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Homotypic protection against influenza in a pediatric cohort in Managua, Nicaragua.

ABSTRACT: The period of protection from repeat infection following symptomatic influenza is not well established due to limited availability of longitudinal data. Using data from a pediatric cohort in Managua, Nicaragua, we examine the effects of natural influenza virus infection on subsequent infection with the same influenza virus subtype/lineage across multiple seasons, totaling 2,170 RT-PCR-confirmed symptomatic influenza infections. Logistic regression models assessed whether infection in the prior influenza season protected against homologous reinfection. We sequenced viruses from 2011-2019 identifying dominant clades and measuring antigenic distances between hemagglutinin clades. We observe homotypic protection from repeat infection in children infected with influenza A/H1N1pdm (OR 0.12, CI 0.02-0.88), A/H3N2 (OR 0.41, CI 0.24-0.73), and B/Victoria (OR 0.00, CI 0.00-0.14), but not with B/Yamagata viruses (OR 0.60, CI 0.09-2.10). Overall, protection wanes as time or antigenic distance increases. Individuals infected with one subtype or lineage of influenza virus have significantly lower odds of homologous reinfection for the following one to two years; after two years this protection wanes. This protection is demonstrated across multiple seasons, subtypes, and lineages among children.

SUBMITTER: Wraith S

PROVIDER: S-EPMC8897407 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Homotypic protection against influenza in a pediatric cohort in Managua, Nicaragua.

Wraith Steph S Balmaseda Angel A Carrillo Fausto Andres Bustos FAB Kuan Guillermina G Huddleston John J Kubale John J Lopez Roger R Ojeda Sergio S Schiller Amy A Lopez Brenda B Sanchez Nery N Webby Richard R Nelson Martha I MI Harris Eva E Gordon Aubree A

Nature communications 20220304 1

The period of protection from repeat infection following symptomatic influenza is not well established due to limited availability of longitudinal data. Using data from a pediatric cohort in Managua, Nicaragua, we examine the effects of natural influenza virus infection on subsequent infection with the same influenza virus subtype/lineage across multiple seasons, totaling 2,170 RT-PCR-confirmed symptomatic influenza infections. Logistic regression models assessed whether infection in the prior i ...[more]

PMID: 35246548

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Project description:BackgroundNicaragua implemented an influenza vaccination program for pregnant women with high-risk obstetric conditions in 2007. In 2014, the recommendation of influenza vaccination expanded to include all pregnant women. Given the expansion in the recommendation of vaccination, we evaluated knowledge, attitudes and practices of pregnant women and their healthcare providers towards influenza vaccination and its recommendation.MethodsWe conducted surveys among pregnant women and their healthcare providers from June to August 2016 at two hospitals and 140 health facilities in Managua. The questions were adapted from the U.S. national CDC influenza survey and related to knowledge, attitudes and practices about influenza vaccination and barriers to vaccination. We analyzed reasons for not receiving vaccination among pregnant women as well as receipt of vaccination recommendation and offer by their healthcare providers.ResultsOf 1,303 pregnant women enrolled, 42% (5 4 5) reported receiving influenza vaccination in the 2016 season. Of those who reported not receiving vaccination, 46% indicated barriers to vaccination. Pregnant women who were vaccinated were more likely to be aware of the recommendation for vaccination and the risks of influenza illness during pregnancy and to perceive the vaccine as safe and effective, compared to unvaccinated pregnant women (p-values < 0.001). Of the 619 health workers enrolled, over 89% recalled recommending influenza vaccination to all pregnant women, regardless of obstetric risk. Of the 1,223 women who had a prenatal visit between the start date of the influenza vaccination and the time of interview, 44% recalled receiving a recommendation for influenza vaccination and 43% were offered vaccination. Vaccination rates were higher for those receiving a recommendation and offer of vaccination compared with those who received neither (95% vs 5%, p-value < 0.001).ConclusionPregnant women in Managua had positive perceptions of influenza vaccine and were receptive to receiving influenza vaccination, especially after the offer and recommendation by their healthcare providers.

Project description:Chikungunya can result in debilitating arthralgia, often presenting as acute, self-limited pain, but occasionally manifesting chronically. Little is known about differences in chikungunya-associated arthralgia comparing children to adults over time. To characterize long-term chikungunya-associated arthralgia, we recruited 770 patients (105 0-4 years old [y/o], 200 5-9 y/o, 307 10-15 y/o, and 158 16+ y/o) with symptomatic chikungunya virus infections in Managua, Nicaragua, during two consecutive chikungunya epidemics (2014-2015). Participants were assessed at ~15 days and 1, 3, 6, 12, and 18 months post-fever onset. Following clinical guidelines, we defined participants by their last reported instance of arthralgia as acute (≤10 days post-fever onset), interim (>10 and <90 days), or chronic (≥90 days) cases. We observed a high prevalence of arthralgia (80-95%) across all ages over the study period. Overall, the odds of acute arthralgia increased in an age-dependent manner, with the lowest odds of arthralgia in the 0-4 y/o group (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.14-0.51) and the highest odds of arthralgia in the 16+ y/o participants (OR: 4.91, 95% CI: 1.42-30.95) relative to 10-15 y/o participants. Females had higher odds of acute arthralgia than males (OR: 1.63, 95% CI: 1.01-2.65) across all ages. We found that 23-36% of pediatric and 53% of adult participants reported an instance of post-acute arthralgia. Children exhibited the highest prevalence of post-acute polyarthralgia in their legs, followed by the hands and torso - a pattern not seen among adult participants. Further, we observed pediatric chikungunya presenting in two distinct phases: the acute phase and the subsequent interim/chronic phases. Thus, differences in the presentation of arthralgia were observed across age, sex, and disease phase in this longitudinal chikungunya cohort. Our results elucidate the long-term burden of chikungunya-associated arthralgia among pediatric and adult populations.

Dataset Information

Homotypic protection against influenza in a pediatric cohort in Managua, Nicaragua.

Publications

Homotypic protection against influenza in a pediatric cohort in Managua, Nicaragua.

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