scholarly journals Vaccine allocation in a declining epidemic

2012 ◽  
Vol 9 (76) ◽  
pp. 2798-2803 ◽  
Author(s):  
E. Goldstein ◽  
J. Wallinga ◽  
M. Lipsitch
Keyword(s):  
High Risk ◽  
Influenza A ◽  
Population Group ◽  
Risk Groups ◽  
Core Group ◽  
School Aged Children ◽  
Risk Of Mortality ◽  
Influenza A H1n1 ◽  
The Usa ◽  
Related Mortality

Sizeable quantities of 2009 pandemic influenza A/H1N1 (H1N1pdm) vaccine in the USA became available at the end of 2009 when the autumn wave of the epidemic was declining. At that point, risk factors for H1N1-related mortality for some of the high-risk groups, particularly adults with underlying health conditions, could be estimated. Although those high-risk groups are natural candidates for being in the top priority tier for vaccine allocation, another candidate group is school-aged children through their role as vectors for transmission affecting the whole community. In this paper, we investigate the question of prioritization for vaccine allocation in a declining epidemic between two groups—a group with a high risk of mortality versus a ‘core’ group with a relatively low risk of mortality but fuelling transmission in the community. We show that epidemic data can be used, under certain assumptions on future decline, seasonality and vaccine efficacy in different population groups, to give a criterion when initial prioritization of a population group with a sufficiently high risk of epidemic-associated mortality is advisable over the policy of prioritizing the core group.

scholarly journals Administration of the Adjuvanted pH1N1 Vaccine in Egg-allergic Children at High Risk for Influenza A/H1N1 Disease

2011 ◽  
Vol 102 (3) ◽  
pp. 196-199 ◽  
Author(s):  
Jane E. SchulerCHEO ◽  
W. James King ◽  
Natalie L. Dayneka ◽  
Lynn Rastelli ◽  
Evelyn Marquis ◽  
...  
Keyword(s):  
High Risk ◽  
Influenza A ◽  
Influenza A H1n1

Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

2011 ◽  
Vol 140 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
N. ARINAMINPATHY ◽  
N. RAPHAELY ◽  
L. SALDANA ◽  
C. HODGEKISS ◽  
J. DANDRIDGE ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Pandemic Influenza ◽  
Summer School ◽  
Influenza A ◽  
Control Measures ◽  
Infection Control Measures ◽  
Influenza A H1n1 ◽  
Hygiene Measures ◽  
The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

scholarly journals Effectiveness of MF59™ Adjuvanted Influenza A(H1N1)pdm09 Vaccine in Risk Groups in the Netherlands

PLoS ONE ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. e63156 ◽  
Author(s):  
Leonoor Wijnans ◽  
Jeanne Dieleman ◽  
Bettie Voordouw ◽  
Miriam Sturkenboom
Keyword(s):  
The Netherlands ◽  
Influenza A ◽  
Risk Groups ◽  
Influenza A H1n1

scholarly journals Seroprevalence of antibodies to influenza A/H1N1/2009 among transmission risk groups after the second wave in Mexico, by a virus-free ELISA method

2011 ◽  
Vol 15 (11) ◽  
pp. e781-e786 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Mario M. Alvarez ◽  
Martín Hernández-Torre ◽  
Patricia A. Ugalde-Casas ◽  
Lorena Lam-Franco ◽  
...  
Keyword(s):  
Influenza A ◽  
Risk Groups ◽  
Transmission Risk ◽  
Elisa Method ◽  
Influenza A H1n1 ◽  
Second Wave

scholarly journals Analysis of Spatial-Temporal Distribution of Respiratory Infectious Diseases in Shandong Province, China During 2005-2014

2020 ◽  
Author(s):  
Xiaomei Li ◽  
Dongzhen Chen ◽  
Yan Zhang ◽  
Xiaojia Xue ◽  
Xuewen Li ◽  
...  
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
Scarlet Fever ◽  
Influenza A ◽  
Temporal Distribution ◽  
Meningococcal Meningitis ◽  
Shandong Province ◽  
Influenza A H1n1 ◽  
Respiratory Infectious Diseases ◽  
Risk Maps

Abstract Background: Little comprehensive information on overall epidemic trend of respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of respiratory infectious diseases.Methods: Time series was firstly performed to describe the temporal distribution feature of respiratory infectious diseases during 2005-2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of respiratory infectious diseases. Global and local Moran’s I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations. Results: A total of 537,506 cases of respiratory infectious diseases were reported in Shandong province during 2005-2014. The morbidity of respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran’s I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively.Conclusions: There were obvious spatiotemporal clusters of respiratory infectious diseases in Shandong during 2005–2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of respiratory infectious diseases to establish new strategies for its control.

scholarly journals Analysis of spatial-temporal distribution of notifiable respiratory infectious diseases in Shandong Province, China during 2005–2014

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaomei Li ◽  
Dongzhen Chen ◽  
Yan Zhang ◽  
Xiaojia Xue ◽  
Shengyang Zhang ◽  
...  
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
Scarlet Fever ◽  
Influenza A ◽  
Temporal Distribution ◽  
Meningococcal Meningitis ◽  
Shandong Province ◽  
Influenza A H1n1 ◽  
Respiratory Infectious Diseases ◽  
Risk Maps

Abstract Background Little comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of notifiable respiratory infectious diseases. Methods Time series was firstly performed to describe the temporal distribution feature of notifiable respiratory infectious diseases during 2005–2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of notifiable respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of notifiable respiratory infectious diseases. Global and local Moran’s I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations. Results A total of 537,506 cases of notifiable respiratory infectious diseases were reported in Shandong Province during 2005–2014. The morbidity of notifiable respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran’s I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively. Conclusions There were obvious spatiotemporal clusters of notifiable respiratory infectious diseases in Shandong during 2005–2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of notifiable respiratory infectious diseases to establish new strategies for its control.

scholarly journals The use of pharmacological protocols during the Covid-19 crisis - a déjà vu of the 2009 A/H1N1 pandemic experience

2020 ◽  
Vol 3 ◽  
Author(s):  
Wladimir Jimenez Alonso ◽  
Cynthia Schuck-Paim ◽  
Veronique Diez Vicera
Keyword(s):  
Influenza A ◽  
Treatment Options ◽  
Risk Groups ◽  
Time Frame ◽  
Conclusive Evidence ◽  
World Health ◽  
Controlled Trials ◽  
Special Importance ◽  
H1n1 Pandemic ◽  
Influenza A H1n1

Only one decade ago, the World Health Organization declared the outbreak of a novel influenza A (H1N1) virus a worldwide pandemic. Then, just as in today’s Covid-19 crisis, treatment options were the center of debate, one of which is of special importance to the current pandemic: the existence of pharmacological treatments that, although available and potentially effective, are approached with reluctance due to concerns around side effects, the development of resistance and lack of conclusive evidence of effectiveness from randomized-controlled trials. History has proven that reluctance to use antivirals during the 2009 A/H1N1 pandemic was unwise, as those countries that restricted their use to at-risk groups and to patients with advanced disease experienced higher mortality. Those same antiviral are now routinely used for seasonal influenza. We revisit this forgotten lesson as a means of weighing in on the debate over the use of new treatments with promising outcomes as observed in clinical practice, but lacking strong evidence from controlled trials, which require a time frame incompatible with that available in unfolding public health emergencies triggered by novel pathogens.

Late morbidity and mortality among survivors of neuroblastoma treated with contemporary therapy: A report from the Childhood Cancer Survivor Study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10044-10044
Author(s):  
Danielle Novetsky Friedman ◽  
Pamela J. Goodman ◽  
Wendy M. Leisenring ◽  
Lisa Diller ◽  
Susan Lerner Cohn ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Malignant Neoplasms ◽  
Intermediate Risk ◽  
High Risk Disease ◽  
Late Morbidity ◽  
All Cause Mortality ◽  
Related Mortality

10044 Background: Survival rates for neuroblastoma vary widely based on risk group. Therapies have evolved over the past four decades to de-intensify treatment for individuals with low/intermediate risk disease and intensify therapy for those with high risk disease. Risk stratification is predicted to result in differential outcomes in late morbidity and mortality; the magnitude of these differences has not been well studied. Methods: We evaluated late mortality, subsequent malignant neoplasms (SMN) and chronic health conditions (CHC) graded according to CTCAE v4.03 among 491 5-year CCSS survivors of neuroblastoma diagnosed 1987-1999 at ≥1 year of age. Using age, stage at diagnosis, and treatment, survivors were classified into risk groups (low [n=182]; intermediate [n=70]; high [n=239]). Standardized mortality ratios (SMR) and standardized incidence ratios (SIR) of SMN were calculated using rates from NCHS and SEER, respectively. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CHC compared to 1,029 CCSS siblings. Results: Among survivors (48% male; median age 22 years, range 7-42; median follow-up 19 years, range 5-29), 80.4% with low risk disease were treated with surgery alone, while 77.8% with high risk disease received surgery, radiation, chemotherapy ± transplant. The 15-year cumulative incidence of all-cause mortality was 9.2% (CI: 7.1-11.4), with a recurrence-related mortality of 7.3% (CI: 5.3-9.3) and SMN-related mortality of 0.3% (CI: 0-0.7). All-cause mortality was significantly higher in all risk groups: (low, SMR=5.8 [CI: 2.6-13.0]; intermediate, SMR=5.7 [CI: 1.4-23.5]; high, SMR=38.6 [CI: 27.9-53.5]). The risk of SMN was elevated among high risk survivors (SIR=25.1, CI: 16.7-37.6), but did not differ from the US population for survivors of low or intermediate risk disease. Table describes the HR of CHCs (grades 1-5 and 3-5) in survivors, by risk group, as compared with siblings, as well as categories of CHCs for which survivors were at increased risk. Conclusions: Long-term survivors of neuroblastoma have a high risk of late morbidity and mortality; risk is particularly pronounced among survivors of high risk disease. Vigilant lifelong medical surveillance will be required for this relatively young population as they age.[Table: see text]

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