Influenza and other respiratory viruses
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Influenza Other Respi Viruses · Nov 2013
ReviewAre we prepared to help low-resource communities cope with a severe influenza pandemic?
Recent research involving lab-modified H5N1 influenza viruses with increased transmissibility and the ongoing evolution of the virus in nature should remind us of the continuing importance of preparedness for a severe influenza pandemic. Current vaccine technology and antiviral supply remain inadequate, and in a severe pandemic, most low-resource communities will fail to receive adequate medical supplies. However, with suitable guidance, these communities can take appropriate actions without substantial outside resources to reduce influenza transmission and care for the ill. Such guidance should be completed, and support provided to developing countries to adapt it for their settings and prepare for implementation.
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Influenza Other Respi Viruses · Sep 2013
ReviewClinical care for severe influenza and other severe illness in resource-limited settings: the need for evidence and guidelines.
The 2009 influenza A (H1N1) pandemic highlighted the importance of quality hospital care of the severely ill, yet there is evidence that the impact of the 2009 pandemic was highest in low- and middle-income countries with fewer resources. Recent data indicate that death and suffering from seasonal influenza and severe illness in general are increased in resource-limited settings. However, there are limited clinical data and guidelines for the management of influenza and other severe illness in these settings. ⋯ These standardized clinical guidelines emphasize syndromic case management and do not require high-resource intensive care units. These efforts must be enhanced by quality clinical research to provide missing evidence and to refine recommendations, which must be carefully integrated into existing healthcare systems. Realizing a sustainable, global impact on death and suffering due to severe influenza and other severe illness necessitates an ongoing and concerted international effort to iteratively generate, implement, and evaluate best-practice management guidelines for use in resource-limited settings.
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Influenza Other Respi Viruses · Sep 2013
ReviewHand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review.
Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. ⋯ There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate- to high-quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.
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Influenza Other Respi Viruses · Sep 2013
The first, second and third wave of pandemic influenza A (H1N1)pdm09 in North Denmark Region 2009-2011: a population-based study of hospitalizations.
Denmark experienced three waves of the new pandemic influenza A (H1N1)pdm09 from July 2009 to February 2011. The aim of the study was to describe the epidemiology and clinical characteristics of hospitalized patients in a defined population of North Denmark Region with a mixed urban and rural community of 579,000 inhabitants. ⋯ Patients hospitalized with pandemic influenza A (H1N1)pdm09 were predominantly children and younger adults, and only a few patients were >65 years. The third wave was the most severe taking the number and percentage of patients admitted to ICUs and 30-day mortality into consideration. We observed that the incidence of hospitalizations as well as clinical severity among younger adults did not decline from the second to the third wave.
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Influenza Other Respi Viruses · Sep 2013
Incidence of influenza-associated mortality and hospitalizations in Argentina during 2002-2009.
We estimated rates of influenza-associated deaths and hospitalizations in Argentina, a country that recommends annual influenza vaccination for persons at high risk of complications from influenza illness. ⋯ Our findings suggest that annual rates of influenza-associated hospitalizations and death in Argentina were substantial and similar to neighboring Brazil.