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Influenza

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Summary: The study found that one third of reproductive-aged women hospitalized with influenza were pregnant over the course of 9 influenza seasons. Pregnant women with influenza A H1N1 had more severe outcomes. It is recommended that pregnant women remain a high-priority target group for vaccination.

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Summary: A lower prevalence of bacterial co-infections was observed in patients with community-acquired SARS-CoV-2 positive pneumonia compared to those with influenza and RSV positive pneumonia.

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Combining baloxavir marboxil with standard-of-care neuraminidase inhibitor in patients hospitalised with severe influenza (FLAGSTONE): a randomised, parallel-group, double-blind, placebo-controlled, superiority trial

Deepali Kumar et al.

Summary: This study tested the combination of baloxavir with NAIs in hospitalized patients with severe influenza but found no superior clinical outcomes compared to NAIs alone. The combination was well tolerated, suggesting that combination antivirals may not be routinely indicated in clinical practice for this patient population.

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Influenza seasonality and its environmental driving factors in mainland China and Hong Kong

Sheikh Taslim Ali et al.

Summary: The study found that absolute humidity is a key factor influencing the seasonality of influenza, showing a U-shaped association with transmissibility and able to predict the transmission patterns of influenza virus in different climate zones. Other climatic factors and holiday-related school closures also have a certain impact on influenza transmission.

SCIENCE OF THE TOTAL ENVIRONMENT (2022)

Article Immunology

Epidemiology, Clinical Characteristics, and Outcomes of Influenza-Associated Hospitalizations in US Children Over 9 Seasons Following the 2009 H1N1 Pandemic

Satoshi Kamidani et al.

Summary: This study provides important population-based data on influenza-associated hospitalizations in US children. It highlights the higher rates of hospitalization and death among younger children, but also emphasizes the increased risk of severe outcomes among older children.

CLINICAL INFECTIOUS DISEASES (2022)

Article Infectious Diseases

Influenza returns with a season dominated by clade 3C.2a1b.2a.2 A(H3N2) viruses, WHO European Region, 2021/22

Angeliki Melidou et al.

Summary: Non-pharmaceutical interventions for COVID-19 have continued to slow down the circulation of influenza in the WHO European Region in the 2021/22 season. The A(H-3) virus strain has dominated, co-circulating with A(H-1)pdmo9 and B/Victoria viruses in some countries. No detections of the B/Yamagata virus have been confirmed. Many of the circulating virus subtypes or lineages have shown antigenic differences from their respective vaccine components in the northern hemisphere. Adequate levels of influenza virus characterizations should be maintained until the end of the season and in future seasons, when surveillance is adapted to include SARS-CoV-2.

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Article Infectious Diseases

Comparison of the safety and immunogenicity of a novel Matrix-M-adjuvanted nanoparticle influenza vaccine with a quadrivalent seasonal influenza vaccine in older adults: a phase 3 randomised controlled trial

Vivek Shinde et al.

Summary: The study aimed to compare the immunological responses of the Matrix-M-adjuvanted quadrivalent nanoparticle influenza vaccine (qNIV) with a licensed, standard-dose quadrivalent inactivated influenza vaccine (IIV4) in older adults. The results showed that qNIV was immunologically non-inferior to IIV4, well tolerated, and produced enhanced immune responses in older adults, indicating potential effectiveness in seasonal influenza vaccination.

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Bat-Borne Influenza A Viruses: An Awakening

Kevin Ciminski et al.

Summary: Influenza A viruses from aquatic waterfowl recurrently cross interspecies barriers by utilizing cell surface-exposed monosaccharide sialic acids as a universal host cell receptor. Batborne IAV subtypes H17N10 and H18N11 encode HA and NA homologs unable to interact with sialic acid residues, but instead use major histocompatibility complex class II proteins of different vertebrate species for cell entry, potentially allowing for a broader host tropism.

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Article Medicine, Research & Experimental

Original Antigenic Sin: How Original? How Sinful?

Jonathan W. Yewdell et al.

Summary: Original antigenic sin (OAS) is a phenomenon in antibody responses to influenza A virus infection or vaccination, which depends on multiple variables. It is not a sin, but rather a part of evolutionary selection that can help improve influenza virus vaccines.

COLD SPRING HARBOR PERSPECTIVES IN MEDICINE (2021)

Article Medicine, Research & Experimental

Influenza Therapeutics in Clinical Practice-Challenges and Recent Advances

John H. Beigel et al.

Summary: This article summarizes recent clinical developments involving influenza antiviral drugs in various categories and important clinical research issues, many of which have knowledge gaps due to unpublished data and ongoing pivotal studies.

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Article Medicine, General & Internal

Dexamethasone in Hospitalized Patients with Covid-19

Peter Horby et al.

Summary: In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Public, Environmental & Occupational Health

Racial/Ethnic and Socioeconomic Disparities in Adult Vaccination Coverage

Kosuke Kawai et al.

Summary: Racial and ethnic disparities in vaccine uptake persisted over the last decade, while socioeconomic disparities narrowed among adults aged 18-64 years but persisted among adults aged >= 65 years.

AMERICAN JOURNAL OF PREVENTIVE MEDICINE (2021)

Article Immunology

Waning Vaccine Effectiveness Against Influenza-Associated Hospitalizations Among Adults, 2015-2016 to 2018-2019, United States Hospitalized Adult Influenza Vaccine Effectiveness Network

Jill M. Ferdinands et al.

Summary: The effectiveness of influenza vaccine decreases with time since vaccination, with an absolute decline of about 8%-9% per month postvaccination.

CLINICAL INFECTIOUS DISEASES (2021)

Article Immunology

Global production capacity of seasonal and pandemic influenza vaccines in 2019

Erin Sparrow et al.

Summary: The study compares global capacity for production of influenza vaccines in 2019, showing a slight increase in annual seasonal influenza vaccine production capacity and a rising trend in potential annual influenza pandemic vaccine production capacity. However, these estimates should be interpreted cautiously as they are based on assumptions that may impact supply. Pandemic vaccines would not be immediately available, taking four to six months for initial supplies with further time needed to reach maximum capacity.

VACCINE (2021)

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Variable seasonal influenza vaccine effectiveness across geographical regions, age groups and levels of vaccine antigenic similarity with circulating virus strains: A systematic review and meta-analysis of the evidence from test-negative design studies after the 2009/10 influenza pandemic

G. N. Okoli et al.

Summary: The study found consistent patterns in seasonal influenza vaccine effectiveness across different regions, age groups, and levels of vaccine antigenic similarity with circulating virus strains. The highest vaccine performance was against A(H1N1)pdm09, while the worst was against A(H3N2). Geographic location, age, and vaccine antigenic similarity with circulating virus strains should be considered when designing and evaluating influenza vaccine effectiveness studies.

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What Is an Aerosol-Generating Procedure?

Michael Klompas et al.

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Letter Infectious Diseases

Re-emergence of influenza virus circulation during 2020 in parts of tropical Asia: Implications for other countries

Joshua A. Mott et al.

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mRNA flu shots move into trials

Elie Dolgin

Summary: The COVID-19 pandemic demonstrated the effectiveness of mRNA vaccines and now pharmaceutical companies are racing to apply this technology platform to influenza vaccines.

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Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19

Anthony C. Gordon et al.

Summary: Interleukin-6 receptor antagonists tocilizumab and sarilumab were found to improve outcomes, including survival, in critically ill patients with Covid-19 receiving organ support in ICUs according to an ongoing international trial. The efficacy of these treatments has been confirmed, with patients benefiting from the therapy.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Medicine, General & Internal

Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis

Kathryn E. Lafond et al.

Summary: This study aimed to estimate the global burden of influenza-associated hospitalizations among adults worldwide. The researchers conducted a systematic review and meta-analysis, finding that influenza was associated with 14% of acute respiratory hospitalizations in adults, with over 5 million cases annually. The findings emphasize the importance of influenza vaccination, especially for older adults, in preventing severe disease and hospitalizations.

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Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis

Siva H. Yedlapati et al.

Summary: The study found that influenza vaccination in patients with cardiovascular disease is associated with a lower risk of all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events. However, it did not show a significant reduction in the risk of myocardial infarction compared to the control group.

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Clinical and virological impact of single and dual infections with influenza A (H1N1) and SARS-CoV-2 in adult inpatients

Jiazhen Zheng et al.

Summary: The study revealed that co-infection of H1N1 and SARS-CoV-2 leads to more severe complications, heavier clinical symptoms, and requires more urgent medical interventions compared to mono-infections. Additionally, initial Ct values can provide important clues for the progression of the co-infection.

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Effectiveness of Influenza Vaccination in Preventing Hospitalization Due to Influenza in Children: A Systematic Review and Meta-analysis

Nicki L. Boddington et al.

Summary: This systematic review found that the effectiveness of influenza vaccine against hospitalization in children varies by influenza subtype and vaccine type, with an overall seasonal IVE of 53.3%. IVE was highest against influenza A/H1N1pdm09 and lowest against influenza A/H3N2.

CLINICAL INFECTIOUS DISEASES (2021)

Article Immunology

Effectiveness of Influenza Vaccines in the HIVE Household Cohort Over 8 Years: Is There Evidence of Indirect Protection?

Ryan E. Malosh et al.

Summary: This study found that the direct effect of influenza vaccine in the HIVE cohort was higher for A/H1N1 and B influenza, and young children had higher direct vaccine effectiveness than adults. Influenza incidence was highest in completely unvaccinated households, and lower in households with vaccination coverage. The study suggests that while influenza vaccines may have benefits beyond direct protection, the indirect effect is small.

CLINICAL INFECTIOUS DISEASES (2021)

Article Infectious Diseases

A remote household-based approach to influenza self-testing and antiviral treatment

Jessica Heimonen et al.

Summary: Through at-home testing, telehealth care, and rapid antiviral home delivery, we demonstrated the feasibility of self-testing combined with rapid home delivery of influenza antiviral treatment, which may be an important control strategy for influenza epidemics and pandemics.

INFLUENZA AND OTHER RESPIRATORY VIRUSES (2021)

Article Public, Environmental & Occupational Health

Interactions between SARS-CoV-2 and influenza, and the impact of coinfection on disease severity: a test-negative design

Julia Stowe et al.

Summary: The study found that influenza patients had a lower risk of SARS-CoV-2 infection, but those with coinfections had a higher risk of death, especially in terms of ventilator use and intensive care unit admission.

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY (2021)

Review Microbiology

Transmissibility and transmission of respiratory viruses

Nancy H. L. Leung

Summary: Respiratory virus infections cause a significant global health problem, with different viruses varying in transmission modes and transmissibility. Understanding the relative contributions of different transmission modes is crucial for guiding the effectiveness of non-pharmaceutical interventions.

NATURE REVIEWS MICROBIOLOGY (2021)

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Neuraminidase inhibitors and single dose baloxavir are effective and safe in uncomplicated influenza: a meta-analysis of randomized controlled trials.

Sofia Tejada et al.

Summary: The study found that baloxavir and neuraminidase inhibitors (NAIs) have a significant reduction effect on complications of uncomplicated influenza, especially in reducing antibiotic prescriptions. Single-dose baloxavir is non-inferior to NAIs in terms of safety and efficacy.

EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2021)

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Aerosol generating procedures: are they of relevance for transmission of SARS-CoV-2?

Fergus Hamilton et al.

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Clinical Effectiveness and Safety of Antivirals for Influenza in Pregnancy

Eric J. Chow et al.

Summary: Early initiation of antiviral treatment of influenza is beneficial in reducing the risk of complications and duration of illness. Pregnant and postpartum women treated with oseltamivir and other neuraminidase inhibitors show reduced risk of severe outcomes with no increase in adverse maternal, fetal, or neonatal outcomes. Baloxavir is not recommended for use in these populations due to lack of safety and efficacy data.

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Early Bacterial Identification among Intubated Patients with COVID-19 or Influenza Pneumonia: A European Multicenter Comparative Clinical Trial

Anahita Rouze et al.

Summary: The prevalence of bacterial identification within 48 hours after intubation is significantly lower in patients with SARSCoV-2 pneumonia compared to influenza pneumonia. Bacterial identification is associated with increased 28-day mortality in patients with SARS-CoV-2 pneumonia.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

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Association Between Caseload Surge and COVID-19 Survival in 558 US Hospitals, March to August 2020

Sameer S. Kadri et al.

Summary: A retrospective cohort study conducted on COVID-19 patients from 558 U.S. hospitals between March and August 2020 found a significant increase in COVID-19 mortality rate with higher surge index percentiles, with the highest mortality rate observed in the 99th percentile and above. The study also revealed that despite increased use of corticosteroids and more judicious intubation in later months, the surge-mortality relationship was stronger in June to August compared to March to May.

ANNALS OF INTERNAL MEDICINE (2021)

Review Biochemistry & Molecular Biology

The cytokine storms of COVID-19, H1N1 influenza, CRS and MAS compared. Can one sized treatment fit all?

Gerwyn Morris et al.

Summary: An analysis of cytokine storms in diseases like COVID-19, H1N1 influenza, cytokine release syndrome (CRS), and macrophage activation syndrome (MAS) reveals common immunological and biochemical abnormalities. These include hyperactive coagulation systems, elevated levels of cytokines, proinflammatory chemokines, and activated macrophages. Differences in immune responses and cytokine levels are also observed among these diseases. Additional elements such as Inflammasome activity and DAMPs contribute to the pathophysiology of cytokine storms.

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Comprehensive Immunologic Evaluation of Bronchoalveolar Lavage Samples from Human Patients with Moderate and Severe Seasonal Influenza and Severe COVID-19

Daniel Reynolds et al.

Summary: Severe cases of seasonal influenza or SARS-CoV-2 infection are associated with an influx of nonclassical monocytes, activated T cells, and plasmablast B cells into the lower airways, along with significantly elevated levels of 28 out of 35 measured cytokines. IP-10 concentration is the only cytokine that correlates between blood and bronchoalveolar lavage during severe infection.

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Viral RNA and Infectious Influenza Virus on Mobile Phones of Patients With Influenza in Hong Kong and the United States

Jingyi Xiao et al.

Summary: The research found that the presence of influenza viral RNA on mobile phones is positively correlated with the upper respiratory tract viral load of patients and negatively correlated with the age of the patients.

JOURNAL OF INFECTIOUS DISEASES (2021)

Article Immunology

Quantifying the Impact of COVID-19 Nonpharmaceutical Interventions on Influenza Transmission in the United States

Yuchen Qi et al.

Summary: The study found that NPIs implemented in 2020 had significant effects on reducing the incidence and transmission of seasonal influenza in the United States, with more than 60% reduction in certain influenza strains during the initial 10 weeks. The reduction in influenza transmission varied geographically, and the potential accumulation of susceptibility to influenza infection post-NPIs may lead to large outbreaks, whose scale could be impacted by the duration of intervention and immunity to influenza. Healthcare systems should prepare for potential surges in influenza patients and promote vaccination and ongoing precautions.

JOURNAL OF INFECTIOUS DISEASES (2021)

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A case series of parainfectious Guillain-Barre syndrome linked to influenza A (H1N1) virus infection

Stefano Giuseppe Grisanti et al.

Summary: GBS is an immune-mediated peripheral neuropathy characterized by a typical post-infectious profile. Some cases have been reported to occur shortly after Zika virus or severe acute respiratory syndrome-related coronavirus-2 infections. In some cases, patients with a history of influenza A (H1N1) virus infection developed GBS in a very short period of time, with some recovering promptly without therapy. The parainfectious cases add heterogeneity to the GBS category, warranting further pathogenetic insights.

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Influenza-Associated Neurologic Complications in Hospitalized Children

Sarah Frankl et al.

Summary: This study found that influenza-associated neurologic complications are common in children hospitalized with influenza. Seizures and encephalopathy were the most commonly identified complications, and children with pre-existing neurologic diagnoses had a higher proportion of these complications. The study suggests that vaccination, lack of seasonal influenza vaccination, and age <= 5 years are independently associated with influenza-associated neurologic complications.

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Influenza Complicating Delivery Hospitalization and Its Association With Severe Maternal Morbidity in the United States, 2000-2018

Timothy Wen et al.

Summary: The study found that an influenza diagnosis at delivery hospitalization is associated with an increased risk of severe maternal morbidity, including maternal death, mechanical intubation, sepsis, shock, acute respiratory distress syndrome, and obstetric complications. The results underscore the importance of primary prevention and early detection of influenza during pregnancy to reduce maternal morbidity and mortality.

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Influenza Antiviral Treatment and Length of Stay

Angela P. Campbell et al.

Summary: This study evaluated the impact of antiviral treatment on hospital length of stay among children hospitalized with confirmed influenza, finding that early antiviral treatment was associated with significantly shorter hospitalizations. These results support the CDC recommendations for prompt empiric antiviral treatment in hospitalized patients with suspected or confirmed influenza.

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Does influenza vaccination attenuate the severity of breakthrough infections? A narrative review and recommendations for further research

Jill M. Ferdinands et al.

Summary: Influenza vaccination is associated with reduced odds of ICU admission and death among adults with influenza-associated hospitalization, as well as reduced odds of fever among children with influenza virus infection.

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Impact of COVID-19 outbreaks and interventions on influenza in China and the United States

Luzhao Feng et al.

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Comparison of Antiviral Agents for Seasonal Influenza Outcomes in Healthy Adults and Children A Systematic Review and Network Meta-analysis

Jen-Wei Liu et al.

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Peng-Jun Lu et al.

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Wayan C. W. S. Putri et al.

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Timothy M. Uyeki et al.

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