Objective To explore the impact of community healthcare workers’ (CHWs) knowledge, attitude and practice (KAP) on the influenza vaccination among elderly people. Methods By means of simple random sampling, 1 residential quarter of each communities, 2 communities of each districts, 5 districts of Chengdu city were randomly selected, and the elderly equal to or more than 60-year-old were on-site investigated. Meanwhile, the questionnaire survey was conducted among healthcare workers in the selected communities. Results There were 4 KAP factors played a positive role in influenza vaccination among elderly people: CHWs’ affirmation of the effectiveness of influenza vaccine, explicitly knowing the focus groups for influenza vaccination, recommendation of vaccination in flu season when the elderly visits, and participation in flu-related education activities. When the accuracy rate of each factor got improved by 1%, the influenza vaccination rate would improve by 2.747%, 1.299%, 0.864%, 0.602%, respectively. Conclusion The knowledge, attitude and practice of HCWs have impacts on the influenza vaccination rates of elderly people. They are significant to improve the influenza vaccination rates of the elderly.
Objective To investigate the epidemical status of influenza in Mianyang during 2010-2011, so as to provide evidence for formulating prevention and control strategies. Methods Surveillance data, ILI etiological results, outbreak and epidemic situation of the influenza-like illnesses (ILI) in Mianyang during 2010-2011 were collected for analysis. Results There were 12 100 ILI cases reported in 2010, accounted for 2.72% of the total outpatients. While 8 364 ILI cases accounted for 1.83% of the total outpatients were reported in 2011, reduced by 32.47% compared with 2010. The temporal distribution of doctor-visiting ratio in those two years was in an increased bimodal pattern. Most cases were children aged 0-5 years, accounted for 46.24%. Most ILI cases were treated in the department of fever, accounted for 88.56%. A total of 788 ILI specimens were collected for the detection of Real time RT-PCR, of which 34 specimens showed positive strains (4.31%) including 5 influenza A/H1N1 (0.63%), 8 influenza A (1.02%), 1 seasonal influenza A/H3 (0.13%) and 20 influenza B (2.54%). No outbreak and epidemic situation in Mianyang during 2010-2011. Conclusion The influenza activity is relatively stable without large-scale outbreak in Mianyang during 2010-2011. The reporting quality of surveillance hospitals should be improved and the lab of flu surveillance network should actively prepare to do the isolation and identification of influenza virus. It is necessary to enhance flu surveillance so as to prevent and control influenza prevalence．
Objective To systematically review the clinical effectiveness and safety of Lianhuaqingwen capsule in the treatment of influenza. Methods Databases including MEDLINE, The Cochrane Library, PubMed, VIP, WanFang Data, CNKI and CBM were searched to collect the randomized controlled trials (RCTs) on Lianhuaqingwen capsule treating influenza published from 2000 to 2011. The studies were screened according to the inclusion and exclusion criteria, the data were extracted, the quality of the included RCTs was assessed, and meta-analysis was performed using RevMan 5.0 software. Results Among 12 RCTs included, 11 were in Chinese and 1 was in English. The results of meta-analyses based on stratified therapeutic strategies showed that: a) Lianhuaqingwen caspule vs. other traditional Chinese medicinals (TCM): A total of 5 RCTs were included. Compared with the Lingyangganmao capsule, significant differences were found in the clinically marked effective rate (RR=1.32, 95%CI 1.15 to 1.52), the marked effective rate of temperature (RR=1.31, 95%CI 1.10 to 1.55), and the time of defervescence (RR=3.98, 95%CI –4.81 to –3.15); compared with the Kugan granules, significant differences were found in the clinically marked effective rate (RR=1.33, 95%CI 1.08 to 1.64) and the marked effective rate of temperature (RR=1.58, 95%CI 1.20 to 2.09); compared with the TCM decoction, the time of defervescence was significantly different (WMD=5.52, 95%CI 0.32 to 10.72); and b) Lianhuaqingwen capsule vs. western drugs: A total of 9 RCTs were included. Compared with ribavirin, the clinically marked effective rate was significantly different (RR=1.52, 95%CI 1.15 to 2.02); compared with Phosphate oseltamivir, the clinically marked effective rate was not significantly different (RR=0.96, 95%CI 0.77 to 1.18), and the WMDs (95%CI) of such indexes as the time of defervescence, the duration of cough, sore throat, myalgia, expectoration and headache, and the time of viral shedding were –4.50 (–8.83, –0.17), –10.38 (–13.89, –6.87), –13.92 (–19.81, –8.04), –16.44 (–26.50, –6.39), –10.80 (–18.98, –2.63), –9.24 (–17.92, –0.57), and 1.39 (–7.24, 10.02), respectively. Except for the time of viral shedding, all the other indexes showed significant differences between the two groups. No obvious adverse reactions related to Lianhuaqingwen capsule were reported. Conclusion Current evidence shows that Lianhuaqingwen capsule is more effective than other Chinese medicinals and western drugs in alleviating flu-like symptoms when treating influenza. Due to the low methodological quality of the included RCTs, more high-quality large-scale RCTs need to be conducted to verify this conclusion.
Objective To investigate safety of influenza A H1N1 vaccine vaccinations. Methods A total of 3 300 medical workers were vaccinated by batch of 200909012 influenza A H1N1 vaccine produced by Shanghai Biological Products Corporation Limited according to the principle of voluntary and concentration. The adverse reactions were observed within half an hour, three days and a week after vaccinations, respectively. Results The inoculators with local or systemic reaction reached 1.18% (39/3 300). There were 0.15% (5/3 300) of the inoculators with adverse reaction within half an hour; 0.70% (23/3 300) within 1 to 3 days after vaccination; and 0.33% (11/3 300) within 3 days to 1 week after vaccination. No severe adverse events were found. Conclusion Influenza A H1N1 vaccine vaccinations is an economic and effective way of influenza A H1N1 prevention with mild reactions.
ObjectivesTo explore a reliable and simple predictive tool for 30-day mortality of influenza A community-acquired pneumonia (CAP).MethodsA multicenter retrospective study was conducted on 178 patients hospitalized with influenza A CAP, including 144 alive patients and 34 dead patients. Receiver operating characteristic (ROC) curves were performed to verify the accuracy of severity scores as 30-day mortality predictors in the study patients.ResultsThe 30-day mortality of influenza A CAP was 19.1%. The actual mortality of PSI risk class Ⅰ-Ⅱ and CURB-65 score 0-1 were 14.5% and 15.7%, respectively, which were much higher than the predicted mortality. Logistic regression confirmed blood urea nitrogen >7 mmol/L (U), albumin <35 g/L (A) and peripheral blood lymphocyte count <0.7×10 9/L (L) were independent risk factors for 30-day mortality of influenza A CAP. The area under the ROC curve (AUC) of UAL (blood urea nitrogen >7 mmol/L+ albumin <35 g/L+ peripheral blood lymphocyte count <0.7×10 9/L) was 0.891, which was higher than CURB-65 score (AUC=0.777, P=0.008 3), CRB-65 score (AUC=0.590, P<0.000 1), and PSI risk class (AUC=0.568,P=0.000 1).ConclusionUAL is a reliable and simple predictive tool for 30-day mortality of influenza A CAP.
ObjectiveTo compare the clinical characteristics of inpatients with different influenza subtypes, so as to identify the subtypes at an early stage.MethodsA retrospective case study was conducted, using influenza surveillance data from January 1st, 2016 to December 31st, 2018 at a tertiary surveillance outpost hospital in Chengdu. Patients diagnosed with different subtypes of influenza by nucleic acid testing or virus isolation and culture were investigated, and their clinical characteristics, laboratory test results, and prognosis were analyzed and compared among the four subtypes including H1N1, H3N2, Victoria (BV), and Yamagata (BY).ResultsThere were 127 inpatients with laboratory-confirmed influenza. Among the confirmed influenza patients, 85.8% (109/127) had low or normal white blood cell counts, and 78.8% (89/113) had abnormally high procalcitonin levels. Among the patients with different subtypes, statistical differences existed in age (P<0.001), low or normal white blood cell count (P=0.041), positive bacteria/fungus/mycoplasma/chlamydia culture (P=0.001), kidney damage (P=0.013), outcome at discharge (P<0.001), and hospitalization expenses (P=0.016). However, there was no statistical difference in gender, clinical symptoms, liver damage, cardiac damage, or length of hospital stay (P>0.05).ConclusionThe infection of influenza can lead to severe clinical complications or even death. The outcomes of patients with influenza A may be more severe. An elevated procalcitonin level can be detected in quite a few patients with influenza.
Co-infection with severe influenza and bacterial is well known, but in recent years, more and more studies report that aspergillus have been identified as important pathogens, secondary only to bacteria in severe influenza. Influenza-associated aspergillus (IAA) brings a high death rate and heavy burden to our country. Therefore, early diagnosis and effective treatment are needed. In order to better understand IAA, this review summarizes the available literature on the association of IAA, including epidemiology, diagnosis and treatment.
ObjectiveTo investigate the clinical characteristics and prognostic factors of influenza pneumonia from 2014 to early 2018.MethodsThe general information, clinical symptoms, laboratory examination and treatment of 69 patients with influenza pneumonia from October 2014 to March 2018 were collected. The clinical characteristics of 32 patients with influenza pneumonia from 2017 to 2018 were compared with 37 patients with influenza pneumonia from 2014 to 2016. The prognostic factors of influenza pneumonia were also investigated.ResultsThe median patient age was 68 (55-78) years, and 41 cases (59.4%) were men in 69 patients. The five most common comorbidities were hypertension (44.9%), diabetes (23.3%), chronic obstructive pulmonary disease (17.4%), coronary atherosclerotic heart disease (13.0%), and chronic kidney disease (10.1%). The median levels of fasting blood glucose, lactate dehydrogenase, C-reactive protein, and procalcitonin in the patients with influenza pneumonia in 2017-2018 were significantly higher than those in the same period of 2014-2016, which were respectively 7.1 (5.4 - 8.3)mmol/L vs. 5.2 (4.5 - 7.3)mmol/L (P=0.017), 213.0 (98.0 - 320.5)U/L vs. 178 (98.0 - 280.0)U/L (P=0.049), 65.5 (15.4 - 139.8)mg/L vs. 45.5 (14.1 - 75.3)mg/L (P=0.050), 0.66 (0.24 - 1.58)μg/L vs. 0.17 (0.11 - 0.43)μg/L (P=0.004). The proportion of bacterial infection, septic shock, acute renal failure and mortality in the patients with influenza pneumonia in 2017-2018 was higher than that in the 2014-2016 group, which were respectively 40.6% vs. 18.9% (P=0.047), 21.9% vs. 5.4% (P=0.043), 21.9% vs. 2.7% (P=0.035), 31.3% vs. 5.4% (P=0.005). Multivariate analysis showed that numbers of lymphocytes, blood urea nitrogen, and procalcitonin were independent risk factors for mortality in the patients with influenza pneumonia. The odds ratio was respectively 0.001 (95%CI 0.00 - 0.200), 1.342 (95%CI 0.996 - 1.808), 1.113. (95%CI 1.006 - 1.230).ConclusionsCompared with the patients with influenza pneumonia in 2014-2016, the patients in 2017-2018 have higher levels of fasting blood glucose and lactate dehydrogenase, and are also susceptible to secondary bacterial infection, septic shock, and acute renal failure. Decreased lymphocytes, elevated blood urea nitrogen, and elevated procalcitonin are independent risk factors for death in patients with influenza pneumonia.
Influenza A is an acute infectious respiratory disease caused by influenza A virus, with typical signs and symptoms of upper and / or lower respiratory tract involvement, and symptoms of systemic disease such as fever, headache, myalgia and fatigue. Although it is a self-limited disease in the general population, it is associated with increased morbidity and mortality in some high-risk populations and often leads serious complications, such as severe acute lung injury, acute respiratory distress syndrome, as well as other extrapulmonary injuries. The exploration of the mechanisms of lung injury caused by influenza A infection could be helpful to understand the pathogenic mechanisms of other viral pneumonias, such as coronavirus disease 2019.