scholarly journals Self-Swabbing for Virological Confirmation of Influenza-Like Illness Among an Internet-Based Cohort in the UK During the 2014-2015 Flu Season: Pilot Study (Preprint)

2017 ◽  
Author(s):  
Clare Wenham ◽  
Eleanor R Gray ◽  
Candice E Keane ◽  
Matthew Donati ◽  
Daniela Paolotti ◽  
...  
Keyword(s):  
Pilot Study ◽  
Influenza Infection ◽  
Routine Data ◽  
Influenza Surveillance ◽  
Influenza Like Illness ◽  
Time Estimates ◽  
Laboratory Confirmation ◽  
Community Transmission ◽  
The Uk ◽  
Study Participants

BACKGROUND Routine influenza surveillance, based on laboratory confirmation of viral infection, often fails to estimate the true burden of influenza-like illness (ILI) in the community because those with ILI often manage their own symptoms without visiting a health professional. Internet-based surveillance can complement this traditional surveillance by measuring symptoms and health behavior of a population with minimal time delay. Flusurvey, the UK’s largest crowd-sourced platform for surveillance of influenza, collects routine data on more than 6000 voluntary participants and offers real-time estimates of ILI circulation. However, one criticism of this method of surveillance is that it is only able to assess ILI, rather than virologically confirmed influenza. OBJECTIVE We designed a pilot study to see if it was feasible to ask individuals from the Flusurvey platform to perform a self-swabbing task and to assess whether they were able to collect samples with a suitable viral content to detect an influenza virus in the laboratory. METHODS Virological swabbing kits were sent to pilot study participants, who then monitored their ILI symptoms over the influenza season (2014-2015) through the Flusurvey platform. If they reported ILI, they were asked to undertake self-swabbing and return the swabs to a Public Health England laboratory for multiplex respiratory virus polymerase chain reaction testing. RESULTS A total of 700 swab kits were distributed at the start of the study; from these, 66 participants met the definition for ILI and were asked to return samples. In all, 51 samples were received in the laboratory, 18 of which tested positive for a viral cause of ILI (35%). CONCLUSIONS This demonstrated proof of concept that it is possible to apply self-swabbing for virological laboratory testing to an online cohort study. This pilot does not have significant numbers to validate whether Flusurvey surveillance accurately reflects influenza infection in the community, but highlights that the methodology is feasible. Self-swabbing could be expanded to larger online surveillance activities, such as during the initial stages of a pandemic, to understand community transmission or to better assess interseasonal activity.

scholarly journals Self-Swabbing for Virological Confirmation of Influenza-Like Illness Among an Internet-Based Cohort in the UK During the 2014-2015 Flu Season: Pilot Study

2018 ◽  
Vol 20 (3) ◽  
pp. e71 ◽  
Author(s):  
Clare Wenham ◽  
Eleanor R Gray ◽  
Candice E Keane ◽  
Matthew Donati ◽  
Daniela Paolotti ◽  
...  
Keyword(s):  
Pilot Study ◽  
Influenza Like Illness ◽  
The Uk

scholarly journals Investigation of SARS-CoV-2 faecal shedding in the community: a prospective household cohort study (COVID-LIV) in the UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natasha Marcella Vaselli ◽  
Wega Setiabudi ◽  
Krishanthi Subramaniam ◽  
Emily R. Adams ◽  
Lance Turtle ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gastrointestinal Symptoms ◽  
Oral Route ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Household Transmission ◽  
Community Transmission ◽  
Observational Cohort ◽  
The Uk ◽  
Study Participants

Abstract Background SARS-CoV-2 is frequently shed in the stool of patients hospitalised with COVID-19. The extent of faecal shedding of SARS-CoV-2 among individuals in the community, and its potential to contribute to spread of disease, is unknown. Methods In this prospective, observational cohort study among households in Liverpool, UK, participants underwent weekly nasal/throat swabbing to detect SARS-CoV-2 virus, over a 12-week period from enrolment starting July 2020. Participants that tested positive for SARS-CoV-2 were asked to provide a stool sample three and 14 days later. In addition, in October and November 2020, during a period of high community transmission, stool sampling was undertaken to determine the prevalence of SARS-CoV-2 faecal shedding among all study participants. SARS-CoV-2 RNA was detected using Real-Time PCR. Results A total of 434 participants from 176 households were enrolled. Eighteen participants (4.2%: 95% confidence interval [CI] 2.5–6.5%) tested positive for SARS-CoV-2 virus on nasal/throat swabs and of these, 3/17 (18%: 95% CI 4–43%) had SARS-CoV-2 detected in stool. Two of three participants demonstrated ongoing faecal shedding of SARS-CoV-2, without gastrointestinal symptoms, after testing negative for SARS-CoV-2 in respiratory samples. Among 165/434 participants without SARS-CoV-2 infection and who took part in the prevalence study, none had SARS-CoV-2 in stool. There was no demonstrable household transmission of SARS-CoV-2 among households containing a participant with faecal shedding. Conclusions Faecal shedding of SARS-CoV-2 occurred among community participants with confirmed SARS-CoV-2 infection. However, during a period of high community transmission, faecal shedding of SARS-CoV-2 was not detected among participants without SARS-CoV-2 infection. It is unlikely that the faecal-oral route plays a significant role in household and community transmission of SARS-CoV-2.

scholarly journals Self-Swabbing for Virological Confirmation of Influenza-Like Illness Among an Internet-Based Cohort in the UK During the 2014-2015 Flu Season: Pilot Study

2017 ◽  
Author(s):  
Clare Wenham ◽  
Eleanor R Gray ◽  
Candice E Keane ◽  
Matthew Donati ◽  
Daniela Paolotti ◽  
...  
Keyword(s):  
Pilot Study ◽  
Influenza Like Illness ◽  
The Uk

scholarly journals Clinical Predictors of Influenza in Young Children: The Limitations of “Influenza-Like Illness”

2012 ◽  
Vol 2 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Nicholas T. Conway ◽  
Zoe V. Wake ◽  
Peter C. Richmond ◽  
David W. Smith ◽  
Anthony D. Keil ◽  
...  
Keyword(s):  
Young Children ◽  
Predictive Value ◽  
Influenza Infection ◽  
Diagnostic Testing ◽  
Epidemiological Data ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Clinical Predictors ◽  
Influenza Like Illness ◽  
Control And Prevention

Abstract Background Influenza-like illness (ILI) definitions have been infrequently studied in young children. Despite this, clinical definitions of ILI play an important role in influenza surveillance. This study aims to identify clinical predictors of influenza infection in children ≤5 years old from which age-specific ILI definitions are then constructed. Methods Children aged 6–59 months with a history of fever and acute respiratory symptoms were recruited in the Western Australia Influenza Vaccine Effectiveness (WAIVE) Study. Clinical data and per-nasal specimens were obtained from all children. Logistic regression identified significant predictors of influenza infection. Different ILI definitions were compared for diagnostic accuracy. Results Children were recruited from 2 winter influenza seasons (2008–2009; n = 944). Of 919 eligible children, 179 (19.5%) had laboratory-confirmed influenza infection. Predictors of infection included increasing age, lack of influenza vaccination, lower birth weight, fever, cough, and absence of wheeze. An ILI definition comprising fever ≥38°C, cough, and no wheeze had 58% sensitivity (95% confidence interval [CI], 50–66), 60% specificity (95% CI, 56–64), 26% positive predictive value (95% CI, 21–31), and 86% negative predictive value (95% CI, 82–89). The addition of other symptoms or higher fever thresholds to ILI definition had little impact. The Centers for Disease Control and Prevention definition of ILI (presence of fever [≥37.8°C] and cough and/or sore throat) was sensitive (92%; 95% CI, 86–95), yet lacked specificity (10%; 95% CI, 8–13) in this population. Conclusions Influenza-like illness is a poor predictor of laboratory-confirmed influenza infection in young children but can be improved using age-specific data. Incorporating age-specific ILI definitions and/or diagnostic testing into influenza surveillance systems will improve the accuracy of epidemiological data.

scholarly journals Influenza-like illness surveillance using a deputising medical service corresponds to surveillance from sentinel general practices

2009 ◽  
Vol 14 (44) ◽  
Author(s):  
M Coory ◽  
K Grant ◽  
H Kelly
Keyword(s):  
Medical Service ◽  
Low Cost ◽  
Data Sources ◽  
Influenza Surveillance ◽  
Web Searches ◽  
Influenza Like Illness ◽  
Laboratory Confirmation ◽  
Timely Fashion ◽  
General Practices ◽  
Definition Of

Standard sources of data for influenza surveillance include notifications of laboratory-confirmed cases and notifications from sentinel general practices. These data are not always available in a timely fashion, leading to proposals to use more immediate data sources such as over-the-counter drug sales, ambulance call-outs and web searches to monitor influenza-like illness (ILI). We aimed to assess data from a deputising medical service as another source of data for timely syndromic influenza surveillance. We measured the extent of agreement between the weekly percentage of patients with ILI reported from sentinel general practices and the corresponding weekly percentage reported from a deputising medical service in Victoria, Australia over ten years, from 1999 to 2008. There was good agreement between the two data sources, with suitably narrow limits of agreement. The deputising medical service did not use a standardised definition of ILI and is not supplemented by laboratory confirmation of suspected cases. Nevertheless, the results of this study show that such data can provide low cost and timely ILI surveillance.

Clinical symptoms cannot predict influenza infection during the 2013 influenza season in Bavaria, Germany

2015 ◽  
Vol 144 (5) ◽  
pp. 1045-1051 ◽  
Author(s):  
H. CAMPE ◽  
S. HEINZINGER ◽  
C. HARTBERGER ◽  
A. SING
Keyword(s):  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Influenza Season ◽  
Influenza Infection ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Case Definition ◽  
Influenza Surveillance ◽  
Case Definitions ◽  
Laboratory Confirmation

SUMMARYFor influenza surveillance and diagnosis typical clinical symptoms are traditionally used to discriminate influenza virus infections from infections by other pathogens. During the 2013 influenza season we performed a multiplex assay for 16 different viruses in 665 swabs from patients with acute respiratory infections (ARIs) to display the variety of different pathogens causing ARI and to test the diagnostic value of both the commonly used case definitions [ARI, and influenza like illness (ILI)] as well as the clinical judgement of physicians, respectively, to achieve a laboratory-confirmed influenza diagnosis. Fourteen different viruses were identified as causing ARI/ILI. Influenza diagnosis based on clinical signs overestimated the number of laboratory-confirmed influenza cases and misclassified cases. Furthermore, ILI case definition and physicians agreed in only 287/651 (44%) cases with laboratory confirmation. Influenza case management has to be supported by laboratory confirmation to allow evidence-based decisions. Epidemiological syndromic surveillance data should be supported by laboratory confirmation for reasonable interpretation.

scholarly journals Respiratory syncytial virus (RSV) in pediatric influenza-like illness (ILI) cases in Lombardy, Northern Italy, during seven consecutive winter seasons (from 2014-2015 to 2020-2021)

2021 ◽  
Author(s):  
Laura Pellegrinelli ◽  
Cristina Galli ◽  
Laura Bubba ◽  
Arlinda Seiti ◽  
Giovanni Anselmi ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza Infection ◽  
Northern Italy ◽  
Influenza Viruses ◽  
Influenza Surveillance ◽  
Reference Laboratory ◽  
Risk Of Infection ◽  
Influenza Like Illness ◽  
Rsv Infection ◽  
Syncytial Virus

INTRODUCTION. Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza-like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10-million inhabitants) from 2014-2015 to 2020-2021 winter seasons. MATERIAL AND METHODS. Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet). RESULTS. RSV accounting for nearly 19% of pediatric ILI with a risk of infection nearly 2-fold greater than that of individuals ≥15 years. The RSV positivity rate increased to 28% considering 0-5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly 2-fold higher than the risk of RSV infection, the age group 4-6 months and 7-12 months showed 5-fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with presence of one or more comorbidities had a nearly 5-fold greater risk of getting RSV infection than otherwise healthy 0-5 years old children. DISCUSSION. The use of the ILI sentinel surveillance allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing and intensity of the RSV and influenza community circulation, determining thresholds based on historical data. This surveillance approach can be implemented to assess the nearly real-time RSV circulation and impact.

Derivation of New Surveillance System for Influenza-like Illness Using Claims Data 2014-2018 in Korea (Preprint)

2020 ◽  
Author(s):  
HeeKyung Choi ◽  
Won Suk Choi ◽  
Euna Han
Keyword(s):  
Surveillance System ◽  
Claims Data ◽  
Health Concern ◽  
Influenza Surveillance ◽  
Utilization Review ◽  
Surveillance Systems ◽  
Influenza Like Illness ◽  
System P ◽  
National Patient ◽  
Antitussive Agents

BACKGROUND Influenza is an important public health concern. A national surveillance system that easily and rapidly detects influenza epidemics is lacking. OBJECTIVE We assumed that the rate of influenza-like illness (ILI) related-claims is similar to the current ILI surveillance system. METHODS We used the Health Insurance Review and Assessment Service-National Patient Samples (HIRA-NPS), 2014-2018. We defined ILI-related claims as outpatient claims that contain both antipyretic and antitussive agents and calculated the weekly rate of ILI-related claims. We compared ILI-related claims and weekly ILI rates from clinical sentinel surveillance data. RESULTS We observed a strong correlation between the two surveillance systems each season. The absolute thresholds for the four-years were 84.64 and 86.19 cases claims per 1,000 claims for claims data and 12.27 and 16.82 per 1,000 patients for sentinel data (Figure 5). Both the claims and sentinel data surpassed the epidemic thresholds each season. The peak epidemic in the claims data was reached one to two weeks later than in the sentinel data. The epidemic patterns were more similar in the 2016-2017 and 2017-2018 seasons than the 2014-2015 and 2015-2016 seasons. CONCLUSIONS Based on hospital reports, ILI-related claims rates were similar to the ILI surveillance system. ILI claims data can be loaded to a drug utilization review system in Korea to make an influenza surveillance system.

scholarly journals Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

2017 ◽  
Vol 46 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Laura Pass ◽  
Carl W. Lejuez ◽  
Shirley Reynolds
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Adolescent Depression ◽  
Psychological Intervention ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Behavioural Activation ◽  
Evidence Based Treatments ◽  
The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

scholarly journals Structural Mapping of Mutations in Spike, RdRp and Orf3a Genes of SARS-CoV-2 in Influenza Like Illness (ILI) Patients

Viruses ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 136
Author(s):  
Bandar Alosaimi ◽  
Asif Naeem ◽  
Majed F. Alghoribi ◽  
Lilian Okdah ◽  
Maaweya E. Hamed ◽  
...  
Keyword(s):  
Surveillance Systems ◽  
Case Definitions ◽  
Structural Mapping ◽  
Policy Makers ◽  
Influenza Like Illness ◽  
Spike Gene ◽  
Ambulatory Patients ◽  
Community Transmission ◽  
Next Generation Sequencing Ngs ◽  
Epidemiological Link

In December 2019, the emergence of SARS-CoV-2 virus in China led to a pandemic. Since both Influenza Like Illness (ILI) and COVID-19 case definitions overlap, we re-investigated the ILI cases using PCR for the presence of SARS-CoV-2 in 739 nasopharyngeal swabs collected from November 2019 to March 2020. SARS-CoV-2 RNA was found in 37 samples (5%) collected mostly during February 2020. It was followed by confirmation of evolutionary and spatial relationships using next generation sequencing (NGS). We observed that the overall incidence of ILI cases during 2019–2020 influenza season was considerably higher than previous years and was gradually replaced with SARS-CoV-2, which indicated a silent transmission among ambulatory patients. Sequencing of representative isolates confirmed independent introductions and silent transmission earlier than previously thought. Evolutionary and spatial analyses revealed clustering in the GH clade, characterized by three amino acid substitutions in spike gene (D614G), RdRp (P323L) and NS3 (Q57H). P323L causes conformational change near nsp8 binding site that might affect virus replication and transcription. In conclusion, assessment of the community transmission among patients with mild COVID-19 illness, particularly those without epidemiological link for acquiring the virus, is of utmost importance to guide policy makers to optimize public health interventions. The detection of SARS-CoV-2 in ILI cases shows the importance of ILI surveillance systems and warrants its further strengthening to mitigate the ongoing transmission of SARS-CoV-2. The effect of NS3 substitutions on oligomerization or membrane channel function (intra- and extracellular) needs functional validation.

Sign in / Sign up

Export Citation Format

Share Document