flu
[Impact of influenza A virus infection as a cause of pediatric hospitalization and use of rapid antigen test of influenza A virus]

[Article in Japanese]

Mitamura K, Sugaya N, Nirasawa M, Takahashi K, Shimizu H, Hirai Y.

Department of Pediatrics, Nippon Kokan Hospital.

From the winter of 1997 to the spring of 1988, a severe epidemic caused by influenza A (H3N2) developed in Japan. During the epidemic (December 1997 to February 1998), 239 children were admitted to the pediatric ward of Nippon Kokan Hospital: as many as 76 (31.8%) were hospitalized with influenza A (H3N2) infection. Most were young healthy children (mean age, 3.7 years), suggesting the need of influenza immunization for this age group. 110 specimens of hospitalized children were examined by rapid antigen test of influenza A virus (Directigen Flu A, Becton Dickinson, USA). The rapid test showed about 90% sensitivity and specificity, as compared with isolation and serum hemagglutination inhibition test. Directigen Flu A proved to be a reliable, rapid screen for influenza A from symptomatic patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9796186&dopt=Abstract flu, flu medicine, tamiflu



flu
Health care workers: vectors of influenza virus? Low vaccination rate among hospital health care workers.

Beguin C, Boland B, Ninane J.

Medical Informatics, St-Luc University Hospital, Bruxelles, Belgium.

The influenza vaccination rate among health care workers is not very high and needs to be improved. The authorities of our university hospital decided to encourage vaccination among health care workers and to include it in the hospital quality of care program. A survey about knowledge of influenza disease and its vaccination was undertaken, and 37.2% of the workers participated in the survey. Among them, 31.8% were vaccinated. The vaccination rate was higher when workers were older, men, physicians, technicians, or laboratory workers, vaccinated in the previous flu season and had fewer contacts with patients. The variables with the highest impact on the vaccination rate were vaccination the previous year, belief that vaccination is highly effective, and affirmation that prevention is important. Our study shows that an active vaccination campaign is also necessary for health workers to put them in the stream of usually vaccinated people.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9833335&dopt=Abstract flu, flu medicine, tamiflu



flu
[Influenza: new therapeutic perspectives]

[Article in French]

Bricaire F.

Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitie-Salpetriere, Paris.

TWO WELL-KNOWN AGENTS: Although the activity of amantadin and rimantadin against type A Myxovirus influenzae are well known, use is still limited. These agents only have a moderate curative effect and, though they are more effective for prophylaxis, can only be used in cases with a certain positive diagnosis, which is difficult to obtain. In addition, questions remain concerning tolerance which is not always excellent, particularly for amantadin. ZANAMIVIR: This compound belongs to a new class. It specifically inhibits the neuraminidase in type A and B Myxovirus influenzae. Given by the nasal route, zanamivir has been shown to be effective compared with placebo, reducing the duration and intensity of flu symptoms and with a very satisfactory tolerance profile. GS4104: Studies are in the preliminary phases for this agent which is a powerful inhibitor of the influenzae A and B virus neuraminidase. It has been found to be active in mouse and rodent models. IN CLINICAL PRACTICE: Vaccination remains the only effective tool today. These new compounds can only be seen as complementary agents to be used in combination with vaccination regimes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9879333&dopt=Abstract flu, flu medicine, tamiflu



flu
Flu vaccine shortage places premium on infection control and surge capacity.

[No authors listed]

There are several steps you can take today to lessen the impact of flu season on your ED. Combine public education, inoculation, and good hygiene to optimize infection control. Improve surge capacity through targeted cohorting of patients with symptoms of airborne diseases and canceling elective admissions. Put an immediate ban on boarding admitted patients in your hallways.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15605897&dopt=Abstract flu, flu medicine, tamiflu



flu
Influenza virus activates human immunodeficiency virus type-1 gene expression in human CD4-expressing T cells through an NF-kappaB-dependent pathway.

Sun J, Bergeron M, Barbeau B, Boivin G, Tremblay MJ.

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.

Influenza virus infection can cause severe complications in human immunodeficiency virus type-1 (HIV-1)-infected individuals leading to an increased risk of complications and death compared to that seen in uninfected individuals. We assessed the capacity of influenza virus (Flu) to modulate transcription of the HIV-1 long terminal repeat (LTR) in human CD4+ T cells. We found that Flu is able to promote expression of both the transiently transfected and stably integrated HIV-1 LTR-driven reporter gene. Experiments performed with Arthrobacter-derived neuraminidase and ammonium chloride revealed that Flu-dependent activation of HIV-1 transcription required an intimate contact between Flu and the target cell and efficient entry of Flu inside human CD4+ T cells. Amplification of a Flu-specific mRNA by RT-PCR indicated that human T cells were indeed productively infected with Flu. Virus preparations rendered noninfectious after UV irradiation could no longer upregulate HIV-1 LTR activity. Furthermore, experiments conducted with wild type and NF-kappaB-mutated HIV-1 LTR-directed reporter vectors suggested that the positive action of Flu on HIV-1 LTR activity was mediated through the induction of NF-kappaB. Our data show that fully competent Flu can lead to NF-kappaB-dependent activation of HIV-1 transcription in CD4+ T cells.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15639653&dopt=Abstract flu, flu medicine, tamiflu



flu
Effect of experimental influenza A infection on systemic immune and inflammatory parameters in allergic and nonallergic adult subjects.

Gentile DA, Doyle WJ, Fireman P, Skoner DP.

Department of Pediatrics, Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pennsylvania 15213, USA. gentild chplink.chp.edu

BACKGROUND: The economic impact and medical complication rate of viral upper respiratory infections are well documented, but many of the physiologic, inflammatory, and immune responses to respiratory viruses have only recently been investigated. A previous study demonstrated differential systemic immune and inflammatory responses in allergic rhinitis (AR) and nonallergic rhinitis (NAR) subjects during experimental infection with rhinovirus-39. OBJECTIVE: The purpose of this study was to compare selected systemic immune and inflammatory responses to experimental influenza A virus (FLU) challenge in seronegative AR and NAR subjects. METHODS: Peripheral blood was obtained at baseline (study day 0) and 3, 6, 18, and 31 days after intranasal FLU challenge and assayed for leukocyte histamine release, serum immunoglobulins, and plasma histamine. RESULTS: All subjects were infected, as manifested by viral shedding in nasal secretions and/or seroconversion. FLU infection induced decreases in spontaneous leukocyte histamine release and increases in anti-immunoglobulin E-induced leukocyte histamine release, which were evident at least 1 month after infection, but caused no significant changes in serum immunoglobulins or plasma histamine. There were no differences between AR and NAR subjects for any of the study parameters. CONCLUSIONS: The results show that intranasal challenge with FLU induces changes in leukocyte histamine release, but not other systemic immune and inflammatory responses.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11770697&dopt=Abstract flu, flu medicine, tamiflu