Viral agents responsible for febrile respiratory illnesses among military recruits training in tropical Singapore

Seah, Shirley Gek Kheng; Lim, Elizabeth Ai-Sim; Kok-Yong, Seng; Liaw, Jasper Chin-Wen; Lee, Vernon; Kammerer, Peter E.; Metzgar, David; Russell, Kevin L.; Tan, Boon Huan

doi:10.1016/j.jcv.2009.12.011

Cited by 25 publications

(38 citation statements)

References 30 publications

(36 reference statements)

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“…Three studies evaluated influenza in military personnel with febrile respiratory illness in 2006‐07, 2009‐10, and 2009‐12 . Influenza detection rate was 36.1% and 28.7% in the two earlier seasons, both with the proportion of influenza B at 33%.…”

Section: Resultsmentioning

confidence: 99%

Literature review of the epidemiology of influenza B disease in 15 countries in the Asia‐Pacific region

Jennings

Huang

Barr

et al. 2018

Influenza Resp Viruses

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Influenza control strategies focus on the use of trivalent influenza vaccines containing two influenza A virus subtypes and one of the two circulating influenza type B lineages (Yamagata or Victoria). Mismatches between the vaccine B lineage and the circulating lineage have been regularly documented in many countries, including those in the Asia‐Pacific region. We conducted a literature review with the aim of understanding the relative circulation of influenza B viruses in Asia‐Pacific countries. PubMed and Western Pacific Region Index Medicus were searched for relevant articles on influenza type B published since 1990 in English language for 15 Asia‐Pacific countries. Gray literature was also accessed. From 4834 articles identified, 121 full‐text articles were analyzed. Influenza was reported as an important cause of morbidity in the Asia‐Pacific region, affecting all age groups. In all 15 countries, influenza B was identified and associated with between 0% and 92% of laboratory‐confirmed influenza cases in any one season/year. Influenza type B appeared to cause more illness in children aged between 1 and 10 years than in other age groups. Epidemiological data for the two circulating influenza type B lineages remain limited in several countries in the Asia‐Pacific, although the co‐circulation of both lineages was seen in countries where strain surveillance data were available. Mismatches between circulating B lineages and vaccine strains were observed in all countries with available data. The data suggest that a shift from trivalent to quadrivalent seasonal influenza vaccines could provide additional benefits by providing broader protection.

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Section: Resultsmentioning

confidence: 99%

Literature review of the epidemiology of influenza B disease in 15 countries in the Asia‐Pacific region

Jennings

Huang

Barr

et al. 2018

Influenza Resp Viruses

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“…Incidence or prevalence of influenza was assessed in 12 studies (83% [n = 10] from high-income countries or areas), with a focus on the general population [33]–[38] and risk groups such as indigenous people [39], children [37], [40], [41], the elderly [36], [38] and military populations [42]. The relationship between the incidence of influenza and climate parameters such as rainfall and humidity was also explored for a number of cities in the Region [43].…”

Section: Resultsmentioning

confidence: 99%

A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

2013

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BackgroundImmunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region.Methodology/Principal FindingsStudies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women.Conclusions/SignificanceThe evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.

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“…These included one major recruit training camp (camp A), as recruits are especially affected by influenza outbreaks [9], [12]–[14]. All medically fit males in Singapore are conscripted for two years after high school; the servicemen in the recruit camp and other camps were mostly young adults out of high school.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Pandemic H1N1-2009 Vaccination in Reducing Laboratory Confirmed Influenza Infections among Military Recruits in Tropical Singapore

et al. 2011

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BackgroundLimited information is available about pandemic H1N1-2009 influenza vaccine effectiveness in tropical communities. We studied the effectiveness of a pandemic H1N1 vaccination program in reducing influenza cases in Singapore.MethodsA surveillance study was conducted among military personnel presenting with febrile respiratory illness from mid-2009 to mid-2010. Consenting individuals underwent nasal washes, which were tested with RT-PCR and subtyped. A vaccination program (inactivated monovalent Panvax H1N1-2009 vaccine) was carried out among recruits. A Bayesian hierarchical model was used to quantify relative risks in the pre- and post-vaccination periods. An autoregressive generalised linear model (GLM) was developed to minimise confounding.ResultsOf 2858 participants, 437(15.3%), 60(2.1%), and 273(9.6%) had pandemic H1N1, H3N2, and influenza B. The ratio of relative risks for pandemic H1N1 infection before and after vaccination for the recruit camp relative to other camps was 0.14(0.016,0.49); for H3N2, 0.44(0.035,1.8); and for influenza B, 18(0.77,89). Using the GLM for the recruit camp, post-vaccination weekly cases decreased by 54%(37%,67%, p<0.001) from that expected without vaccination; influenza B increased by 66 times(9–479 times, p<0.001); with no statistical difference for H3N2 (p = 0.54).ConclusionsPandemic vaccination reduced H1N1-2009 disease burden among military recruits. Routine seasonal influenza vaccination should be considered.

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Viral agents responsible for febrile respiratory illnesses among military recruits training in tropical Singapore

Cited by 25 publications

References 30 publications

Literature review of the epidemiology of influenza B disease in 15 countries in the Asia‐Pacific region

Literature review of the epidemiology of influenza B disease in 15 countries in the Asia‐Pacific region

A Review of the Evidence to Support Influenza Vaccine Introduction in Countries and Areas of WHO's Western Pacific Region

Effectiveness of Pandemic H1N1-2009 Vaccination in Reducing Laboratory Confirmed Influenza Infections among Military Recruits in Tropical Singapore

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