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Despite high vaccine coverage with either the whole-cell or acellular vaccine in many countries, the incidence of pertussis has increased globally during the past 20 years (1-4). Disease increase has [...]

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]

Background COVID-19 vaccine effectiveness (VE) studies leveraging systematic surveillance in sub-Saharan Africa are limited. We assessed the effectiveness of two vaccines (Pfizer BNT162b2 and Johnson & Johnson Ad26.COV2.S) against SARS-CoV-2-associated hospitalization in South African adults aged ≥18 years. Methods We conducted a test-negative case-control study using pneumonia surveillance data in South Africa. Inpatients with physician-diagnosed lower respiratory tract infection or suspected COVID-19, testing SARS-CoV-2 positive or negative from June 2021–March 2022, were cases or controls, respectively. Fully vaccinated individuals received one Ad26.COV2.S dose or two BNT162b2 doses ≥14-days before enrollment. VE was estimated using multivariable logistic regression for Delta- and Omicron BA.1/BA.2-predominant periods, stratified by age and HIV status. Results The study included 925 cases and 1890 controls; 38 (4%) cases and 186 (10%) controls were fully vaccinated with BNT162b2, and 30 (3%) cases and 94 (5%) controls with Ad26.COV2.S. The vaccine effectiveness of BNT162b2 against SARS-CoV-2-associated hospitalization over Delta and Omicron BA.1/BA.2 periods was 91% (95% CI: 52%, 98%) and 33% (-16%, 86%), respectively. The vaccine effectiveness of Ad26.COV2.S against hospitalization over Delta and Omicron BA.1/BA.2 periods was 72% (-36% ,94%), and -19% (-130%, 39%), respectively. The vaccine effectiveness of BNT162b2 against hospitalization over the Delta period was 94% (50%, 99%) and 89% (27%, 98%) among adults aged ≥60 years and HIV-uninfected, respectively. Conclusions The BNT162b2 vaccine was effective against SARS-CoV-2-associated hospitalization during the Delta period for adults aged ≥18 years, ≥60 years and those HIV-uninfected. VE for Ad26.COV2.S was inconclusive, potentially due to limited sample size or residual confounding. These findings highlight the utility of sentinel surveillance for estimating VE. [ABSTRACT FROM AUTHOR]

Background: Identifying children at risk for severe COVID‐19 disease from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may guide future mitigation interventions. Using sentinel surveillance data, we aimed to identify risk factors for SARS‐CoV‐2–associated hospitalisation among patients aged ≤ 18 years with respiratory illness. Methods: From April 2020 to March 2022, patients meeting study case definitions were enrolled at four outpatient influenza‐like illness (ILI) and five inpatient severe respiratory infection (SRI) surveillance sites and tested for SARS‐CoV‐2 infection using polymerase chain reaction (PCR). Each ILI clinic shared a catchment area with its corresponding SRI hospital. Potential risk factors for SARS‐CoV‐2–associated hospitalisation were analysed using multivariable logistic regression by comparing inpatient versus outpatient SARS‐CoV‐2 cases. Results: Of 4688 participants aged ≤ 18 years, 4556 (97%) with complete PCR and HIV data were included in the analysis. Among patients with ILI and SRI, 92/1145 (8%) and 154/3411 (5%) tested SARS‐CoV‐2 positive, respectively. Compared to outpatients, hospitalised SARS‐CoV‐2 cases were associated with age < 6 months ([adjusted odds ratio (aOR) 8.0, 95% confidence interval (CI) 2.7–24.0] versus 1–4 years); underlying medical condition other than HIV [aOR 5.8, 95% CI 2.3–14.6]; laboratory‐confirmed Omicron BA.1/BA.2 or Delta variant ([aOR 4.9, 95% CI 1.7–14.2] or [aOR 2.8, 95% CI 1.1–7.3] compared to ancestral SARS‐CoV‐2); and respiratory syncytial virus coinfection [aOR 6.2, 95% CI 1.0–38.5]. Conclusion: Aligning with previous research, we identified age < 6 months or having an underlying condition as risk factors for SARS‐CoV‐2–associated SRI hospitalisation and demonstrated the potential of sentinel surveillance to monitor COVID‐19 in children. [ABSTRACT FROM AUTHOR]

In 1986, [approximately equal to] 4 million deaths were attributed to pneumonia in children Mycoplasma pneumoniae causes respiratory illness and pneumonia with estimated prevalence ranging 2%-35%, depending on the identification [...]

Respiratory diphtheria, caused by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae, is an upper respiratory tract disease characterized by a sore throat; mild fever; and gray-white pseudomembrane on the [...]

Background: Approaches for determining whether influenza vaccination prevents infection, attenuates illness, or both, are important for developing improved vaccines. We estimated influenza infection incidence, and evaluated symptom ascertainment methodologies in children to inform future vaccine trial design., Methods: We conducted a prospective cohort study among children aged 6-23 months from May-October 2022. Study nurses collected symptom and temperature data and mid-turbinate nasal swabs twice-weekly irrespective of symptoms; caregivers entered symptom data daily and collected nasal swabs weekly. Samples were tested for influenza using PCR., Results: Of 230 healthy, screened children, 93 were enrolled of whom 87 (94%) completed 6-months follow-up. 95% (4245/4476) of scheduled nurse, 90% (2045/2276) of caregiver swabs, 99% (92/93) of baseline blood collections and 67% (9245/13768) of scheduled symptom diaries were completed. PCR-confirmed influenza incidence was 65% (60/93) for ≥1 infection; 11 (18%) individuals had 2 and 1 (2%) had 3 episodes. Of 73 episodes, 55 (75%) had ≥1 symptom and 37 (51%) had fever (measured and/or reported). Median infection duration was 7 days (interquartile range 4-9). Human RNase P gene was detected in 99% (2032/2045) of caregiver-collected swabs, through which 5 additional episodes were identified. Per episode, caregiver's diaries of reported and measured fever were 19%(25/73,34%) and 11%(15/73,21%) higher than nurse-reported (11/73,15%) and -measured fevers (7/73,10%), respectively., Conclusions: The incidence of influenza infection was high and mainly symptomatic suggesting that this platform could be suitable for future trials of vaccine efficacy and correlates of protection against infection and illness in children., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)