Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population.
Adult ; Aged ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Female ; Humans ; Influenza Vaccines/*immunology ; Influenza, Human/*prevention & control ; Logistic Models ; Male ; Middle Aged ; Nutrition Surveys ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Republic of Korea ; Respiratory Function Tests ; Vaccination/*statistics & numerical data

Inflammatory bowel disease (IBD) is a long-standing disease that often requires long-term use of immunosuppressive agents including immunomodulators (such as azathioprine, 6-mercaptopurine and methotrexate) and tumor necrosis factor-alpha inhibitors (such as infliximab and adalimumab). Introduction of immunosuppressive therapies, however, involves the risk of host susceptibility to opportunistic infections in this patient population. Therefore, adequate immunization for vaccine-preventable infectious diseases is currently recommended for all patients with IBD and is emerging as an important target for quality improvements in IBD care. However, ongoing issues regarding underuse of immunization, safety and efficacy of vaccines in patients with IBD remain. For quality improvements in IBD care, all physicians should follow the recent immunization guidelines proposed by professional IBD societies. Additionally, there are ongoing needs for intensive educational programs regarding a role of immunization in long-term care of IBD and up-to-date immunization guidelines. Immunization status should be checked at the time of diagnosis of IBD and timely vaccination before initiation of immunosuppressive therapies can be a practical solution for maximizing the efficacy of vaccination at this point. Inactivated vaccines can be used safely irrespective of immunization status of patients, while attenuated vaccines are contraindicated in patients on immunosuppressive therapies. This article reviews an ideal strategy for vaccinating patients with IBD based on the currently recommended immunization guidelines.
Antibodies, Monoclonal/therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Inflammatory Bowel Diseases/diagnosis/drug therapy/*immunology ; Influenza Vaccines/immunology ; Influenza, Human/prevention & control ; Pneumonia/prevention & control ; *Vaccination ; Vaccines, Synthetic/immunology

PURPOSE: To evaluate the feasibility for gold immunochromatographic assay (GICA) in rapid detection of influenza virus A infection. MATERIALS AND METHODS: Seventy-three patients were enrolled. All patients contributed nasopharyngeal secretions and paired serum samples. Nasopharyngeal secretions was used for colloidal gold immunochromatographic rapid assay for influenza A virus immediately after the collection of specimen. Paired serum samples were used for the hemagglutination inhibition assay at the Centers for Disease Control and Prevention influenza network laboratory in Beijing. RESULTS: Compare GICA test to hemagglutination inhibition (HI) assay, the Kappa value was 0.402 and the p value in the paired chi2 test was higher than 0.05. Therefore, the difference was not statistically significant. The sensitivity of GICA was 50.0% and the specificity was 90.2%, and the negative predictive value was 90.2%. CONCLUSION: The sensitivity for Influenza A antigen detection by using GICA is relatively low, the specificity is relatively satisfactory.
Adult ; Aged ; Aged, 80 and over ; Antigens, Viral/*blood ; Female ; *Gold Colloid ; Humans ; Immunochromatography/*methods ; Influenza A virus/*immunology ; Influenza, Human/*diagnosis/immunology ; Male ; Middle Aged ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

No abstract available.
Antigens, Viral/*analysis ; Biological Markers/analysis ; DNA, Viral/analysis ; *Fluorescent Antibody Technique ; Humans ; Influenza A Virus, H1N1 Subtype/genetics/*immunology ; Influenza, Human/*diagnosis/epidemiology/immunology/virology ; *Pandemics ; Predictive Value of Tests ; Republic of Korea/epidemiology ; *Seasons

OBJECTIVETo investigate the epidemiological features of influenza virus B (IVB) in the winter and the clinical features of pediatric pneumonia caused by IVB only.

METHODSA retrospective study was performed on the clinical data of children with respiratory infection who received pathogen testing and therapy at Soochow University Affiliated Children's Hospital during the winters of 2008, 2009, 2010 and 2011.

RESULTSThe positive rates of influenza viruses A and B in the winters of 2008, 2009, and 2010 were 0.89%, 5.49%, and 6.24% respectively; the positive rate of influenza viruses A and B in the winter of 2011 was 8.72%, significantly higher than those in 2008-2010. The positive rates of IVB in the winters of 2008, 2009, and 2010 were 0%, 0%, and 0.21% respectively; the positive rate of IVB in the winter of 2011 was 5.36%, which was significantly higher than in the years 2008 to 2010. Pneumonia caused by IVB was confirmed in 94 children during the winter of 2011, including 27 cases of pneumonia caused by IVB only. Most of children with pneumonia caused by IVB only were aged over 6 months. The common symptoms in the 27 children caused by IVB only were fever (85%), runny nose (89%), and cough (100%). Wheezing (26%) and dyspnea (7%) were also seen in some cases. Among the 27 children, 19% showed abnormal white blood cell count, 30% showed increased C-reactive protein, 70% showed decreased prealbumin, and none showed visible organ dysfunction. No specific imaging findings were seen in the children with pneumonia caused by IVB only. However, many abnormal humoral and cellular immunological parameters were found in the majority of these children. The average length of hospital stay was approximately one week, there were no critical patients and the prognosis was good.

CONCLUSIONSInfluenza viruses were at a peak level in inpatient children in the winter of 2011. IVB infection rate was gradually increasing. In children with pneumonia caused by IVB only, there are few critical patients, the symptoms are nonspecific and the prognosis is good.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Influenza B virus ; Influenza, Human ; diagnosis ; epidemiology ; immunology ; Length of Stay ; Male ; Pneumonia, Viral ; diagnosis ; epidemiology ; immunology ; Retrospective Studies

Though the 2009 worldwide influenza A (H1N1) pandemic has been declared to have ended, the influenza virus is expected to continue to circulate from some years as a seasonal influenza. A rapid antigen test (RAT) can aid in rapid diagnosis and allow for early antiviral treatment. We evaluated the clinical usefulness of RAT using SD Bioline Influenza Antigen Test(R) kit to detect the influenza virus, considering various factors. From August 1, 2009 to October 10, 2009, a total of 938 patients who visited the outpatient clinic at Korea University Guro Hospital with influenza-like illnesses were enrolled in the study. Throat or nasopharyngeal swab specimens were obtained from each of the patients. Using these specimens, we evaluated the influenza detection rate by rapid antigen test based on the real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) method. In comparison with rRT-PCR, the sensitivity and specificity of the RAT were 44.0% and 99.9%, respectively. The cyclic threshold values of RAT negative specimens were higher than RAT positive specimens (30.1+/-3.1 vs. 28.3+/-3.9, p=0.031). The sensitivity of the RAT kit was higher in patients who visited clinics within two days of symptom onset (60.4% vs. 11.1%, p=0.026). The results of this study show that the RAT cannot be recommended for general use in all patients with influenza-like illness because of its low sensitivity. The RAT may be used, only in the settings with limited diagnostic resources, for patients who visit a clinic within two days of symptom onset.
Antigens, Viral/genetics ; Humans ; Influenza A Virus, H1N1 Subtype/genetics/immunology/*isolation & purification ; Influenza, Human/*diagnosis/virology ; Reagent Kits, Diagnostic ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Time Factors

Uveitis was a rare adverse event of vaccination. We met two cases of acute uveitis with exudative retinal detachment following vaccination of H1N1 influenza. Case 1 was a 10-year-old boy who was admitted for bilateral blurred vision at 10 days after vaccination of H1N1 influenza. Vitreous opacity was obvious in both eyes. Broad exudative retinal detachment was observed in the right eye. Case 2 was a 47-year-old female who suffered from an acute high fever at 2 days after the vaccination of H1N1 influenza. Later, she encountered bilateral headache and decreasing vision. In both eyes, mutton fat keratic precipitates, positive Tyndall phenomenon, congestion of optic disc and exudative retinal detachment were observed.
Child ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza Vaccines ; adverse effects ; therapeutic use ; Influenza, Human ; immunology ; prevention & control ; Male ; Middle Aged ; Retinal Detachment ; diagnosis ; etiology ; Uveitis ; diagnosis ; etiology

OBJECTIVETo explore the value of different types of samples, including throat swabs, stools, bloods in pandemic A (H1N1) influenza diagnosis and virus shedding patterns.

METHODSFrom May to June in 2009, 135 samples were collected from 23 confirmed cases of pandemic influenza A (H1N1) infection, including 99 throat swabs, 14 stools, 11 bloods, 1 respiratory tract washing from 13 confirmed cases and 10 blood samples from other confirmed cases. The virus was detected by real-time RT-PCR, the antibody was detected by haemagglutination inhibition assay.

RESULTSFor 99 throat swabs of 13 patients, the median time of the first positive real-time RT-PCR was 1 day (ranged from 0 to 7 days) after the onset of the symptoms of illness; the median length of time duration of positive real-time RT-PCR results from throat swabs was 3 days (ranged from 1 to 15 days). Four cases intermittently released virus. One respiratory tract washing sample was positive. In 14 stools, 8 stools were real-time RT-PCR positive, the positive rate was 57.14%. The median time of the positive real-time RT-PCR was 3 days (ranged from 1 to 4 days) after the onset of the symptoms of illness. In 21 blood samples collected at 2 to 9 days of onset, 1 blood sample was real-time RT-PCR positive, the positive rate was 4.76%. All these 21 blood samples were antibody negative.

CONCLUSIONThroat swabs and stools samples can be used as A (H1N1) influenza early diagnosis. The length of time duration of positive real-time RT-PCR in throat swabs was longer than stool samples and intermittently releasing of virus were found in throat swabs. Influenza A H1N1 cases showed the presence of small amount of viremia and antibody was negative in early blood samples (< 9 days).

Adolescent ; Adult ; Antibodies, Viral ; analysis ; Child ; China ; epidemiology ; Female ; Hemagglutination Inhibition Tests ; Humans ; Influenza A Virus, H1N1 Subtype ; immunology ; Influenza, Human ; diagnosis ; epidemiology ; virology ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Virus Shedding ; Young Adult

BACKGROUND: In April 2009, a novel influenza A (H1N1) virus was detected in the US, and at the time of conducting this study, H1N1 infection had reached pandemic proportions. In Korea, rapid antigen tests and PCR assays have been developed to detect the H1N1 virus. We evaluated the efficacies of rapid antigen test, multiplex PCR, and real-time PCR for detecting the H1N1 virus. METHODS: From August to September 2009, we tested 734 samples obtained from nasopharyngeal swab or nasal swab using rapid antigen test (SD Influenza Antigen, Standard Diagnostics, Inc., Korea) and multiplex PCR (Seeplex FluA ACE Subtyping, Seegene, Korea). We also tested 224 samples using the AdvanSure real-time PCR (LG Life Sciences, Korea) to compare the results obtained using real-time PCR with those obtained using multiplex PCR. Furthermore, 99 samples were tested using the AdvanSure real-time PCR and the AccuPower real-time PCR (Bioneer, Korea). RESULTS: In comparison with the results of multiplex PCR, the sensitivity and specificity of the rapid antigen test were 48.0% and 99.8%, respectively. The concordance rate for multiplex PCR and the AdvanSure real-time PCR was 99.6% (kappa=0.991, P=0.000), and that for the AdvanSure real-time PCR and the AccuPower real-time PCR was 97.0% (kappa=0.936, P=0.000). CONCLUSIONS: The rapid antigen test is significantly less sensitive than PCR assay; therefore, it is not useful for H1N1 detection; however multiplex PCR, the AdvanSure real-time PCR, and the Accu-Power real-time PCR can be useful for H1N1 detection.
Antigens, Viral/genetics ; Humans ; Influenza A Virus, H1N1 Subtype/genetics/immunology/*isolation &purification ; Influenza, Human/*diagnosis/virology ; *Polymerase Chain Reaction ; RNA, Viral/genetics ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Sequence Analysis, RNA

OBJECTIVETo study the clinical characteristics and laboratory results of 24 confirmed H1N1 influenza cases.

METHODSThe characters of clinical, laboratory, iconography and etiology of 24 patients with A/H1N1 were studied, and the changes of T-lymphocyte subsets that between the pre- and post-treatment were evaluated.

RESULTSThe ages of patients were ranged from 6 to 65 years old; average age was 26 years old.15 patients were under 25 years old. 22 (22/24, 91.7%) patients had recently traveled to USA or Canada. The most common presenting symptoms were: fever (22/24, 91.7%); sore throat (22/24, 91.7%); cough (20/24, 83.3%); dry cough (14/24, 58.3%); expectoration (6/24, 25.0%); nasal discharge (6/24, 25.0%). Six had pneumonia in sixteen patients (6/16, 37.5%) who took CT scan; seven (7/24, 29.2%) had headache and four (4/24, 16.7%) had muscular soreness; two (2/24, 8.3%) had sneeze and nasal obstruction; only one(1/24, 4.2%) had diarrhea; one (1/24, 4.2%) had conjunctivitis. The result of 23 patients about T-Lymphocyte subsets: most of CD4 and CD8 were decreased (18/23, 78.3%), ranging from 122 to 691 cells/microl (normal was 706 - 1125 cells/microl), with the average of 408 cells/microl, but ratios of CD4/CD8 were normal. Fourteen patients were detected CD4 and CD8 after received the treatment during 5 to 7 days.the results of CD4 (cells/microl) were different between the pre- and post-treatment: 436.29 +/- 189.06, 976.71 +/- 332.96 (paired-samples t test: t = -5.416, P < 0.05) while the results of CD8 (cells/microl) were: 323.64 +/- 176.47, 703.14 +/- 211.77 (t = -5.319, P < 0.05); the results of leukocytes in 22 patients were different between pre- and post-treatment: (5.13 +/- 1.47) x 10(9)/L, (6.25 +/- 1.37) x 10(9)/L (t = -2.900, P < 0.05) while the results of lymphocytes were: (1.16 +/- 0.43) x 10(9)/L, (2.30 +/- 0.37) x 10(9)/L (t = -6.819, P < 0.05); but the ratios of CD4/CD8 were: 1.44 +/- 0.41, 1.40 +/- 0.26 (t = 0.507, P > 0.05). All the patients were received antivirus treatment (Oseltamivir) and the virus conversed during 1 - 10 days (average 4.5 days). The temperature was normal after onset during 3 - 4 days and the patients were recovered during 3 - 13 days (with the average of 7.3 days).

CONCLUSIONInfluenza A virus H1N1 subtype was identified as the cause of outbreaks of febrile respiratory infection which was self-limited. There was no evidence to show that the changes of T-Lymphocyte subsets could indicate the prognosis of patients.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; diagnosis ; immunology ; virology ; Male ; Middle Aged ; Prognosis ; T-Lymphocyte Subsets ; Young Adult