Navegando por Palavras-chave "Influenza"

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    Fatores associados à vacinação influenza em pacientes em prevenção cardiovascular
    (Universidade Federal de São Paulo, 2022-07-04) Rodrigues, Esteferson Fernandes [UNIFESP]; Fonseca, Henrique Andrade Rodrigues da [UNIFESP]; Gidlund, Magnus Ake; http://lattes.cnpq.br/1938952491463219; http://lattes.cnpq.br/4644910503257565; http://lattes.cnpq.br/5718505801052526
    Introdução: A doença cardiovascular (DCV) é hoje uma das principais causas de morte no Brasil e em todo o mundo. Estima-se que em 2014 no Brasil, cerca de 34% dos óbitos em idosos foram por DCV. Dados do Departamento de Informática do Sistema Único de Saúde do Brasil (DATA-SUS) do mesmo ano, mostrou que as doenças isquêmicas do coração e as doenças cerebrovasculares foram as causas mais comuns entre os óbitos por DCV, e responsáveis pelo elevado ônus por internações envolvendo os idosos. Dados publicados pela Organização Mundial da Saúde (OMS), destaca que em 2016 foram quase 18 milhões de óbitos relacionadas ao acidente vascular cerebral (AVC) e ao infarto agudo do miocárdio (IAM). A influenza é uma infecção respiratória, e desde o início do século XX já havia sido levantado hipóteses de que poderia existir uma associação das mortes cardiovasculares provocadas por influenza. Estudos prévios mostram-tram a possível associação do processo infeccioso provocado pela infecção do vírus influenza ao aumento do risco de eventos cardiovasculares, como IAM e AVC, principalmente em indivíduos com diabetes mellitus (DM), hipertensão arterial sistêmica (HAS), e com histórico de eventos cardiovasculares prévios, que normalmente manifestam um sistema imunológico fragilizado, que somado a piora do quadro provocado pela infecção por influenza, aumenta a morbimortalidade. Muito se discute quanto ao potencial efeito benéfico das vacinas no contexto das DCV. Embora estudos anteriores trabalhem na hipótese de associação da influenza com óbitos por DCV, poucos estudos exploram a relação do uso da vacina contra a influenza em indivíduos em prevenção cardiovascular primária e secundária. Objetivos: Avaliar a adesão à vacina contra a influenza durante as campanhas nacionais de imunização (2014-2016) em indivíduos em prevenção cardiovascular primária e secundária, e a associação entre a adesão à vacina e os principais fatores de risco cardiovascular (diabetes mellitus, hipertensão arterial sistêmica e dislipidemia). Métodos: Esse trabalho foi dividido em dois capítulos. O primeiro capítulo buscou avaliar a adesão à vacina durante as campanhas nacionais de imunização contra influenza em indivíduos em prevenção cardiovascular primária e secundária e a associação com os principais FRC. Esse foi um estudo de coorte, observacional, retrospectivo e piloto, incluindo 181 participantes de ambos os sexos. Os dados foram coletados entre 2014 e 2016 no Setor de Lípides, Aterosclerose e Biologia Vascular e no centro de Cardiopatia Hipertensiva, unidade vinculada à Universidade Federal de São Paulo. O segundo capítulo da dissertação avaliou a adesão vacinal durante as campanhas nacionais de imunização contra influenza em indivíduos exclusivamente em prevenção cardiovascular primária e a associação com os principais FRC. Esse foi um estudo de coorte, observacional, transversal, multicêntrico e piloto, com inclusão de 987 participantes elegíveis de ambos os sexos, com idade ≥18 anos, e com ao menos um dos principais FRC. Os dados foram coletados em 44 Unidade Básica de Saúde (UBS) e Estratégia Saúde da Família (ESF) em diferentes municípios do Estado de São Paulo. A avaliação da adesão à vacinação autorreferida foi confirmada por meio do cartão de vacinação e no registro clínico obtido do prontuário médico. As análises estatísticas foram realizadas utilizando o teste de qui-quadrado(X2) de Pearson e, quando apropriado, o teste exato de Fisher, e foram realizadas análises por testes para amostra independente não paramétricos e os valores foram considerados significativos-cativos quando p≤0,05. Modelos de regressão logística foram empregados para avaliar possíveis preditores para a vacinação pelo sexo, presença de fatores de risco, idade e adesão farmacológica. Resultados: Os achados preliminares apontam a existência de uma baixa adesão à vacinação anual, e uma quantidade significativa da ausência da vacinação completa. Foi observado uma diferença entre adesão vacinal e condições de alto risco (69%) entre os indivíduos que tinham ≥2 FRC bem como entre os que estavam em prevenção cardiovascular secundária (77%). Mais de 50% da população apresentava idade ≥ 60 anos, menos de 62% apresentavam controle dos principais FRC, mais de 33% apresentavam ≥2 FRC, indivíduos com idade ≥60 anos e que apresentavam ≥2 FRC tiveram uma maior adesão vacinal, menos da metade dos participantes fizeram o uso corretamente das medicações todos os dias, e o esquecimento-mento foi o principal motivo para não aderir às medicações de uso continuo. O modelo de regressão logística revelou que apenas pacientes mais idosos apresentam relação com a adesão vacinal (OR 0,12; 95% CI = 0,06 – 0,21). Os demais fatores não foram associados à adesão vacinal completa. Conclusão: Existe uma distinta adesão à vacina influenza entre pacientes em prevenção cardiovascular primária e secundária. Além disso, pacientes jovens com apenas um FRC possui menor adesão ao uso da vacina influenza, comparados a indivíduos com maior presença de FRC e idosos. Apenas os idosos apresentavam relação com a adesão vacinal. Diante dos fatos, salientamos a relevância em aumentar a divulgação dos programas de vacinação, bem como a necessidade de discutir e atualizar sua importância, principalmente ao público-alvo, ainda mais nesse período marcado pela volta de doenças erradicadas e de grande potencial de contaminação, como a COVID-19. Descritores: doença cardiovascular, fator de risco cardiovascular, vacina contra influenza, vacina influenza, influenza.
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    H1N1: pandemia e perspectiva atual
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2011-12-01) Bellei, Nancy Cristina Junqueira [UNIFESP]; Melchior, Thaís Boim [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The swine origin influenza virus A/CALIFORNIA/04/2009 (H1N1) was first detected in Mexico and determined the 2009 influenza pandemic. In August 2010, World Health Organization (WHO) declared the beginning of the post-pandemic period. This last pandemic was distinctly different from previous ones. The virus emerged from genetic rearrangement in non-human mammalian host. Moreover, its inter-species transmission is fully reported. However, it affected human population differently from previous pandemic viruses (1918, 1957, 1968), with increased morbidity and mortality among children and young adults. Currently, the virus has a seasonal pattern in the same way as influenza A H3N2 and influenza B, maintaining the same pathogenicity profile, clinical spectrum and sensitivity to antiviral agents. The strain was included in the annual trivalent seasonal vaccine formulation, mainly for risk groups, which are more vulnerable to complications caused by different influenza strains.
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    Influenza
    (Sociedade Brasileira de Medicina Tropical - SBMT, 2003-04-01) Forleo-neto, Eduardo; Halker, Elisa; Santos, Verônica Jorge; Paiva, Terezinha Maria; Toniolo Neto, João [UNIFESP]; Grupo de Vigilância Epidemiológica da Gripe Divisão VigiVírus; Instituto Adolfo Lutz de São Paulo Seção de Vírus Respiratórios; Universidade Federal de São Paulo (UNIFESP)
    Influenza (flu) is an acute contagious viral infection characterized by inflammation of the respiratory tract that every winter affects more than 100 million people in Europe, Japan and the United States of America, also being responsible for several thousand of excess deaths (data from the United States reveal between 20,000 to 40,000 excess deaths annually). The Mixovirus influenzae is the agent that causes influenza, commonly called flu. There are 3 types of influenza virus: A, B, C, and only types A and B are perceived to be clinically relevant in humans. Due to the segmented nature of its genetic material, the influenza virus is highly mutagenic, causing frequent insertion of new antigenic strains into the community, against which the population presents no immunity. Presently, there are few options for the control of influenza and annual immunization is the most effective means to prevent disease and its complications. In Brazil, according to data collected by the VigiGripe's Project - linked to the Federal University of São Paulo -, circulation of the influenza virus also has a seasonal pattern, with peak activity occurring between May and September. Yearly vaccination is, therefore, best indicated on March and April. Currently, there are four medications available for the treatment of influenza viruses: amantadine and rimantadine, and two second generation pharmaceutical products, the neuraminidase inhibitors, oseltamivir and zanamivir. The latter two drugs have set the stage for a new approach to the management and control of influenza infections.
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    Influenza detection and subtyping by reverse transcriptase polymerase chain reaction-restriction fragment length polymorphism for laboratory surveillance in Brazil
    (Elsevier B.V., 2008-04-01) Carraro, Emerson [UNIFESP]; Watanabe, Aripuanã Sakurada Aranha [UNIFESP]; Lima Neto, Daniel Ferreira [UNIFESP]; Granato, Celso Francisco Hernandes [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    A duplex reverse transcriptase polymerase chain reaction-restriction fragment length polymorphism for influenza virus subtyping was applied to 412 patient samples. the assay was able to discriminate all 47 influenza A H1N1 and H3N2 viruses. This rapid technique assessed if positive samples were current circulating strains or an emergent one and could be used as the 1st test in prepandemic stages. (C) 2008 Elsevier Inc. All rights reserved.
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    Influenza virus and proteolytic bacteria co-infection in respiratory tract from individuals presenting respiratory manifestations
    (Instituto de Medicina Tropical, 2008-02-01) Mancini, Dalva Assunção Portari; Alves, Rosely C. Barbosa; Mendonça, Rita Maria Zucatelli; Bellei, Nancy Cristina Junqueira [UNIFESP]; Carraro, Emerson [UNIFESP]; Machado, Antonia M.o. [UNIFESP]; Pinto, José Ricardo; Mancini Filho, Jorge [UNIFESP]; Instituto Butantan Laboratório de Virologia; Universidade Federal de São Paulo (UNIFESP)
    A role for proteolytic bacteria in the exacerbation of influenza virus has been shown in natural hosts such as pigs and humans. Four hundred seven samples were collected from the respiratory tract of individuals presenting clinical manifestations, during influenza season (2003-2005) in São Paulo City. The aim of this study was to evaluate the incidence of determined bacteria co-infecting virus in human respiratory tract. Tests, such as bacteriological, immunofluorescence (IF), RT/PCR and hemagglutination (HA) were used for bacterial and viral investigation. Thirty seven (9.09%) positive for influenza virus were screened by IF. The RT/PCR confirmed the presence of influenza virus in these samples. Bacterial and agar casein tests demonstrated that 18 (48.64%) individuals were infected with proteolytic bacteria such as Staphylococcus spp., Streptococcus spp. and Pseudomonas spp. Among these samples, 13 (35.13%) were co-infected with influenza A virus. Influenza type B, co-infecting bacteria were found in five (13.51%) samples. In vitro the S. aureus protease increased the influenza HA titer after contact for 30 min at 25 ºC. Results revealed the occurrence of co-infection with proteolytic bacteria and influenza in the evaluated individuals. This finding corroborates that virus versus bacteria synergism could be able to potentiate respiratory infection, increasing damage to hosts.
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    Morbimortality of Pandemic Influenza A H1N1 Infection in Kidney Transplant Recipients Requiring Hospitalization: A Comparative Analysis With Nonimmunocompromised Patients
    (Lippincott Williams & Wilkins, 2012-01-15) Camargo, Luis Fernando A. [UNIFESP]; Sandes-Freitas, Taina V. de [UNIFESP]; Silva, Camila D. R. [UNIFESP]; Bittante, Carolina D. [UNIFESP]; Ono, Gislaine [UNIFESP]; Correa, Luci [UNIFESP]; Silva, Moacyr [UNIFESP]; Bellei, Nancy Cristina J. [UNIFESP]; Goto, Janaina M. [UNIFESP]; Medeiros, Eduardo A. S. [UNIFESP]; Gomes, Pollyane S. [UNIFESP]; Medina-Pestana, Jose O. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Rim & Hipertensao
    Background. Clinical and epidemiological data of pandemic influenza A H1N1 infection in solid-organ transplant recipients have been described, but scarce data compare these outcomes with nonimmunocompromised patients.Methods. We retrospectively reviewed and compared the clinical presentation, morbidity, and mortality of all kidney transplant (KT) and nonimmunocompromised (non-KT) patients admitted for at least 12 hr with a diagnosis of pandemic influenza A H1N1 infection in a single hospital complex during the 2009 pandemic.Results. There were 22 patients in the KT group (29.3%) and 53 in the non-KT group (70.7%). the prevalence of diabetes was higher in KT group (27.3% vs. 5.7%) while chronic pulmonary disease was more frequent in non-KT group (34% vs. 9.1%). Clinical and radiological presentations and duration of disease were similar between the two groups. the incidence of acute renal failure was higher among KT patients (40.9% vs. 17%). No differences in the rate of intensive care unit admission (22.7% vs. 22.6%) or hospital mortality (9.1% vs. 7.5%) were observed. for the overall population, poor outcome, defined as intensive care unit admission or death, was associated with in-hospital acquisition (relative risk [RR] = 42.6 [95% confidence interval {95% CI} 2.2-831.9], P = 0.003), symptom onset more than 48 hr (RR = 12.17 [95% CI 1.3-117.2], P = 0.007), and acute renal failure (RR = 11.8 [95% CI 2.9-48.8], P = 0.001). Among KT recipients, in-hospital acquisition was the only covariate associate with poor outcome (RR = 30.0 [95% CI 2.1421.1], P = 0.004).Conclusions. No significant differences in morbidity and mortality were observed comparing KT and non-KT patients infected with pandemic H1N1 influenza A virus.
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    As novas facetas e a ameaça da gripe aviária no mundo globalizado
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2007-08-01) Granato, Celso Francisco Hernandes [UNIFESP]; Bellei, Nancy Cristina Junqueira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Hamburgo Instituto Central de Microbiologia e Imunologia; Fleury Medicina e Saúde
    Influenza, or as it is best known, flu, is an acute respiratory infection caused by a virus that affects many different animal species from felines to birds, including humans.Ten years ago, initialy in Hong Kong and after that in Holand and Canada, outbreaks of avian flu have been increasingly reported in human beings. The question is innevitable: are we in the surge of a new flu pandemic like the one we had in 1918? The perspective is even worse now that we have five times the world population and the international travels are no longer made in slow-going ships but instead in super fast jet planes. For us, laboratory professionals, the question of the laboratory diagnosis is crucial. Considering that so many different viruses are associated with respiratory infections and therapeutic measures depend on this definition, this subject assumes an even greater interest.
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    Pandemic H1N1 illness prognosis: evidence from clinical and epidemiological data from the first pandemic wave in São Paulo, Brazil
    (Faculdade de Medicina / USP, 2013-06-01) Bellei, Nancy Cristina Junqueira [UNIFESP]; Cabeça, Tatiane Karen; Carraro, Emerson [UNIFESP]; Goto, Janaina Midori [UNIFESP]; Cuba, Gabriel Trova [UNIFESP]; Hidalgo, Sônia Regina; Burattini, Marcelo Nascimento [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    OBJECTIVES: The pandemic of 2009 H1N1 influenza A emerged in February 2009, with high morbidity and mortality, and rapidly spread globally. São Paulo was among the most affected areas in Brazil. This study compares the clinical and epidemiological characteristics of influenza-like illness between outpatients and hospitalized patients and evaluates the impact of oseltamivir therapy on the outcome of 2009 H1N1 influenza A patients. METHODS: This is a case series study comparing the clinical and epidemiological characteristics of influenza-like illness between outpatients attended at Hospital São Paulo in August 2009 (the peak of the first pandemic wave) and those patients hospitalized between May and September 2009 (the entire first pandemic wave). RESULTS: The 1651 patients evaluated were predominantly female (927×686, p<0.001) and aged 31.71±16.42 years, with 148 reporting chronic pulmonary disease. Dyspnea was presented by 381 (23.4%) patients and was more frequent among those aged 30 years or more (p<0.001). Hospitalization occurred at 3.73±2.85 days, and antiviral treatment started 2.27±2.97 days after the onset of first symptoms. A delay of more than 5 days in starting oseltamivir therapy was independently associated with hospitalization (p<0.001), a stay in the ICU (p<0.001) and a higher risk of dying (OR = 28.1, 95% CI 2.81-280.2, p = 0.007). CONCLUSION: The 2009 pandemic of H1N1 influenza A affected young adults, presented a significant disease burden and produced severe cases with a significant fatality rate. However, promptly starting specific therapy improved the outcome.
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    Risk factors for poor immune response to influenza vaccination in elderly people
    (Brazilian Society of Infectious Diseases, 2006-08-01) Bellei, Nancy Cristina Junqueira [UNIFESP]; Carraro, Emerson [UNIFESP]; Castelo Filho, Adauto [UNIFESP]; Granato, Celso Francisco Hernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Influenza vaccination of elderly people is efficacious and cost effective for the prevention of influenza and its complications. Some studies have pointed out low immunogenicity in this group. Health status has been poorly investigated as a risk factor that may influence the immune response to influenza vaccine. We established an immunization response study of a highly-matched elderly population in a nursing home. One-hundred-twenty subjects of Ashkenazian origin had their vaccine-induced antibody response assessed. Good response was obtained in 30.8% (37/120), and 31.7% (38/120) did not react. A lack of good response was found to be associated with dementia (P=0.016) in a multivariate analysis. In addition to dementia, malnutrition was frequently observed among poor responders, suggesting that these factors should be considered in vaccination studies. Chemoprophylaxis in addition to vaccination for elderly presenting dementia should be considered, particularly for those people living nursing homes.