Evidence of Sexual Transmission of Zika Virus D'Ortenzio, Eric; Matheron, Sophie; Yazdanpanah, Yazdan ...
The New England journal of medicine,
2016-Jun-02, Volume:
374, Issue:
22
Journal Article
Background
Estimating the global burden of influenza hospitalizations is required to allocate resources and assess interventions that aim to prevent severe influenza. In France, the current routine ...influenza surveillance system does not fully measure the burden of severe influenza cases. The objective was to describe the characteristics and severity of influenza hospitalizations by age‐group and by season between 2012 and 2017.
Methods
All hospitalizations with a diagnosis of influenza in metropolitan France between July 2012 and June 2017 were extracted from the French national hospital discharge database (PMSI). For each season, the total number of influenza hospitalizations, admissions to intensive care units (ICU), proportion of deaths, lengths of stay, and distribution in diagnosis‐related groups were described by age‐group.
Results
Over the five seasons, 91 255 hospitalizations with a diagnosis of influenza were identified. The average influenza hospitalization rate varied from 13/100 000 in 2013‐2014 to 46/100 000 in 2016‐2017. A high rate was observed in elderlies during the 2014‐2015 and 2016‐2017 seasons, dominated by A(H3N2) virus. The youngest were impacted in 2015‐2016, dominated by B/Victoria virus. The proportion of influenza hospitalizations with ICU admission was 10%, and was higher in age‐group 40‐79 years. The proportion of deaths and length of stay increased with age.
Conclusions
The description of influenza hospitalizations recorded in the PMSI give key information on the burden of severe influenza in France. Analyses of these data annually is valuable in order to document the severity of influenza hospitalizations by age‐group and according to the circulating influenza viruses.
During the 2009/10 pandemic, a national surveillance system for severe influenza cases was set up in France. We present results from the system's first four years. All severe influenza cases admitted ...to intensive care units (ICU) were reported to the Institut de Veille Sanitaire using a standardised form: data on demographics, immunisation and virological status, risk factors, severity (e.g. acute respiratory distress syndrome (ARDS) onset, mechanical ventilation, extracorporeal life support) and outcome. Multivariate analysis was performed to identify factors associated with ARDS and death. The number of confirmed influenza cases varied from 1,210 in 2009/10 to 321 in 2011/12. Most ICU patients were infected with A(H1N1)pdm09, except during the 2011/12 winter season when A(H3N2)-related infections predominated. Patients' characteristics varied according to the predominant strain. Based on multivariate analysis, risk factors associated with death were age ≥ 65 years, patients with any of the usual recommended indications for vaccination and clinical severity. ARDS occurred more frequently in patients who were middle-aged (36-55 years), pregnant, obese, or infected with A(H1N1)pdm09. Female sex and influenza vaccination were protective. These data confirm the persistent virulence of A(H1N1)pdm09 after the pandemic and the heterogeneity of influenza seasons, and reinforce the need for surveillance of severe influenza cases.
Background. An increase in the incidence and severity of Clostridium difficile-associated disease in Québec and the United States has been associated with a hypervirulent strain referred to as North ...American pulsed-field type 1 (NAP1)/027. Methods. In 2005, a prospective study was conducted in 88 Québec hospitals, and 478 consecutive nosocomial isolates of C. difficile were obtained. The isolates were subjected to pulsed-field gel electrophoresis (PFGE) typing, antimicrobial susceptibility testing, and detection of binary toxin genes and tcdC gene deletion. Data on patient age and occurrence of complications were collected. Results. PFGE typing of 478 isolates of C. difficile yielded 61 PFGE profiles. Pulsovars A (57%), B (10%), and B1 (8%) were predominant. The PFGE profile of pulsovar A was identical to that of strain NAP1. It showed 67% relatedness with 15 other PFGE patterns, among which 11 had both binary toxin genes and a partial tcdC deletion but different antibiotic susceptibility profiles. Pulsovars B and B1 were identical to strain NAP2/ribotype 001. In hospitals showing a predominant clonal A or B-B1 PFGE pattern, incidence of C. difficile-associated disease was 2 and 1.3 times higher, respectively, than in hospitals without any predominant clonal PFGE pattern. Severe disease was twice as frequent among patients with strains possessing binary toxin genes and tcdC deletion than among patients with strains lacking these virulence factors. Conclusions. This study helped to quantify the impact of strain NAP1 on the incidence and severity of C. difficile-associated disease in Québec in 2005. The identification of the geographic dissemination of this predominant strain may help to focus regional infection-control efforts.
Comparing age and sex differences in SARS-CoV-2 hospitalization and mortality with MERS-CoV, seasonal coronaviruses, influenza and other health outcomes opens the way to generating hypotheses as to ...underlying mechanisms driving disease risk. Using 60-year-olds as a reference age group, we find that relative rates of hospitalization and mortality associated with the emergent coronaviruses are lower during childhood and start to increase earlier (around puberty) as compared with influenza and seasonal coronaviruses. The changing distribution of disease risk by age for emerging pathogens appears to broadly track the gradual deterioration of the immune system (immunosenescence), which starts around puberty. By contrast, differences in severe disease risk by age from endemic pathogens are more decoupled from the immune ageing process. Intriguingly, age-specific sex differences in hospitalizations are largely similar across endemic and emerging infections. We discuss potential mechanisms that may be associated with these patterns.
An epidemic of dengue 1 virus (DENV-1) occurred in French Polynesia in 2001, 4 years after a DENV-2 epidemic that ended in 1997. Surveillance data from hospitalized case-patients showed that ...case-patients with dengue hemorrhagic fever (DHF) exhibited a bimodal age distribution with 1 peak among infants 6-10 months of age and a second peak at 4-11 years of age. The relative risk of DHF developing in children born before rather than after the DENV-2 epidemic was 186 (95% confidence interval 26-1,324). Among children born toward the end of the DENV-2 epidemic, a strong temporal association was found between the month of birth and the risk of being hospitalized for DHF. This study documents epidemic pathogenicity associated with the sequence of DENV-2 infection followed by DENV-1 infection.
In the context of global warming and climate change, ciguatera disease is put forward as an indicator of environmental disturbance. However, to validate this indicator, some unknown parameters such ...as the delay between environmental perturbation and outbreaks of ciguatera need to be investigated. The main goal of this study was to investigate the temporal link between the growth of
Gambierdiscus spp., and one of its influencing factors and the declared cases of ciguatera disease in humans. Algal cell density and seawater temperature (SWT) were recorded monthly from February 1993 to December 2001 on the Atimaono barrier reef of Tahiti Island. Reports of ciguatera cases were obtained from three community health clinics near the study sites. The autoregressive integrated moving average model (ARIMA) shows: (1) SWT were positively associated with
Gambierdiscus spp. growth at a lagtime of 13 and 17 months (
p
<
0.001); (2)
Gambierdiscus spp. growth measured at a given time is related to a peak number of cases of ciguatera recorded 3 months after peak densities of this dinoflagellate (
p
<
0.001). These results allow the construction of a predictive model of the temporal link between ciguatera disease in humans and its etiologic agent:
Gambierdiscus spp. This model constructed by using 1993–1999 data, then validated by 2000–2001 data, demonstrates an appreciable ability to predict changes in the incidence of ciguatera disease following algae blooms.
Summary
Objectives The purpose of this study was to report the temporal trends of the incidence of ciguatera poisoning from 1992 to 2001 in French Polynesia.
Methods This retrospective study ...analysed 7842 cases of ciguatera disease recorded over a period of 10 years.
Results The annual incidence varied from 26.3 to 41.9 per 10 000 person‐years. An analysis of cases grouped by archipelago revealed differences in incidences (P < 0.0001) with the most remote archipelagos having the highest incidences. A detailed analysis on a sub‐sample of recorded cases for which clinical information was available (n = 1824) confirmed the neurological and gastrointestinal nature of this seafood poisoning.
Conclusion The incidence of ciguatera poisoning appeared relatively stable during the 10 years of the study period. However, the gradient of remoteness observed suggests an adaptation of management of ciguatera disease to each archipelago.
Objectifs Le but de cette étude était de rapporter les tendances temporelles de l'incidence de l'empoisonnement de ciguatera de 1992 à 2001 en Polynésie française.
Méthodes Etude rétrospective de 7842 cas de ciguatera enregistrés sur une période de dix ans.
Résultats L'incidence annuelle variait de 26,3 à 41,9 par 10000 personnes année. Une analyse des cas groupés par archipel a indiqué des différences dans les incidences (p < 0.0001); les archipels les plus éloignés ayant les incidences les plus élevées. Une analyse détaillée sur une partie de l’échantillon de cas enregistrés pour lesquels l'information clinique était disponible (n = 1824) a confirmé la nature neurologique et gastro‐intestinale de cet empoisonnement par fruits de mer.
Conclusion L'incidence de l'empoisonnement de ciguatera semble relativement stable au cours des dix années de la période d’étude. Cependant, le gradient observé de l’éloignement suggère une adaptation dans la prise en charge de la ciguatera dans chacun des archipels.
Objetivos El propósito de este estudio es reportar las tendencias temporales en la incidencia de envenenamiento por ciguatera entre 1992 y 2001 en la Polinesia Francesa.
Métodos En este estudio retrospectivo se analizaron 7842 casos de ciguatera reportados durante un período de 10 años.
Resultados La incidencia anual varió entre 26.3 y 41.9 por 10,000 personas‐años. El análisis de los casos agrupados por archipiélago reveló diferencias entre las incidencias (p < 0.0001), con los archipiélagos más remotos presentando las mayores incidencias. Un análisis detallado de una sub‐muestra de casos reportados para los cuales había información clínica disponible (n = 1824), confirmó la naturaleza neurológica y gastrointestinal de esta intoxicación por marisco.
Conclusión La incidencia de ciguatera fue relativamente estable durante los diez años del período de estudio. Sin embargo, el gradiente de lejanía observado, sugiere una adaptación del manejo de la ciaguatera en cada archipiélago.
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