pooled influenza-associated SARI hospitalizations for all sites as a numerator and the pooled catchment population of all sites as denominator. National influenza-associated SARI case counts were estimated by applying hospitalization rates to the national population. RESULTS: The national annual rates of influenza-associated hospitalizations per 100 000 population was highest for the two youngest age groups at 323 for

The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009- 2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza--i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to Include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed In the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden. La formulation de definitions precises de cas cliniques fait partie integrente d'un processus efncace de surveillance de la sante publique. Alors que ees definitions devraient, dans l'ideal, s'appuyer sur un ensemble standardise et fixe de criteres de definition, elles necessitent souvent une revision pour tenir compte des nouvelles connaissances relatives a la maladie concernee et des ameliorations apportees aux tests diagnostiques. Pour etre optimales, les definitions de cas doivent aussi etablir un equilibre entre sensibilite et specificite qui reflete leur utilisation aux fins prevues. A la suite de la pandemie de grippe H1N1 de 2009-2010, l'Organisation mondiale de la Sante (OMS) a lance une consultation technique sur la surveillance mondiale de la grippe. Cela a conduit a des ameliorations concernant la sensibilite et la specificite de la definition de cas pour la grippe--c'est-a-dire une maladie respiratoire dont seule la symptomatologie reste a definir. Le processus de revision n'a pas seulement modifie la definition du syndrome de type grippal pour indure une liste simplifiee des criteres le mieux a meme de predire une infection grippale, il a egalement permis de clarifier le langage utilise dans la definition pour en ameliorer Interpretation. Par ailleurs, afin de tenir compte des cas severes de grippe qui necessitaient une hospitalisation, une nouvelle definition de cas a ete introduite concernant l'infection aigue severe des voies respiratoires dans tous les groupes d'age. Il a ete constate que les nouvelles definitions refletaient davantage de cas, sans pour autant compromettre la specificite. S'il est vral que la distinction clinique de la grippe des autres infections respiratoires continue de poser probleme, l'utilisation mondiale des nouvelles definitions de cas de l'OMS devralt permettre de degager des tendances mondiales concernant les caracteristiques et la transmission des virus grippaux ainsi que la charge de morbidite qui leur est associee. La elaboracion de definiciones precisas de los casos clinicos es una parte fundamental de un proceso efectivo de la vigilancia de la salud publica. Aunque tales definiciones deberian, idealmente, estar basadas en una recopilacion estandarizada y fija de criterios de definicion, a menudo necesitan una revision para reflejar el nuevo conocimiento de la enfermedad existente y las mejoras en las pruebas de diagnostico. Las definiciones optimas de los casos tambien deben tener un equilibrio entre sensibilidad y especificidad que refleje su uso previsto. Despues de la pandemia de gripe H1N1 en 2009-2010, la Organizacion Mundial de la Salud (OMS) inicio una consulta tecnica para la vigilancia mundial de la gripe. Esto dio lugar a mejoras en la sensibilidad y la especificidad de las definiciones de los casos de gripe, es decir, una enfermedad respiratoria que carece de una sintomatologia definitoria singular. El proceso de revision no solo modifico la definicion de las enfermedades similares a la gripe para incluir una lista simplificada de los criterios que demostraron ser mas predictivos de la infeccion por gripe, sino que tambien aclaro el lenguaje utilizado para la definicion, con el fin de mejorar su interpretacion. Para englobar los casos graves de gripe que requirieron hospitalizacion, tambien se desarrollo una nueva definicion de los casos de la infeccion respiratoria aguda grave en todos los grupos de edad. Se ha descubierto que las nuevas definiciones engloban mas casos sin comprometer la especificidad. A pesar del desafio que todavia plantea la separacion clinica de la gripe de otras infecciones respiratorias, el uso global de las nuevas definiciones de los casos de la OMS deberia ayudar a determinar las tendencias mundiales en las caracteristicas y transmision de los virus de la gripe y la carga de la enfermedad asociada., Introduction Case definitions form an important part of standardized systems for public health surveillance. They can be used in the reporting of the conditions under surveillance, the monitoring of geographical [...]

Aims: Seasonal influenza vaccination is strongly recommended in patients with heart failure (HF). The NUDGE‐FLU trial recently found two electronic behavioural nudging letter strategies – a letter highlighting potential cardiovascular benefits of vaccination and a repeated letter at day 14 –effective in increasing influenza vaccination in Denmark. The aims of this pre‐specified analysis was to further examine vaccination patterns and effects of these behavioural nudges in patients with HF including potential off‐target effects on guideline‐directed medical therapy (GDMT) use. Methods and results: The nationwide NUDGE‐FLU trial randomized 964 870 Danish citizens ≥65 years to usual care or nine different electronic nudging letter strategies. Letters were delivered through the official Danish electronic letter system. The primary endpoint was the receipt of an influenza vaccine; additional outcomes for this analysis included GDMT use. In this analysis, we also assessed influenza vaccination rates in the overall Danish HF population including those <65 years (n = 65 075). During the 2022–2023 season, influenza vaccination uptake was 71.6% in the overall Danish HF population but this varied considerably with only 44.6% uptake in those <65 years. A total of 33 109 NUDGE‐FLU participants had HF at baseline. Vaccination uptake was higher among those on higher levels of baseline GDMT (≥3 classes: 85.3% vs. ≤2 classes: 81.9%; p < 0.001). HF status did not modify the effects of the two overall successful nudging strategies on influenza vaccination uptake (cardiovascular gain‐framed letter: pinteraction = 0.37; repeated letter: pinteraction = 0.55). No effect modification was observed across GDMT use levels for the repeated letter (pinteraction = 0.88), whereas a trend towards attenuated effect among those on low levels of GDMT was observed for the cardiovascular gain‐framed letter (pinteraction = 0.07). The letters had no impact on longitudinal GDMT use. Conclusions: Approximately one in four patients with HF did not receive influenza vaccination with a pronounced implementation gap in those <65 years where less than half were vaccinated. HF status did not modify the effectiveness of cardiovascular gain‐framed and repeated electronic nudging letters in increasing influenza vaccination rates. No unintended negative effects on longitudinal GDMT use were observed. Clinical Trial Registration: ClinicalTrials.gov NCT05542004. [ABSTRACT FROM AUTHOR]

Henipaviruses belong to a genus of recently emerging viruses within the family Paramyxoviridae (1-3) and include 2 zoonotic members: Hendra virus (HeV) and Nipah virus (NiV). HeV was first described [...]

Acute respiratory infections (ARIs) and diarrheal diseases cause substantial illness and death worldwide. Most of the estimated 5.5 million deaths associated with ARI and diarrhea occur in children from resource-limited [...]

Abstract Background Brucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis. Methods Brucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI) patients presenting to a network of infectious disease hospitals from 1999–2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results A total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64%) and 7 (2%) of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p Conclusions Despite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis.