Browsing by Author "Guiomar, R."
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- Congenital SARS-CoV-2 Infection in a Neonate With Severe Acute Respiratory SyndromePublication . Correia, C.R.; Marçal, M.; Vieira, F.; Santos, E.; Novais, C.; Maria, A.T.; Malveiro, D.; Prior, A.R.; Aguiar, M.; Salazar, A.; Pinto, C.G.; Rodrigues, L.C.; Pessanha, M.A.; Borges, V.; Isidro, J.; Gomes, J.P.; Duarte, S.; Vieira, L.; Costa, I.; Alves, M.J.; Calhau, C.; Guiomar, R.; Tuna, M.L.Coronavirus disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is mainly transmitted through droplets, but other ways of transmission have been hypothesized. We report a case of vertical transmission of SARS-CoV-2 in a preterm born to an infected mother, confirmed by the presence of the virus in the neonatal blood, nasopharyngeal and oropharyngeal swabs collected in the first half an hour of life. The neonate presented with acute respiratory distress, similar to the findings in severely affected adults. This case highlights the importance of pregnancy, labor and neonatal period surveillance of affected mothers and their newborns.
- Estimates of 2012/13 influenza vaccine effectiveness using the case test-negative control design with different influenza negative control groupsPublication . Nunes, Baltazar; Machado, Ausenda; Guiomar, R.; Pechirra, P.; Conde, P.; Cristovão, P.; Falcão, I.Background: In recent years several reports of influenza vaccine effectiveness (VE) have been made early for public health decision. The majority of these studies use the case test-negative control design (TND), which has been showed to provide, under certain conditions, unbiased estimates of influenza VE. Nevertheless, discussions have been taken on the best influenza negative control group to use. The present study aims to contribute to the knowledge on this field by comparing influenza VE estimates using three test-negative controls: all influenza negative, non-influenza respiratory virus and pan-negative. Methods Incident ILI patients were prospectively selected and swabbed by a sample of general practitioners. Cases were ILI patients tested positive for influenza and controls ILI patients tested negative for influenza. The influenza negative control group was divided into non-influenza virus control group and pan-negative control group. Data were collected on vaccination status and confounding factors. Influenza VE was estimated as one minus the odds ratio of been vaccinated in cases versus controls adjusted for confounding effect by logistic regression. Results Confounder adjusted influenza VE against medically attended laboratory-confirmed influenza was 68.4% (95% CI: 20.7–87.4%) using all influenza negatives controls, 82.1% (95% CI: 47.6–93.9%) using non-influenza controls and 49.4% (95% CI: −44.7% to 82.3%) using pan-negative controls. Conclusions Influenza VE estimates differed according to the influenza negative control group used. These results are in accordance with the expected under the hypothesis of differential viral interference between influenza vaccinated and unvaccinated individuals. Given the wide importance of TND study further studies should be conducted in order to clarify the observed differences.
- Improving influenza surveillance in Portuguese preschool children by parents' reportPublication . Paixão, P.; Piedade, C.; Papoila, A.; Caires, I.; Pedro, C.; Santos, M.; Silvestre, M.J.; Brum, L.; Nunes, Baltazar; Guiomar, R.; Curran, M.D.; Carvalho, A.; Marques, T.; Neuparth, N.Influenza surveillance is usually based on nationally organized sentinel networks of physicians and on hospital reports. This study aimed to test a different report system, based on parents’ phone contact to the research team and in home collection of samples by a dedicated team. The identification of influenza and other respiratory viruses in children who attended a Hospital Emergency Department was also recorded. Real-time PCR and reverse transcription PCR were performed for influenza A and B, parainfluenza 1-4, adenovirus, human metapneumovirus, respiratory syncytial virus A and B, rhinovirus, enterovirus, group 1 coronaviruses, group 2 coronaviruses, and human bocavirus. One hundred children were included, 64 from the day care centers and 36 from the Hospital. Overall, 79 samples were positive for at least one respiratory virus. Influenza A (H3) was the virus most frequently detected: 25 cases, 20 of these in children under 5 years of age (ten from day care centers and ten who went to the hospital) which was higher than those reported by the National Influenza Surveillance Programme for this age. Conclusion: The results obtained in this study suggest that a surveillance system based on parents’ reports could complement the implanted system of the National Influenza Surveillance Programme.
- Influenza vaccine effectiveness estimates in Europe in a season with three influenza type/subtypes circulating: the I-MOVE multicentre case-control study, influenza season 2012/13Publication . Kissling, E.; Valenciano, M.; Buchholz, U.; Larrauri, A.; Cohen, J.M.; Nunes, Baltazar; Rogalska, J.; Pitigoi, D.; Paradowska-Stankiewicz, I.; Reuss, J.; Jiménez-Jorge, S.; Daviaud, I.; Guiomar, R.; O'Donnell, J.; Necula, G.; Głuchowska, M.; Moren, A.In the fifth season of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE), we undertook a multicentre case–control study (MCCS) in seven European Union (EU) Member States to measure 2012/13 influenza vaccine effectiveness against medically attended influenza-like illness (ILI) laboratory confirmed as influenza. The season was characterised by substantial co-circulation of influenza B, A(H1N1)pdm09 and A(H3N2) viruses. Practitioners systematically selected ILI patients to swab ≤7 days of symptom onset. We compared influenza-positive by type/subtype to influenza-negative patients among those who met the EU ILI case definition. We conducted a complete case analysis using logistic regression with study as fixed effect and calculated adjusted vaccine effectiveness (AVE), controlling for potential confounders (age, sex, symptom onset week and presence of chronic conditions). We calculated AVE by type/subtype. Study sites sent 7,954 ILI/acute respiratory infection records for analysis. After applying exclusion criteria, we included 4,627 ILI patients in the analysis of VE against influenza B (1,937 cases), 3,516 for A(H1N1)pdm09 (1,068 cases) and 3,340 for influenza A(H3N2) (730 cases). AVE was 49.3% (95% confidence interval (CI): 32.4 to 62.0) against influenza B, 50.4% (95% CI: 28.4 to 65.6) against A(H1N1)pdm09 and 42.2% (95% CI: 14.9 to 60.7) against A(H3N2). Our results suggest an overall low to moderate AVE against influenza B, A(H1N1)pdm09 and A(H3N2), between 42 and 50%. In this season with many co-circulating viruses, the high sample size enabled stratified AVE by type/subtype. The low estimates indicate seasonal influenza vaccines should be improved to achieve acceptable protection levels.
- SARS-CoV-2 introductions and early dynamics of the epidemic in PortugalPublication . Borges, V.; Isidro, J.; Trovão, N.S.; Duarte, S.; Cortes-Martins, H.; Martiniano, H.; Gordo, I.; Leite, R.; Vieira, L.; Portuguese network for SARS-CoV-2 genomics (Consortium); Guiomar, R.; Gomes, J.P.Background: Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods: By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARS-CoV-2 introductions and early dissemination in Portugal. Results: We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions: Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.
- Temporal Patterns of Influenza A and B in Tropical and Temperate Countries: What Are the Lessons for Influenza Vaccination?Publication . Caini, S.; Andrade, W.; Badur, S.; Balmaseda, A.; Barakat, A.; Bella, A.; Bimohuen, A.; Brammer, L.; Bresee, J.; Bruno, A.; Castillo, L.; Ciblak, M.A.; Clara, A.W.; Cohen, C.; Daouda, C.; de Lozano, C.; De Mora, D.; Dorji, K.; Emukule, G.O.; Fasce, R.A.; Feng, L.; Ferreira de Almeida, W.A.; Guiomar, R.; Heraud, J.M.; Holubka, O.; Huang, Q.S.; Kadjo, H.A.; Kiyanbekova, L.; Kosasih, H.; Kusznierz, G.; Lee, V.; Lara, J.; Li, M.; Lopez, L.; Mai, H.P.; Pessanha, H.C.; Matute, M.L.; Mironenko, A.; Moreno, B.; Mott, J.A.; Njouom, R.; Nurhayati; Ospanova, A.; Owen, R.; Pebody, R.; Pennington, K.; Puzelli, S.; Quynh, Le M.T.; Razanajatovo, N.H.; Rodrigues, A.; Rudi, J.M.; Venter, M.; Vernet, M.A.; Wei, A.L.; Wangchuk, S.; Yang, J.; Yu, H.; Zambon, M.; Schellevis, F.; Paget, J.; Global Influenza B StudyIntroduction: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes. Methods: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with 80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics. Results: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics. Discussion: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate.