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Fulltext Outbreak of influenza amongst residential school students in Malaysia

Ayob A, Selviendran N, Hampson AW, Barr IG, Kumarasamy V, Chua KB

Med J Malaysia, 2006 Jun;61(2):168-72.
PMID: 16898307 MyJurnal

In the months of July and August 2003, an outbreak of acute respiratory illness caused by influenza A virus occurred among students in seven residential schools situated in the northern part (Perak) of Peninsular Malaysia. Out of 4989 students, aged 13 to 18 years (mean = 15.9), 1419 (28%) were effected by influenza-like illness. All patients were treated as outpatients except for 36 students who required admission for high fever, severe coughing and shortness of breath. Abnormal chest X-ray findings were noted for those that required inpatient management. Influenza A virus was isolated from 37 sputum specimens, 20 throat swabs and three nasal swab specimens from a total of 278 clinical samples obtained from 180 patients. Isolates from each of the outbreaks were sent to WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia for antigenic and genetic analysis. One school outbreak was due to influenza A (H1N1), A/New Caledonia/20/99-like virus while the other six school outbreaks were due to influenza A (H3N2) viruses which were A/Fujian/411/2002-like).

Matched MeSH terms: Influenza A Virus, H1N1 Subtype
[The 2005-2006 influenza season in the Netherlands and the vaccine composition for the 2006-2007 season]

Rimmelzwaan GF, de Jong JC, Donker GA, Meijer A, Fouchier RA, Osterhaus AD

Ned Tijdschr Geneeskd, 2006 Oct 7;150(40):2209-14.
PMID: 17061434

The first sign of influenza activity in the Netherlands during the 2005-2006 influenza season was the isolation of influenza viruses in the last week of 2005. From Week 1 of 2006 onwards, an increase in clinical influenza activity was also observed that did not return to baseline levels until Week 15. Two waves of influenza activity were observed with peak incidences of 13.8 and 9.8 influenza-like illnesses per 10,000 inhabitants on Weeks 7 and 12, respectively. The first wave of influenza was caused primarily by influenza B viruses, whereas the second wave was caused predominantly by influenza A/H3N2 viruses. The influenza B viruses appeared to belong to two different phylogenetic lineages and were antigenically distinguishable from the vaccine strain. The isolated influenza A/H3N2 viruses were closely related to the vaccine strain for this subtype and only minor antigenic differences with the vaccine strain were observed for a limited number of isolates. Only a small number of influenza A/H1N1 viruses were isolated, which all closely resembled the H1N1 vaccine strain. For the 2006-2007 influenza season, the World Health Organization has recommended the following vaccine composition: A/Wisconsin/67/05 (H3N2), A/New Caledonia/20/99 (H1N1) and B/Malaysia/2506/05.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/immunology*; Influenza A Virus, H1N1 Subtype/isolation & purification
Effectiveness of influenza vaccination in prevention of influenza-like illness among inhabitants of old folk homes

Isahak I, Mahayiddin AA, Ismail R

Southeast Asian J. Trop. Med. Public Health, 2007 Sep;38(5):841-8.
PMID: 18041300

The aims of the study were to determine the attack rate of influenza-like illness among inhabitants of five old folk homes nationwide using influenza vaccine as a probe and the effectiveness of influenza vaccination in prevention of influenza-like illness. We conducted a nonrandomized, single-blind placebo control study from June 2003 to February 2004. VAXIGRIP(R) 2003 Southern hemisphere formulation was used. Among 527 subjects, the attack rates of influenza-like illness in the influenza vaccine group were 6.4, 4.6 and 2.4% during the first, second and third 2-month periods, respectively. The attack rates of influenza-like illness in the placebo group were 17.7, 13.8 and 10.1%. Influenza vaccination reduced the risk of contracting influenza-like illness by between 14, and 45%. The vaccine effectiveness in reducing the occurrence of influenza-like illness ranged from 55 to 76%, during the 6-month study followup. The presence of cerebrovascular diseases significantly increased the risk of influenza-like illness (p < 0.005). Vaccine recipients had fewer episodes of fever, cough, muscle aches, runny nose (p < 0.001) and experience fewer sick days due to respiratory illness. Subjects who received influenza vaccination had clinically and statistically significant reductions in the attack rate of influenza-like illness. Our data support influenza vaccination of persons with chronic diseases and >50 year olds living in institutions.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/immunology
Influenza viruses circulating in Thailand in 2004 and 2005

Waicharoen S, Thawatsupha P, Chittaganpitch M, Maneewong P, Thanadachakul T, Sawanpanyalert P

Jpn J Infect Dis, 2008 Jul;61(4):321-3.
PMID: 18653981

Determining the local circulating strain of influenza is essential to prevent and control epidemics. In the years 2004 and 2005, the National Influenza Center of Thailand received 3,854 and 3,834 specimens, respectively, from patients throughout the country, including submissions from 4 established influenza surveillance sentinel sites. In 2004, of 539 influenza-positive specimens, 461 were positive for influenza A and 78 were positive for influenza B by isolation. Influenza A subtyping revealed that 249, 197, and 15 isolates were H1N1, H3N2, and H5N1, respectively. In 2005, of 748 influenza-positive specimens, 492 were influenza A and the remaining 256 were influenza B. The results of influenza A subtyping indicated that 55, 437, and 5 isolates were H1N1, H3N2, and H5N1. All isolated strains of subtype H1N1 were A/New Caledonia/20/99-like. The isolated strains of H3N2 were A/Fujian/411/2002-like in the first half of the year 2004, while those in the latter half of 2004 gradually drifted to a mixture of A/Wellington/1/2004-like, A/California/7/2004-like, and A/Wisconsin/67/2005-like, and this mixture continued through the end of 2005. The influenza B strains were B/Sichuan/379/99-like, B/Hong Kong/330/2001-like, B/Shanghai/361/2002-like and B/Malaysia/2506/2004-like. The strains circulating in the years 2004 and 2005 were antigenically similar to the vaccine formulas recommended in the same period by WHO. Our results underscore that local influenza surveillance plays an important role in responding to epidemics and potential pandemics.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/isolation & purification
Seroprevalence and risk factors for influenza A viruses in pigs in Peninsular Malaysia

Suriya R, Hassan L, Omar AR, Aini I, Tan CG, Lim YS, et al.

Zoonoses Public Health, 2008 Sep;55(7):342-51.
PMID: 18667027 DOI: 10.1111/j.1863-2378.2008.01138.x

Following a series of H5N1 cases in chickens and birds in a few states in Malaysia, there was much interest in the influenza A viruses subtypes that circulate among the local pig populations. Pigs may act as a mixing vessel for avian and mammal influenza viruses, resulting in new reassorted viruses. This study investigated the presence of antibodies against influenza H1N1 and H3N2 viruses in pigs from Peninsular Malaysia using Herdcheck Swine Influenza H1N1 and H3N2 Antibody Test Kits. At the same time, the presence of influenza virus was examined from the nasal swabs of seropositive pigs by virus isolation and real time RT-PCR. The list of pig farms was obtained from the headquarters of the Department of Veterinary Services, Malaysia, and pig herds were selected randomly from six of 11 states in Peninsular Malaysia. A total of 727 serum and nasal swab samples were collected from 4- to 6-month-old pigs between May and August 2005. By ELISA, the seroprevalences of swine influenza H1N1 and H3N2 among pigs were 12.2% and 12.1% respectively. Seropositivity for either of the virus subtypes was detected in less than half of the 41 sampled farms (41.4%). Combination of both subtypes was detected in 4% of all pigs and in 22% of sampled farms. However, no virus or viral nucleic acid was detected from nasal samples. This study identified that the seropositivity of pigs to H1N1 and H3N2 based on ELISA was significantly associated with factors such as size of farm, importation or purchase of pigs, proximity of farm to other pig farms and the presence of mammalian pets within the farm.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype
Fulltext Component-specific effectiveness of trivalent influenza vaccine as monitored through a sentinel surveillance network in Canada, 2006-2007

Skowronski DM, De Serres G, Dickinson J, Petric M, Mak A, Fonseca K, et al.

J Infect Dis, 2009 Jan 15;199(2):168-79.
PMID: 19086914 DOI: 10.1086/595862

Trivalent inactivated influenza vaccine (TIV) is reformulated annually to contain representative strains of 2 influenza A subtypes (H1N1 and H3N2) and 1 B lineage (Yamagata or Victoria). We describe a sentinel surveillance approach to link influenza variant detection with component-specific vaccine effectiveness (VE) estimation.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/classification; Influenza A Virus, H1N1 Subtype/genetics; Influenza A Virus, H1N1 Subtype/immunology; Influenza A Virus, H1N1 Subtype/isolation & purification
Fulltext Immune response to influenza vaccine in children with inflammatory bowel disease

Lu Y, Jacobson DL, Ashworth LA, Grand RJ, Meyer AL, McNeal MM, et al.

Am J Gastroenterol, 2009 Feb;104(2):444-53.
PMID: 19174786 DOI: 10.1038/ajg.2008.120

Patients with inflammatory bowel disease (IBD) frequently receive immunosuppressive therapy. The immune response in these patients to vaccines has not been well studied. We conducted a prospective, open label study to evaluate the serologic response to influenza vaccine in children with IBD.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/immunology*
Fulltext Pandemic influenza A (H1N1) 2009 in Malaysia--the next phase

Sam IC, Abu Bakar S

Med J Malaysia, 2009 Jun;64(2):105-7.
PMID: 20058566

In recent years, zoonotic RNA viruses such as Nipah, SARS coronavirus, avian influenza (H5N1) and Chikungunya have emerged with global impact. The latest has now been designated by World Health Organization (WHO) as pandemic (H1N1) 2009 virus. It was first reported as an outbreak in Mexico in April, and has now caused the first influenza pandemic since 1968. By July 11, 2009, there were 105,304 confirmed cases and 463 deaths in 143 countries, including 627 cases in Malaysia1 . The rapid spread of the disease has been matched by the speed of dissemination of information and protocols, co-ordinated by WHO. The experiences of SARS and H5N1 have been enormously beneficial in preparing the world for a pandemic.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype*
Sulfated membrane adsorbers for economic pseudo-affinity capture of influenza virus particles

Opitz L, Lehmann S, Reichl U, Wolff MW

Biotechnol Bioeng, 2009 Aug 15;103(6):1144-54.
PMID: 19449393 DOI: 10.1002/bit.22345

Strategies to control outbreaks of influenza, a contagious respiratory tract disease, are focused mainly on prophylactic vaccinations in conjunction with antiviral medications. Currently, several mammalian cell culture-based influenza vaccine production processes are being established, such as the technologies introduced by Novartis Behring (Optaflu) or Baxter International Inc. (Celvapan). Downstream processing of influenza virus vaccines from cell culture supernatant can be performed by adsorbing virions onto sulfated column chromatography beads, such as Cellufine sulfate. This study focused on the development of a sulfated cellulose membrane (SCM) chromatography unit operation to capture cell culture-derived influenza viruses. The advantages of the novel method were demonstrated for the Madin Darby canine kidney (MDCK) cell-derived influenza virus A/Puerto Rico/8/34 (H1N1). Furthermore, the SCM-adsorbers were compared directly to column-based Cellufine sulfate and commercially available cation-exchange membrane adsorbers. Sulfated cellulose membrane adsorbers showed high viral product recoveries. In addition, the SCM-capture step resulted in a higher reduction of dsDNA compared to the tested cation-exchange membrane adsorbers. The productivity of the SCM-based unit operation could be significantly improved by a 30-fold increase in volumetric flow rate during adsorption compared to the bead-based capture method. The higher flow rate even further reduced the level of contaminating dsDNA by about twofold. The reproducibility and general applicability of the developed unit operation were demonstrated for two further MDCK cell-derived influenza virus strains: A/Wisconsin/67/2005 (H3N2) and B/Malaysia/2506/2004. Overall, SCM-adsorbers represent a powerful and economically favorable alternative for influenza virus capture over conventional methods using Cellufine sulfate.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/isolation & purification*
Fulltext Initial psychological responses to Influenza A, H1N1 ("Swine flu")

Goodwin R, Haque S, Neto F, Myers LB

BMC Infect Dis, 2009 Oct 06;9:166.
PMID: 19807908 DOI: 10.1186/1471-2334-9-166

BACKGROUND: The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses.
METHODS: 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption
RESULTS: 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001). 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened.
CONCLUSION: Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype*
Immunogenicity and tolerability of a virosome influenza vaccine compared to split influenza vaccine in patients with sickle cell anemia

Souza AR, Braga JA, de Paiva TM, Loggetto SR, Azevedo RS, Weckx LY

Vaccine, 2010 Jan 22;28(4):1117-20.
PMID: 20116631 DOI: 10.1016/j.vaccine.2009.05.046

The immunogenicity and tolerability of virosome and of split influenza vaccines in patients with sickle cell anemia (SS) were evaluated. Ninety SS patients from 8 to 34 years old were randomly assigned to receive either virosome (n=43) or split vaccine (n=47). Two blood samples were collected, one before and one 4-6 weeks after vaccination. Antibodies against viral strains (2006) A/New Caledonia (H1N1), A/California (H3N2), B/Malaysia were determined using the hemagglutinin inhibition test. Post-vaccine reactions were recorded over 7 days. Seroconversion rates for H1N1, H3N2 and B were 65.1%, 60.4% and 83.7% for virosome vaccine, and 68.0%, 61.7% and 68.0% for split vaccine. Seroprotection rates for H1N1, H3N2 e B were 100%, 97.6% and 69.7% for virosome, and 97.8%, 97.8% and 76.6% for split vaccine. No severe adverse reactions were recorded. Virosome and split vaccines in patients with sickle cell anemia were equally immunogenic, with high seroconversion and seroprotection rates. Both vaccines were well tolerated.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/immunology
Detection of influenza A and B neutralizing antibodies in vaccinated ferrets and macaques using specific biotin-streptavidin conjugated antibodies

Sirskyj D, Weltzin R, Golshani A, Anderson D, Bozic J, Diaz-Mitoma F, et al.

J Virol Methods, 2010 Feb;163(2):459-64.
PMID: 19913054 DOI: 10.1016/j.jviromet.2009.11.014

Several critical factors of an influenza microneutralization assay, utilizing a rapid biotin-streptavidin conjugated system for detecting influenza virus subtypes A and B, are addressed within this manuscript. Factors such as incubation times, amount of virus, cell seeding, sonication, and TPCK trypsin were evaluated for their ability to affect influenza virus neutralization in a microplate-based neutralization assay using Madin-Darby canine kidney (MDCK) cells. It is apparent that the amount of virus used in the assay is the most critical factor to be optimized in an influenza microneutralization assay. Results indicate that 100xTCID(50) of influenza A/Solomon Islands/03/2006 (H1N1) virus overloads the assay and results in no, to low, neutralization, in both ferret and macaque sera, respectively, whereas using 6xTCID(50) resulted in significantly improved neutralization. Conversely, strong neutralization was observed against 100xTCID(50) of B/Malaysia/2506/04 virus. In this manuscript the critical factors described above were optimized and the results indicate that the described biotin-streptavidin conjugated influenza microneutralization assay is a rapid and robust method for detecting the presence of functional, influenza virus-neutralizing antibodies.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/immunology*
Fulltext Influenza A (H1N1) 2009 pandemic virus: learning from the first wave, preparing for the second

Lee CK

Med J Malaysia, 2010 Mar;65(1):1-2.
PMID: 21265237

In a short period of two months, the novel influenza A/H1N1 virus has circumnavigated the entire planet leaving behind in its wake approximately 3000 reported deaths worldwide. Fortunately, in many areas around the world, September 2009 brought a lull in the number of new H1N1 infections. This brought welcomed relief in many countries that had earlier experienced high respiratory disease activity in their communities. However, based on previous influenza pandemics, this reprieve may well be short-lived. As the Northern hemisphere approaches its winter months, many experts are now predicting a second wave of influenza A/H1N1 infections. This prediction maybe well placed as all 3 influenza pandemics in the last century reported second or even subsequent waves of new infections, all of which appeared to be more severe than the primary event (ref). The timing of these second waves have varied from 6 months to 3 years and invariably seemed to be linked to the winter months. It is unclear precisely what changes caused the increased severity seen during the second waves; one possibility is the progressive adaptation of the novel influenza virus to its new human host . Molecular analysis, for example, suggests that the 1918 Spanish influenza virus that emerged during the second wave had undergone changes in the hemagglutinin binding site that increased the binding specificity for human receptors. This is thought to have increased the replicative capacity and hence, the pathogenicity of the virus. It is also evident that as the H1N1 2009 pandemic virus continues to spread, opportunities for adaptation that increases virulence will also increase. Nonetheless, the changes needed for such adaptation and for increased virulence are unpredictable and by no means inevitable

Matched MeSH terms: Influenza A Virus, H1N1 Subtype*
Fulltext Preliminary evaluation of various rapid influenza diagnostic test methods for the detection of the novel influenza A (H1N1) in Universiti Kebangsaan Malaysia Medical Centre

Zetti ZR, Wong KK, Haslina M, Ilina I

Med J Malaysia, 2010 Mar;65(1):27-30.
PMID: 21265244 MyJurnal

We evaluated the performance of four rapid influenza diagnostic test methods (RIDT) compared to real-time reverse-transcription polymerase chain reaction (rRT-PCR), for the detection of the novel swine-origin influenza A (H1N1) virus (S-OIV) in August 2009. A total of 270 respiratory specimens were tested with rRT-PCR, where 74 of these were tested by BinaxNow (Inverness), 80 by QuickVue (Quidel), 37 by Influenza A Antigen Rapid Test (Rockeby Biomed) and 79 by Directigen (BD). The sensitivities ranged from 4.4% to 37.0%, specificities 90.9% to 100.0%, positive predictive values 75.0% to 100.0% and negative predictive values 32.3% to 75.0%. RIDT were able to detect S-OIV but the sensitivities were low. The limitations of RIDT must be considered when interpreting results for clinical management.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/isolation & purification*
Fulltext Influenza outbreaks during World Youth Day 2008 mass gathering

Blyth CC, Foo H, van Hal SJ, Hurt AC, Barr IG, McPhie K, et al.

Emerg Infect Dis, 2010 May;16(5):809-15.
PMID: 20409371 DOI: 10.3201/eid1605.091136

Influenza outbreaks during mass gatherings have been rarely described, and detailed virologic assessment is lacking. An influenza outbreak occurred during World Youth Day in Sydney, Australia, July 2008 (WYD2008). We assessed epidemiologic data and respiratory samples collected from attendees who sought treatment for influenza-like illness at emergency clinics in Sydney during this outbreak. Isolated influenza viruses were compared with seasonal influenza viruses from the 2008 influenza season. From 100 infected attendees, numerous strains were identified: oseltamivir-resistant influenza A (H1N1) viruses, oseltamivir-sensitive influenza A (H1N1) viruses, influenza A (H3N2) viruses, and strains from both influenza B lineages (B/Florida/4/2006-like and B/Malaysia/2506/2004-like). Novel viruses were introduced, and pre-WYD2008 seasonal viruses were amplified. Viruses isolated at mass gatherings can have substantial, complex, and unpredictable effects on community influenza activity. Greater flexibility by public health authorities and hospitals is required to appropriately manage and contain these outbreaks.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/genetics; Influenza A Virus, H1N1 Subtype/isolation & purification
Fulltext Comparison of egg and high yielding MDCK cell-derived live attenuated influenza virus for commercial production of trivalent influenza vaccine: in vitro cell susceptibility and influenza virus replication kinetics in permissive and semi-permissive cells

Hussain AI, Cordeiro M, Sevilla E, Liu J

Vaccine, 2010 May 14;28(22):3848-55.
PMID: 20307595 DOI: 10.1016/j.vaccine.2010.03.005

Currently MedImmune manufactures cold-adapted (ca) live, attenuated influenza vaccine (LAIV) from specific-pathogen free (SPF) chicken eggs. Difficulties in production scale-up and potential exposure of chicken flocks to avian influenza viruses especially in the event of a pandemic influenza outbreak have prompted evaluation and development of alternative non-egg based influenza vaccine manufacturing technologies. As part of MedImmune's effort to develop the live attenuated influenza vaccine (LAIV) using cell culture production technologies we have investigated the use of high yielding, cloned MDCK cells as a substrate for vaccine production by assessing host range and virus replication of influenza virus produced from both SPF egg and MDCK cell production technologies. In addition to cloned MDCK cells the indicator cell lines used to evaluate the impact of producing LAIV in cells on host range and replication included two human cell lines: human lung carcinoma (A549) cells and human muco-epidermoid bronchiolar carcinoma (NCI H292) cells. The influenza viruses used to infect the indicators cell lines represented both the egg and cell culture manufacturing processes and included virus strains that composed the 2006-2007 influenza seasonal trivalent vaccine (A/New Caledonia/20/99 (H1N1), A/Wisconsin/67/05 (H3N2) and B/Malaysia/2506/04). Results from this study demonstrate remarkable similarity between influenza viruses representing the current commercial egg produced and developmental MDCK cell produced vaccine production platforms. MedImmune's high yielding cloned MDCK cells used for the cell culture based vaccine production were highly permissive to both egg and cell produced ca attenuated influenza viruses. Both the A549 and NCI H292 cells regardless of production system were less permissive to influenza A and B viruses than the MDCK cells. Irrespective of the indicator cell line used the replication properties were similar between egg and the cell produced influenza viruses. Based on these study results we conclude that the MDCK cell produced and egg produced vaccine strains are highly comparable.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/growth & development*; Influenza A Virus, H1N1 Subtype/immunology; Influenza A Virus, H1N1 Subtype/physiology
Factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population

Wong LP, Sam IC

Vaccine, 2010 Jun 17;28(28):4499-505.
PMID: 20451639 DOI: 10.1016/j.vaccine.2010.04.043

The study aimed to determine factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population. Population-based, cross-sectional survey was conducted between October and December 2009. Approximately 70% of overall participants indicated willingness to be vaccinated against the 2009 H1N1 influenza. Participants who indicated positive intention to vaccinate against 2009 H1N1 influenza were more likely to have favorable attitudes toward the 2009 H1N1 vaccine. A halal (acceptable to Muslims) vaccine was the main factor that determined Malay participants' decision to accept vaccination, whereas safety of the vaccine was the main factor that influenced vaccination decision for Chinese and Indian participants. The study highlights the challenges in promoting the 2009 H1N1 vaccine. Ethnic-sensitive efforts are needed to maximize acceptance of H1N1 vaccines in countries with diverse ethnic communities and religious practices.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype
Temporal changes in psychobehavioral responses during the 2009 H1N1 influenza pandemic

Wong LP, Sam IC

Prev Med, 2010 Jul;51(1):92-3.
PMID: 20403375 DOI: 10.1016/j.ypmed.2010.04.010

This paper aimed to examine the temporal changes in psychobehavioral responses in relation to reported 2009 H1N1 influenza deaths.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype*
Production of cell culture (MDCK) derived live attenuated influenza vaccine (LAIV) in a fully disposable platform process

George M, Farooq M, Dang T, Cortes B, Liu J, Maranga L

Biotechnol Bioeng, 2010 Aug 15;106(6):906-17.
PMID: 20589670 DOI: 10.1002/bit.22753

The majority of influenza vaccines are manufactured using embryonated hens' eggs. The potential occurrence of a pandemic outbreak of avian influenza might reduce or even eliminate the supply of eggs, leaving the human population at risk. Also, the egg-based production technology is intrinsically cumbersome and not easily scalable to provide a rapid worldwide supply of vaccine. In this communication, the production of a cell culture (Madin-Darby canine kidney (MDCK)) derived live attenuated influenza vaccine (LAIV) in a fully disposable platform process using a novel Single Use Bioreactor (SUB) is presented. The cell culture and virus infection was maintained in a disposable stirred tank reactor with PID control of pH, DO, agitation, and temperature, similar to traditional glass or stainless steel bioreactors. The application of this technology was tested using MDCK cells grown on microcarriers in proprietary serum free medium and infection with 2006/2007 seasonal LAIV strains at 25-30 L scale. The MDCK cell growth was optimal at the agitation rate of 100 rpm. Optimization of this parameter allowed the cells to grow at a rate similar to that achieved in the conventional 3 L glass stirred tank bioreactors. Influenza vaccine virus strains, A/New Caledonia/20/99 (H1N1 strain), A/Wisconsin/67/05 (H3N2 strain), and B/Malaysia/2506/04 (B strain) were all successfully produced in SUB with peak virus titers > or =8.6 log(10) FFU/mL. This result demonstrated that more than 1 million doses of vaccine can be produced through one single run of a small bioreactor at the scale of 30 L and thus provided an alternative to the current vaccine production platform with fast turn-around and low upfront facility investment, features that are particularly useful for emerging and developing countries and clinical trial material production.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/growth & development*
An influenza B outbreak during the 2007/2008 winter among appropriately immunized elderly people living in a nursing home

Camilloni B, Neri M, Lepri E, Basileo M, Sigismondi N, Puzelli S, et al.

Vaccine, 2010 Nov 3;28(47):7536-41.
PMID: 20846530 DOI: 10.1016/j.vaccine.2010.08.064

The study evaluated the immunogenicity and efficacy of a trivalent subunit MF59-adjuvanted influenza vaccine (A/Wisconsin/67/05 (H3N2), A/Solomon Islands/3/06 (H1N1) and B/Malaysia/2506/04) in preventing serologically diagnosed infections in a group of 67 institutionalized elderly volunteers during 2007/2008 winter, characterized by co-circulation of drifted A/H3N2, A/H1N1 and B influenza viruses. Influenza vaccination induced a significant increase in the amounts of hemagglutination inhibiting antibodies, both against the vaccine and the epidemic drifted strains. However, vaccination did not prevent the circulation of the new drifted influenza B virus (B/Florida/4/06-like), belonging to the B/Yamagata/16/88-lineage, antigenically and genetically distinct from B/Victoria/2/87-lineage viruses from which the vaccine B strain was derived.

Matched MeSH terms: Influenza A Virus, H1N1 Subtype/classification; Influenza A Virus, H1N1 Subtype/genetics

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