scholarly journals Near Real-time Surveillance of Disease during 2016-17 Influenza Season in the U.S.

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Sushruth K. Reddy ◽  
Jhobe Steadman ◽  
John Tamerius
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Real Time ◽  
Influenza A ◽  
Influenza Season ◽  
The United States ◽  
Influenza B ◽  
Test Results ◽  
Influenza Activity ◽  
The U.S

ObjectiveDemonstrate performance of the Virena Global Wireless Surveillance System, an automated platform utilized in conjunction with the Sofia FIA Analyzer, for near real-time transmission of infectious disease test results to public health and other healthcare organizations.IntroductionPublic health agencies worldwide all enjoy the same mission—providing healthcare warnings, guidance, and support to the public and healthcare professionals they represent. A critical element in achieving this mission is accessing timely and comprehensive surveillance information about disease in their regions of responsibility. Advances in diagnostic technologies for infectious disease and in the wireless conveyance of information hold great promise for advancing the quality of surveillance information and in facilitating the delivery of timely, accurate, and impactful public health information. Quidel Corporation has developed a cloud–based, wireless communications system that is fully integrated with its Sofia fluorescence immunoassay (FIA) platform for rapid, point-of-care diagnosis of infectious disease. The system, called the Virena Global Wireless Surveillance System (hereinafter, Virena) provides test results to public health organizations and other appropriate entities in near-real time. Currently, more than 4,000 Sofia instruments are transmitting results automatically by Virena. This presentation describes the use of Virena in surveilling influenza in the U.S. in the 2016-2017 influenza season, when over 700,000 influenza-like-illness (ILI) patient results were transmitted. The methods employed, results, and the promise of this innovative system will be discussed.MethodsThe Sofia Fluorescent Immunoassay Analyzer (FIA) is a small FDA-cleared, CLIA-waived bench top device that uses immunofluorescence-based, lateral-flow technology for rapid analyte detection within 15 minutes for influenza. With Sofia2, a recent upgrade, positive influenza test results can be obtained in as few as 3 minutes, depending on virus levels. The results are encrypted, and automatically transmitted by Virena--often within 5 seconds--to a dual cloud system for further encryption and formatting. The test results (also including location, date, and patient age) are subsequently pushed to participating public health and healthcare organizations for daily collection and analysis. Healthcare providers utilizing the Virena system may also access their own data and facility-de-identified regional and national data, using a password-enabled internet application called MyVirena.com.ResultsBetween August 1, 2016 and October 6, 2017, 706,654 ILI patient results were transmitted by Virena from over 3,000 clinical sites in the United States. The influenza positivity rate (influenza A and B combined) peaked on February 9th at 33% and maintained this level for two weeks (Figure 1). During this period, as many as 7,048 results were transmitted by Virena per day. Influenza A activity peaked on the same day at 26%, and influenza B peaked at 18% nearly 6.5 weeks later. In the six months from December 15th to June 15th, the influenza positivity rate for patients with ILI was 10% or greater in the United States. Data analysis for individual states revealed significant differences in time of onset of influenza and in the peak positivity rates. For example, the state of Arizona experienced peak positivity rates for influenza activity (42%) as late as mid-May, driven largely by influenza B. In California, influenza A peaked at 43% on January 16th and maintained a positivity rate greater than 15% for nearly three months, while influenza B averaged below 4% for the entire period. Age-specific analysis showed that children in the 2 to 18 year old group had the highest positivity rate (44%, n=251,756) and the longest incidence period. Virena data demonstrated similar influenza activity trends on national and regional levels as that depicted by the clinical laboratory and NREVSS data collected by the CDC; however, the Virena data were collected and reported sooner (Figure 2).ConclusionsThe Virena system represents a major stride for disease surveillance, providing clinical testing data in near real-time time, with local, national, and global scope. This first substantial evaluation of the Virena system, with over 4,000 transmitting Sofia Analyzers, demonstrates capabilities for near real-time assessment of disease onset, regionally varying positivity rates, durations of outbreaks, differential assessment of influenza A and B prevalence, and dynamic mapping throughout the year. With expanding regional and metropolitan coverage, the Virena system holds promise as both a powerful surveillance tool, and as a valuable resource for healthcare quality initiatives, epidemiological research, and the development of new mathematical models for influenza forecasting .

scholarly journals Virological analysis of fatal influenza cases in the United Kingdom during the early wave of influenza in winter 2010/11

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
J Ellis ◽  
M Galiano ◽  
R Pebody ◽  
A Lackenby ◽  
CI Thompson ◽  
...  
Keyword(s):  
United Kingdom ◽  
Vaccine Strain ◽  
Influenza A ◽  
Influenza Season ◽  
Severe Illness ◽  
Influenza B ◽  
The United Kingdom ◽  
Influenza A H1n1 ◽  
Influenza Activity ◽  
Children And Young Adults

The 2010/11 winter influenza season is underway in the United Kingdom, with co-circulation of influenza A(H1N1)2009 (antigenically similar to the current 2010/11 vaccine strain), influenza B (mainly B/Victoria/2/87 lineage, similar to the 2010/11 vaccine strain) and a few sporadic influenza A(H3N2) viruses. Clinical influenza activity has been increasing. Severe illness, resulting in hospitalisation and deaths, has occurred in children and young adults and has predominantly been associated with influenza A(H1N1)2009, but also influenza B viruses.

scholarly journals Public health implications of influenza B outbreaks in closed settings in the United Kingdom in the 2007/08 influenza season

2008 ◽  
Vol 13 (38) ◽  
Author(s):  
P Mook ◽  
J Ellis ◽  
J M Watson ◽  
CI Thompson ◽  
M Zambon ◽  
...  
Keyword(s):  
Public Health ◽  
United Kingdom ◽  
Burden Of Disease ◽  
Influenza A ◽  
Health Management ◽  
Influenza Season ◽  
Influenza B ◽  
Influenza A Viruses ◽  
School Aged Children ◽  
The United Kingdom

Several influenza B outbreaks occurred in closed settings late in the 2007/08 influenza season (October to mid-May) in the United Kingdom (UK), with implications for public health management. Influenza B viruses usually circulate late in the season and cause a milder disease than influenza A viruses [1]. Epidemics of influenza B usually occur every two to three years with the burden of disease falling predominantly on school-aged children [2].

scholarly journals Spotlight influenza: The 2019/20 influenza season and the impact of COVID-19 on influenza surveillance in the WHO European Region

2021 ◽  
Vol 26 (40) ◽  
Author(s):  
Cornelia Adlhoch ◽  
Miriam Sneiderman ◽  
Oksana Martinuka ◽  
Angeliki Melidou ◽  
Nick Bundle ◽  
...  
Keyword(s):  
Influenza A ◽  
Influenza Season ◽  
Healthcare Access ◽  
World Health ◽  
European Region ◽  
Influenza Surveillance ◽  
Influenza B ◽  
Rapid Reduction ◽  
Influenza Activity ◽  
The Impact

Background Annual seasonal influenza activity in the northern hemisphere causes a high burden of disease during the winter months, peaking in the first weeks of the year. Aim We describe the 2019/20 influenza season and the impact of the COVID-19 pandemic on sentinel surveillance in the World Health Organization (WHO) European Region. Methods We analysed weekly epidemiological and virological influenza data from sentinel primary care and hospital sources reported by countries, territories and areas (hereafter countries) in the European Region. Results We observed co-circulation of influenza B/Victoria-lineage, A(H1)pdm09 and A(H3) viruses during the 2019/20 season, with different dominance patterns observed across the Region. A higher proportion of patients with influenza A virus infection than type B were observed. The influenza activity started in week 47/2019, and influenza positivity rate was ≥ 50% for 2 weeks (05–06/2020) rather than 5–8 weeks in the previous five seasons. In many countries a rapid reduction in sentinel reports and the highest influenza activity was observed in weeks 09–13/2020. Reporting was reduced from week 14/2020 across the Region coincident with the onset of widespread circulation of SARS-CoV-2. Conclusions Overall, influenza type A viruses dominated; however, there were varying patterns across the Region, with dominance of B/Victoria-lineage viruses in a few countries. The COVID-19 pandemic contributed to an earlier end of the influenza season and reduced influenza virus circulation probably owing to restricted healthcare access and public health measures.

scholarly journals Tracking and predicting U.S. influenza activity with a real-time surveillance network

2020 ◽  
Vol 16 (11) ◽  
pp. e1008180
Author(s):  
Sequoia I. Leuba ◽  
Reza Yaesoubi ◽  
Marina Antillon ◽  
Ted Cohen ◽  
Christoph Zimmer
Keyword(s):  
United States ◽  
Real Time ◽  
Logistic Models ◽  
The United States ◽  
Test System ◽  
Test Results ◽  
Surveillance Network ◽  
Physician Visits ◽  
National Network ◽  
Influenza Activity

Each year in the United States, influenza causes illness in 9.2 to 35.6 million individuals and is responsible for 12,000 to 56,000 deaths. The U.S. Centers for Disease Control and Prevention (CDC) tracks influenza activity through a national surveillance network. These data are only available after a delay of 1 to 2 weeks, and thus influenza epidemiologists and transmission modelers have explored the use of other data sources to produce more timely estimates and predictions of influenza activity. We evaluated whether data collected from a national commercial network of influenza diagnostic machines could produce valid estimates of the current burden and help to predict influenza trends in the United States. Quidel Corporation provided us with de-identified influenza test results transmitted in real-time from a national network of influenza test machines called the Influenza Test System (ITS). We used this ITS dataset to estimate and predict influenza-like illness (ILI) activity in the United States over the 2015-2016 and 2016-2017 influenza seasons. First, we developed linear logistic models on national and regional geographic scales that accurately estimated two CDC influenza metrics: the proportion of influenza test results that are positive and the proportion of physician visits that are ILI-related. We then used our estimated ILI-related proportion of physician visits in transmission models to produce improved predictions of influenza trends in the United States at both the regional and national scale. These findings suggest that ITS can be leveraged to improve “nowcasts” and short-term forecasts of U.S. influenza activity.

scholarly journals Anomalous influenza seasonality in the United States and the emergence of novel influenza B viruses

2021 ◽  
Vol 118 (5) ◽  
pp. e2012327118
Author(s):  
Rebecca K. Borchering ◽  
Christian E. Gunning ◽  
Deven V. Gokhale ◽  
K. Bodie Weedop ◽  
Arash Saeidpour ◽  
...  
Keyword(s):  
United States ◽  
Influenza A ◽  
Reproduction Number ◽  
Influenza Season ◽  
The United States ◽  
Influenza B ◽  
Relative Dynamics ◽  
2009 H1n1 ◽  
Kinetics Of ◽  
Early Activity

The 2019/2020 influenza season in the United States began earlier than any season since the 2009 H1N1 pandemic, with an increase in influenza-like illnesses observed as early as August. Also noteworthy was the numerical domination of influenza B cases early in this influenza season, in contrast to their typically later peak in the past. Here, we dissect the 2019/2020 influenza season not only with regard to its unusually early activity, but also with regard to the relative dynamics of type A and type B cases. We propose that the recent expansion of a novel influenza B/Victoria clade may be associated with this shift in the composition and kinetics of the influenza season in the United States. We use epidemiological transmission models to explore whether changes in the effective reproduction number or short-term cross-immunity between these viruses can explain the dynamics of influenza A and B seasonality. We find support for an increase in the effective reproduction number of influenza B, rather than support for cross-type immunity-driven dynamics. Our findings have clear implications for optimal vaccination strategies.

scholarly journals Epidemiological and virological assessment of influenza activity in Europe, during the 2004-2005 winter

2006 ◽  
Vol 11 (5) ◽  
pp. 9-10 ◽  
Author(s):  
A Meijer ◽  
W J Paget ◽  
T J Meerhoff ◽  
C S Brown ◽  
L. E. Meuwissen ◽  
...  
Keyword(s):  
Influenza A ◽  
Historical Data ◽  
Influenza Season ◽  
World Health ◽  
Influenza B ◽  
The West ◽  
Influenza Activity ◽  
Health Organization ◽  
H3 Subtype ◽  
Reference Strains

The 2004-2005 influenza season in Europe started in late December 2004 and the first influenza activity occurred in the west and southwest (Spain, United Kingdom and Ireland). Influenza activity then moved gradually east across Europe during January and early February 2005, and from late February until late March, most movement was south to north. The intensity of clinical influenza activity in ten out of 23 countries was higher than during the 2003-2004 season, and lower or equal to the 2003-2004 season in the other 13 countries. The highest consultation rates were generally observed among children aged 0-14 years. However, the peak consultation rates due to influenza-like illness or acute respiratory infection were not especially high when compared with historical data. The predominant virus strain was influenza A (83% of total detections) of the H3 subtype (85% of H-subtyped A viruses), with fewer influenza B (17% of total detections) or A(H1) viruses (15 % of H-subtyped A viruses) detected. The vast majority of A(H3) viruses were similar to the reference strains A/Wellington/1/2004 (H3N2) and, subsequently, A/California/7/2004 (H3N2) that are closely related drift variants of the A/Fujian/411/2002 (H3N2) prototype vaccine strain. The B viruses co-circulated with A viruses during the whole influenza season in 11 out of 24 countries. Seven of these were located in the northeast of Europe and in these countries the proportion of B viruses was higher (range: 31-60%) than in the rest of Europe (range: 6-26%). In 13 out of 24 countries the B viruses circulated relatively late in the season. About 43% of all antigenically characterised B viruses were B/Hong Kong/330/2001-like (B/Victoria/2/87 lineage), a strain that is distinguishable from the vaccine influenza B strain, which was a B/Yamagata/16/88 lineage virus. Based on the viruses detected worldwide until February 2005, the World Health Organization modified the composition of the 2005-2006 influenza vaccine from the 2004-2005 season vaccine to include a new A(H3N2) component: an A/California/7/2004 (H3N2)-like virus.

scholarly journals High Public-Health Impact in an Influenza-B-Mismatch Season in Southern Italy, 2017-2018

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Daniela Loconsole ◽  
Anna Lisa De Robertis ◽  
Anna Morea ◽  
Daniele Casulli ◽  
Rosanna Mallamaci ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Southern Italy ◽  
Influenza Season ◽  
The Elderly ◽  
Molecular Characteristics ◽  
Influenza B ◽  
Age Group ◽  
Influenza A Viruses ◽  
Genetic Subgroup

Background. Yearly influenza epidemics have considerable effects on public health worldwide. The 2017-2018 influenza season in Italy was of greater severity than previous seasons. The aim of this study was to describe the 2017-2018 influenza season in Southern Italy and the molecular characteristics of the circulating viral strains. Methods. The incidence of influenza-like illness (ILI) was analysed. Nasopharyngeal swabs collected from patients with ILI from week 46/2017 to week 17/2018 were tested to identify influenza A viruses (IAV) and influenza B viruses (IBV). Sequencing and phylogenetic analysis of haemagglutinin genes were also performed on 73 positive samples (35 IBV, 36 IAV H1, and 2 IAV H3 strains). Results. During the 2017-2018 season, the peak incidence was 14.32 cases per 1,000 inhabitants. IBV strains were identified in 71.0% of cases. The 35 characterised IBV strains belonged to Yamagata lineage clade 3, the 36 A/H1N1pdm09 strains clustered with the genetic subgroup 6B.1, and the 2 A/H3N2 strains clustered with the genetic subgroup 3C.2a. Intensive-care unit (ICU) admission was required in 50 cases of acute respiratory distress syndrome (ARDS). Among the >64-year age group, 18 out of 26 ICU-ARDS cases (69.2%) were caused by IBV, and 14 of these (77.8%) were B/Yamagata lineage. Conclusions. The 2017-2018 influenza season was one of the most severe in a decade in Southern Italy. IBV mismatch between the trivalent vaccine and the circulating strains occurred. The high number of ICU-ARDS cases caused by B/Yamagata strains in the >64-year age group suggests that further data on the effectiveness of the available influenza vaccines are needed to determine the best way to protect the elderly against both IBV lineages.

scholarly journals Improving Probabilistic Infectious Disease Forecasting Through Coherence

2019 ◽  
Author(s):  
Graham Casey Gibson ◽  
Kelly R. Moran ◽  
Nicholas G. Reich ◽  
Dave Osthus
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Disease Control ◽  
The United States ◽  
Weighted Sum ◽  
Public Health Burden ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
The U.S ◽  
Geographical Units

AbstractWith an estimated $10.4 billion in medical costs and 31.4 million outpatient visits each year, influenza poses a serious burden of disease in the United States. To provide insights and advance warning into the spread of influenza, the U.S. Centers for Disease Control and Prevention (CDC) runs a challenge for forecasting weighted influenza-like illness (wILI) at the national and regional level. Many models produce independent forecasts for each geographical unit, ignoring the constraint that the national wILI is a weighted sum of regional wILI, where the weights correspond to the population size of the region. We propose a novel algorithm that transforms a set of independent forecast distributions to obey this constraint, which we refer to as probabilistically coherent. Enforcing probabilistic coherence led to an increase in forecast skill for 90% of the models we tested over multiple flu seasons, highlighting the importance of respecting the forecasting system’s geographical hierarchy.Author SummarySeasonal influenza causes a significant public health burden nationwide. Accurate influenza forecasting may help public health officials allocate resources and plan responses to emerging outbreaks. The U.S. Centers for Disease Control and Prevention (CDC) reports influenza data at multiple geographical units, including regionally and nationally, where the national data are by construction a weighted sum of the regional data. In an effort to improve influenza forecast accuracy across all models submitted to the CDC’s annual flu forecasting challenge, we examined the effect of imposing this geographical constraint on the set of independent forecasts, made publicly available by the CDC. We developed a novel method to transform forecast densities to obey the geographical constraint that respects the correlation structure between geographical units. This method showed consistent improvement across 90% of models and that held when stratified by targets and test seasons. Our method can be applied to other forecasting systems both within and outside an infectious disease context that have a geographical hierarchy.

scholarly journals Automated Real-Time Collection of Pathogen-Specific Diagnostic Data: Syndromic Infectious Disease Epidemiology (Preprint)

2018 ◽  
Author(s):  
Lindsay Meyers ◽  
Christine C Ginocchio ◽  
Aimie N Faucett ◽  
Frederick S Nolte ◽  
Per H Gesteland ◽  
...  
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Real Time ◽  
Large Scale ◽  
The United States ◽  
Molecular Diagnostic ◽  
Respiratory Pathogens ◽  
Test Results ◽  
Patient Privacy ◽  
Clinical Laboratories

BACKGROUND Health care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are comprehensive and specific with respect to the pathogen but are rapid in reporting the data. It has proven difficult to implement these requirements on a large scale while maintaining patient privacy. OBJECTIVE The aim of this study was to demonstrate the automated export, aggregation, and analysis of infectious disease diagnostic test results from clinical laboratories across the United States in a manner that protects patient confidentiality. We hypothesized that such a system could aid in monitoring the seasonal occurrence of respiratory pathogens and may have advantages with regard to scope and ease of reporting compared with existing surveillance systems. METHODS We describe a system, BioFire Syndromic Trends, for rapid disease reporting that is syndrome-based but pathogen-specific. Deidentified patient test results from the BioFire FilmArray multiplex molecular diagnostic system are sent directly to a cloud database. Summaries of these data are displayed in near real time on the Syndromic Trends public website. We studied this dataset for the prevalence, seasonality, and coinfections of the 20 respiratory pathogens detected in over 362,000 patient samples acquired as a standard-of-care testing over the last 4 years from 20 clinical laboratories in the United States. RESULTS The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks, and adenovirus and the bacterial pathogens show constant detection over the year. The dataset can also be considered in an ecological framework; the viruses and bacteria detected by this test are parasites of a host (the human patient). Interestingly, the rate of pathogen codetections, on average 7.94% (28,741/362,101), matches predictions based on the relative abundance of organisms present. CONCLUSIONS Syndromic Trends preserves patient privacy by removing or obfuscating patient identifiers while still collecting much useful information about the bacterial and viral pathogens that they harbor. Test results are uploaded to the database within a few hours of completion compared with delays of up to 10 days for other diagnostic-based reporting systems. This work shows that the barriers to establishing epidemiology systems are no longer scientific and technical but rather administrative, involving questions of patient privacy and data ownership. We have demonstrated here that these barriers can be overcome. This first look at the resulting data stream suggests that Syndromic Trends will be able to provide high-resolution analysis of circulating respiratory pathogens and may aid in the detection of new outbreaks.

scholarly journals Pneumococcal Colonization and Pneumococcal Disease in Children with Influenza Clinical, laboratory and epidemiological features

2018 ◽  
Vol 69 (10) ◽  
pp. 2749-2753 ◽  
Author(s):  
Victor Daniel Miron ◽  
Anca Cristina Draganescu ◽  
Oana Sandulescu ◽  
Constanta Angelica Visan ◽  
Maria Madalina Merisescu ◽  
...  
Keyword(s):  
Influenza A ◽  
Pneumococcal Disease ◽  
Clinical Laboratory ◽  
Influenza Season ◽  
Influenza B ◽  
Inflammation Markers ◽  
Erythrocyte Sedimentation ◽  
Epidemiological Features ◽  
Influenza Activity ◽  
Pneumococcal Colonization

We retrospectively studied clinical features of the 2015-2016 paediatric influenza season and the rate of pneumococcal colonization/disease in a reference Romanian infectious diseases institute. Peak influenza activity occurred between weeks 5-10/2016; A viruses initially predominated, switching to B viruses after week 12/2016. Patients� median age was 4.4 years. Patients with influenza A were significantly younger compared with influenza B (p[0.001), and required longer hospitalization (p[0.001). S. pneumoniae was identified in 5.4% of cases (only influenza A), accounting for 2.1% pneumococcal disease and 3.3% pneumococcal colonization. Patients with S. pneumoniae were younger compared to negative cases (p=0.164), presented to the hospital later (p=0.049), had higher erythrocyte sedimentation rate (ESR, p=0.008), and prolonged hospitalization (p=0.016), regardless of whether the strains caused disease or were colonizers. Commonly used inflammation markers may identify the presence of pneumococci (ESR, p=0.008) or differentiate between colonization and disease (neutrophil count, p=0.011) in children with influenza A.

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