#Urbanization affects peak timing, prevalence, and bimodality of #influenza #pandemics in #Australia: Results of a census-calibrated model (Sci Adv., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Sci Adv. 2018 Dec 12;4(12):eaau5294. doi: 10.1126/sciadv.aau5294. eCollection 2018 Dec.

Urbanization affects peak timing, prevalence, and bimodality of influenza pandemics in Australia: Results of a census-calibrated model.

Zachreson C1, Fair KM1, Cliff OM1, Harding N1, Piraveenan M1, Prokopenko M1,2.

Author information: 1 Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, The University of Sydney, Sydney, NSW 2006, Australia. 2 Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead, NSW 2145, Australia.



We examine salient trends of influenza pandemics in Australia, a rapidly urbanizing nation. To do so, we implement state-of-the-art influenza transmission and progression models within a large-scale stochastic computer simulation, generated using comprehensive Australian census datasets from 2006, 2011, and 2016. Our results offer a simulation-based investigation of a population’s sensitivity to pandemics across multiple historical time points and highlight three notable trends in pandemic patterns over the years: increased peak prevalence, faster spreading rates, and decreasing spatiotemporal bimodality. We attribute these pandemic trends to increases in two key quantities indicative of urbanization: the population fraction residing in major cities and international air traffic. In addition, we identify features of the pandemic’s geographic spread that we attribute to changes in the commuter mobility network. The generic nature of our model and the ubiquity of urbanization trends around the world make it likely for our results to be applicable in other rapidly urbanizing nations.

PMID: 30547086 PMCID: PMC6291314 DOI: 10.1126/sciadv.aau5294

Keywords: Pandemic Influenza; Australia; Society; Mathematical models.



[#NZ] New Zealand’s #experience of the 1918-19 #influenza #pandemic: a systematic review after 100 years (N Z Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

N Z Med J. 2018 Dec 14;131(1487):54-69.

New Zealand’s experience of the 1918-19 influenza pandemic: a systematic review after 100 years.

Summers JA1, Baker M2, Wilson N2.

Author information: 1 Postdoctoral Research Fellow in Medical Statistics, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom. 2 Professor of Public Health, Department of Public Health, University of Otago, Wellington.




The 1918-1919 influenza pandemic has been New Zealand’s most severe disaster event (around 9,000 deaths). We aimed to review the literature related to this pandemic in New Zealand and among New Zealanders overseas, to identify any remaining research gaps (given ongoing risks of future influenza pandemics and from new pathogens, eg, synthetic bioweapons).


Systematic literature searches and comparisons with international findings for this pandemic to facilitate identification of research gaps.


A total of 61 relevant publications were identified. The epidemiological patterns reported were largely consistent with the international literature for this pandemic. These features included the w-shaped age-distribution for mortality, and the much higher mortality rates for indigenous people (ie, seven-fold for Māori vs New Zealand European). But some novel risk factors were identified (eg, large chest size as a risk factor for death in military personnel), and there was an extremely high mortality troop ship outbreak (probably related to crowding). In contrast to some international work, there was an apparent lack of a socio-economic gradient in mortality rates in two studies using modern analytical methods. New Zealand work has clearly shown how the pandemic spread via the rail network and internal shipping routes and the rarity of successful measures to prevent spread in contrast to some other jurisdictions. It has also found a marked lack of memorials to the pandemic (in contrast to war memorials). Nevertheless, some research gaps remain, including on the apparent marked reduction in birth rates in 1918-1919 and the reasons for no socio-economic gradient despite other New Zealand evidence for occupational class variation in lifespan at this time.


This is a relatively well-studied disaster event but there remain important research questions relating to this pandemic in New Zealand. Filling these gaps may contribute to improved planning for managing future pandemics.

PMID: 30543612

Keywords: Pandemic Influenza; Spanish Flu; New Zealand.


Comparison of the effects of #peramivir and #oseltamivir on the rise in #platelet count in patients with or without proven #influenza (Int J Clin Pharmacol Ther., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Int J Clin Pharmacol Ther. 2018 Dec 11. doi: 10.5414/CP203366. [Epub ahead of print]

Comparison of the effects of peramivir and oseltamivir on the rise in platelet count in patients with or without proven influenza.

Kim YG, Ko SY, Lee SW.




Neuraminidase (sialidase) inhibitors are considered to delay platelet clearance through the inhibition of platelet desialylation. A novel neuraminidase inhibitor, peramivir, was recently approved for intravenous administration by the US FDA. We aimed to compare the effects of peramivir and oseltamivir on patient platelet count.


Consecutive patients who were treated with peramivir or tested positive for influenza between January 2015 and December 2017 were analyzed. The analysis included 461 patients with platelet counts available; the patients were divided into three groups: patients with proven influenza treated with peramivir (n = 305); those treated with peramivir without proven influenza (n = 83), and those with proven influenza treated with oseltamivir (n = 73).


Patients treated with peramivir did not show an increase in platelet count from the baseline count, regardless of proven influenza (from 263.4 × 109/L to 267.4 × 109/L; 9 = 0.410) or not (from 257.1 × 109/L to 255.4 × 109/L; p = 0.873); wheeras for patients treated with oseltamivir, a significant increase above the baseline was found (from 223.3 × 109/L to 249.9 × 109/L; p = 0.016), although it was transient.


Peramivir and oseltamivir appear to have different effects on patient platelet count when administered at the recommended doses

PMID: 30526812 DOI: 10.5414/CP203366

Keywords: Seasonal Influenza; Antivirals; Oseltamivir; Zanamivir.


#Socioeconomic #disparities associated with 29 common #infectious #diseases in #Sweden, 2005–14: an individually matched case-control study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Socioeconomic disparities associated with 29 common infectious diseases in Sweden, 2005–14: an individually matched case-control study

Alessandro Pini, MD, Magnus Stenbeck, PhD, Ilias Galanis, MSc, Henrik Kallberg, PhD, Kostas Danis, PhD, Anders Tegnell, MD, Anders Wallensten, MD

Published: December 14, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30485-7




Although the association between low socioeconomic status and non-communicable diseases is well established, the effect of socioeconomic factors on many infectious diseases is less clear, particularly in high-income countries. We examined the associations between socioeconomic characteristics and 29 infections in Sweden.


We did an individually matched case-control study in Sweden. We defined a case as a person aged 18–65 years who was notified with one of 29 infections between 2005 and 2014, in Sweden. Cases were individually matched with respect to sex, age, and county of residence with five randomly selected controls. We extracted the data on the 29 infectious diseases from the electronic national register of notified infections and infectious diseases (SmiNet). We extracted information on country of birth, educational and employment status, and income of cases and controls from Statistics Sweden’s population registers. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression to examine the association between infections or groups of infections and place of birth, education, employment, and income.


We included 173 729 cases notified between Jan 1, 2005, and Dec 31, 2014 and 868 645 controls. Patients with invasive bacterial diseases, blood-borne infectious diseases, tuberculosis, and antibiotic-resistant infections were more likely to be unemployed (amOR 1·59, 95% CI 1·49–1·70; amOR 3·62, 3·48–3·76; amOR 1·88, 1·65–2·14; and amOR 1·73, 1·67–1·79, respectively), to have a lower educational attainment (amOR 1·24, 1·15–1·34; amOR 3·63, 3·45–3·81; amOR 2·14, 1·85–2·47; and amOR 1·07, 1·03–1·12, respectively), and to have a lowest income (amOR 1·52, 1·39–1·66; amOR 3·64, 3·41–3·89; amOR 3·17, 2·49–4·04; and amOR 1·2, 1·14–1·25, respectively). By contrast, patients with food-borne and water-borne infections were less likely than controls to be unemployed (amOR 0·74, 95% CI 0·72–0·76), to have lower education (amOR 0·75, 0·73–0·77), and lowest income (amOR 0·59, 0·58–0·61).


These findings indicate persistent socioeconomic inequalities in infectious diseases in an egalitarian high-income country with universal health care. We recommend using these findings to identify priority interventions and as a baseline to monitor programmes addressing socioeconomic inequalities in health.


The Public Health Agency of Sweden.

Keywords: Society; Public Health; Sweden; Poverty.


#Enterovirus A71 #Infection and #Neurologic Disease, Madrid, #Spain, 2016 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 1—January 2019 / CME ACTIVITY – Synopsis

Enterovirus A71 Infection and Neurologic Disease, Madrid, Spain, 2016

Carmen Niño Taravilla1  , Isabel Pérez-Sebastián1, Alberto García Salido, Claudia Varela Serrano, Verónica Cantarín Extremera, Anna Duat Rodríguez, Laura López Marín, Mercedes Alonso Sanz, Olga María Suárez Traba, and Ana Serrano González

Author affiliations: Hospital Infantil Universitario Niño Jesús, Madrid, Spain



We conducted an observational study from January 2016 through January 2017 of patients admitted to a reference pediatric hospital in Madrid, Spain, for neurologic symptoms and enterovirus infection. Among the 30 patients, the most common signs and symptoms were fever, lethargy, myoclonic jerks, and ataxia. Real-time PCR detected enterovirus in the cerebrospinal fluid of 8 patients, nasopharyngeal aspirate in 17, and anal swab samples of 5. The enterovirus was genotyped for 25 of 30 patients; enterovirus A71 was the most common serotype (21/25) and the only serotype detected in patients with brainstem encephalitis or encephalomyelitis. Treatment was intravenous immunoglobulins for 21 patients and corticosteroids for 17. Admission to the pediatric intensive care unit was required for 14 patients. All patients survived. At admission, among patients with the most severe disease, leukocytes were elevated. For children with brainstem encephalitis or encephalomyelitis, clinicians should look for enterovirus and not limit testing to cerebrospinal fluid.

Keywords: EV-A71; Encephalitis; Spain.


After failure, Vasily Vereshchagin (1868)



After failure
Vasily Vereshchagin
Original Title: После неудачи
Date: 1868
Style: Realism
Genre: battle painting
Tag: military-and-soldiers, battles-and-wars, birth-and-death


Permissions: Public domain.

Source: WikiArt, full page: https://www.wikiart.org/en/vasily-vereshchagin/after-failure-1868


What is the Value of Different #Zika #Vaccination Strategies to Prevent and Mitigate Zika #Outbreaks (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

What is the Value of Different Zika Vaccination Strategies to Prevent and Mitigate Zika Outbreaks

Sarah M Bartsch, MPH, Lindsey Asti, MPH, Sarah Cox, MSPH, David P Durham, PhD, Samuel Randall, Peter J Hotez, MD, PhD, Alison P Galvani, PhD, Bruce Y Lee, MD, MBA

The Journal of Infectious Diseases, jiy688, https://doi.org/10.1093/infdis/jiy688

Published: 13 December 2018




While the 2015–2016 Zika epidemics prompted accelerated vaccine development, decision makers need to know the potential economic value of vaccination strategies.


We developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination (women of childbearing age, school-aged children, young adults, and everyone) and then introduced various Zika outbreaks. Sensitivity analyses varied vaccine characteristics.


With a 2% attack rate ($5 vaccination), compared to no vaccination, vaccinating women of childbearing age cost $314–1664 per case averted ($790–4,221/DALY averted) in Honduras, and saved $847–1,644/case averted in Brazil, and $3,648–4,177/case averted in Puerto Rico, varying with vaccination coverage and efficacy (societal perspective). Vaccinating school-aged children cost $718–1,849/case averted ($5,002/DALY averted) in Honduras, saved $819–1,609/case averted in Brazil, and saved $3,823–4,360/case averted in Puerto Rico. Vaccinating young adults cost $310–1,666/case averted ($731–4,017/DALY averted) in Honduras, saved $953–1,703/case averted in Brazil, and saved $3,857–4,372/case averted in Puerto Rico. Vaccinating everyone averted more cases but cost more, decreasing cost-savings per case averted. Vaccination resulted in more cost-savings and better outcomes at higher attack rates.


When considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.

brucelee@jhu.edu, Zika, Cost-Effectiveness, Vaccine

Topic: –  cost effectiveness – brazil – cost savings – disease outbreaks – honduras – puerto rico – vaccination – vaccines – disability-adjusted life-year – attack rate – young adult – school-age child – zika virus – zika virus disease – zika vaccine

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Zika Virus; Vaccines.