Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study

Huang, Q. Sue; Bandaranayake, Don; Wood, Tim; Newbern, E. Claire; Seeds, Ruth; Ralston, Jacqui; Waite, Ben; Bissielo, Ange; Prasad, Namrata; Todd, Angela; Jelley, Lauren; Gunn, Wendy; McNicholas, Anne; Metz, Thomas O.; Lawrence, Shirley; Collis, Emma; Retter, Amanda; Wong, Sook‐San; Webby, Richard J.; Bocacao, Judy; Haubrock, Jennifer; Mackereth, Graham; Turner, Nikki; McArdle, Barbara; Cameron, John L.; Reynolds, Edwin; Baker, Michael G; Grant, Cameron; McArthur, Colin; Roberts, Sally; Trenholme, Adrian; Wong, Conroy; Taylor, Susan; Thomas, Paul G.; Duque, Jazmin; Gross, Diane; Thompson, Mark G.; Widdowson, Marc‐Alain; Haven, Kathryn; Chand, Bhamita; Muponisi, Pamela; Aley, Debbie; Sherring, Claire; Rea, M. J. F.; Barry, Judith; Bushell, Tracey; Brewer, Julianne; McClymont, Catherine; Chamberlin, Shona; Ongcoy, Reniza; Davey, Kirstin; Jasmat, Emilina; Dickson, Maree; Western, Annette; Lai, Olive; Fowlie, Sheila; Aupa’au, Faasoa; Robertson, Louise; Kawakami, Pam; Walker, Susan; Madge, Robyn; Barres, Amanda des; Qiao, Helen; Tse, Fifi; Zibaei, Mahtab; Korrapadu, Tirzah; Optland, Louise; Cruz, Cecilia Dela

doi:10.1093/infdis/jiy443

Cited by 51 publications

(56 citation statements)

References 35 publications

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“…All of these studies identified the exposure of healthcare personnel to household contacts as having the highest odds of respiratory illness after exposure, with ORs ranging from 2.9 to 16.7. These data are also supported by several studies documenting that the number of children in a household is a risk for influenza in adults, which is to be expected since the seasonal attack rate for influenza in children is higher than that for adults [13,16,25].…”

Section: Discussionsupporting

confidence: 74%

“…The variable whose elimination caused the least significant deterioration of model fit was removed and the process repeated until all variables were significant at P 0.20 [24]. Age and sex were retained as they are associated with incidence of influenza and other viral respiratory infections [25]. Collinearity of eligible variables was investigated, and the final multivariable model was assessed for fit, influential observations and overfitting.…”

Section: Discussionmentioning

confidence: 99%

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Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel

Buckrell

Coleman

McNeil

et al. 2020

Journal of Hospital Infection

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Adult to ill household members [7.0, 95% confidence interval (CI) 5.4e9.1], co-workers (3.4, 95% CI 2.4e4.7) or other social contacts (5.1, 95% CI 3.6e7.1). Exposures to patients with respiratory illness were not associated with infection (aOR 0.9, 95% CI 0.7e1.2); however, healthcare personnel with direct patient contact did have higher odds (aOR 1.3, 95% CI 1.1 e1.6). The aORs for exposure and for direct patient contact were similar for illnesses caused by influenza. Conclusion: Community and co-worker contacts are important sources of viral respiratory illness in healthcare personnel, while exposure to patients with recognized respiratory infections is not associated. The comparatively low risk associated with direct patient contact may reflect transmission related to asymptomatic patients or unrecognized infections.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel

Buckrell

Coleman

McNeil

et al. 2020

Journal of Hospital Infection

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“…to the HI assay that only measures antibodies that prevent virus attachment to red blood cells. While the LIPS HA seropositive controls may represent true subclinical infections, 10,11 cross-reactivity of anti-H1 antibody to previous non-H1N1pdm09 infections is possible. 8 The main strength of this study was access to human samples from a well-characterized cohort, combining national registry data, self-reported questionnaire data and HI titre data.…”

Section: Discussionmentioning

confidence: 99%

“…For mild cases, a clinical diagnosis based on symptoms may suffice, 9 or medical care may not be sought; moreover, a large proportion of infected individuals remain asymptomatic. 10,11 Consequently, most cases of influenza infection remain undetected, 6,7 underscoring the need for other sources of information, such as questionnaires, health registries and biological specimens, for ascertaining or estimating the infection status of an individual. In prospective studies, direct laboratory testing requires active screening of participants, which is labour intensive and expensive, and typically limited to clinical vaccine trials.…”

Section: Introductionmentioning

confidence: 99%

Detection of anti‐NS1 antibodies after pandemic influenza exposure: Evaluation of a serological method for distinguishing H1N1pdm09 infected from vaccinated cases

Robertson

Mahic

Savic

et al. 2020

Influenza Resp Viruses

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Background: Reliable exposure information is crucial for assessing health outcomes of influenza infection and vaccination. Current serological methods are unable to distinguish between anti-hemagglutinin (HA) antibodies induced by infection or vaccination. Objectives:We aimed to explore an alternative method for differentiating influenza infection and vaccination. Methods: Sera from animals inoculated with influenza viruses or purified H1N1pdm09HA were obtained. Human samples were selected from a pregnancy cohort established during the 2009 H1N1 pandemic. Unvaccinated, laboratory-confirmed cases (N = 18), vaccinated cases without influenza-like-illness (N = 18) and uninfected, unvaccinated controls (N = 18) were identified based on exposure data from questionnaires, national registries and maternal hemagglutination inhibition (HI) titres at delivery.Animal and human samples were tested for antibodies against the non-structural protein 1 (NS1) and HA from H1N1pdm09, using a Luciferase Immunoprecipitation System (LIPS). Results:Anti-NS1 H1N1pdm09 antibodies were detected in sera from experimentally infected, but not from vaccinated, animals. Anti-HA H1N1pdm09 antibodies were detectable after either of these exposures. In human samples, 28% of individuals with laboratory-confirmed influenza were seropositive for H1N1pdm09 NS1, whereas vaccinated cases and controls were seronegative. There was a trend for H1N1pdm09 NS1 seropositive cases reporting more severe and longer duration of symptomatic illness than seronegative cases. Anti-HA H1N1pdm09 antibodies were detected in all cases and in 61% of controls. Conclusions:The LIPS method could differentiate between sera from experimentally infected and vaccinated animals. However, in human samples obtained more than 6

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“…However, NA evolves at nearly the same rate as HA and has similar signatures of adaptive evolution [12]. Additionally, recent work showed the importance of anti-NA antibodies to protective immunity through natural infection and vaccination [13,14]. This suggests that NA evolution is a substantial contributor to the changing antigenic properties and dynamics of influenza viruses.…”

mentioning

confidence: 99%

Evolution and rapid spread of a reassortant A(H3N2) virus that predominated the 2017-2018 influenza season

Potter

Garten

Hadfield

et al. 2019

Preprint

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The 2017-2018 North American influenza season caused more hospitalizations and deaths than any year since the 2009 H1N1 pandemic. The majority of recorded influenza infections were caused by A(H3N2) viruses, with most of the virus's North American diversity falling into the A2 clade. Within A2, we observe a subclade which we call A2/re that rose to comprise almost 70% of A(H3N2) viruses circulating in North America by early 2018. Unlike most fast-growing clades, however, A2/re contains no amino acid substitutions in the hemagglutinin (HA) segment. Moreover, HI assays did not suggest substantial antigenic differences between A2/re viruses and viruses sampled during the 2016-2017 season. Rather, we observe that the A2/re clade was the result of a reassortment event that occurred in late 2016 or early 2017 and involved the combination of the HA and PB1 segments of an A2 virus with neuraminidase (NA) and other segments a virus from the clade A1b. The success of this clade shows the need for antigenic analysis that targets NA in addition to HA. Our results illustrate the potential for non-HA drivers of viral success and necessitate the need for more thorough tracking of full viral genomes to better understand the dynamics of influenza epidemics.

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Risk Factors and Attack Rates of Seasonal Influenza Infection: Results of the Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) Seroepidemiologic Cohort Study

Abstract: Measurement of anti-neuraminidase antibodies in addition to anti- hemagglutinin antibodies may be important in capturing the true influenza infection rates.

Cited by 51 publications

References 35 publications

Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel

Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel

Detection of anti‐NS1 antibodies after pandemic influenza exposure: Evaluation of a serological method for distinguishing H1N1pdm09 infected from vaccinated cases

Evolution and rapid spread of a reassortant A(H3N2) virus that predominated the 2017-2018 influenza season

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