Stories about: flu

Severe flu infections linked to underlying genetic variation

Flu virusesThe Center for Disease Control estimates that influenza virus–related illnesses account for more than 200,000 U.S. hospitalizations and 12,000 deaths annually. Young children, the elderly and people with respiratory, cardiac and other chronic health conditions are at particularly high risk for being hospitalized for influenza-related complications. Until now, there has not been a clear reason to explain why some individuals become severely ill from flu and not others.

New findings published in Nature Medicine, however, might change that.

“We’ve identified a genetic variant that we believe may put people at risk of getting life-threatening influenza infections,” says Adrienne Randolph, MD, MSc, a senior associate in pediatric critical care medicine at the Boston Children’s Hospital.

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Did Tamiflu reviewers have a bad case of the financial conflict bug?

Tamiflu influenza neuraminidase inhibitors conflicts of interest
(stanrandom/Flickr)

This winter, if your doctor suggests that you take Tamiflu, you might want to ask for a conflict of interest statement: a new study suggests that doctors who received payments from the makers of flu-fighting neuraminidase inhibitors—drugs like Tamiflu® and Relenza®—were more likely to view the drugs’ prowess in a favorable light.

In the study, published last week in the Annals of Internal Medicine, a team led by Boston Children’s Hospital’s Florence Bourgeois, MD, MPH, tallied up the financial connections of doctors who participated in 37 reviews of neuraminidase inhibitors.

While it’s been unclear for years whether these drugs really are effective against influenza, it was crystal clear that financial relationships are associated with positive reviews.

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Digital disease detection: We see the trends, but who is actually sick?

Three teenagers wearing hospital masks flu influenza healthmap social media twitter digital epidemiology digital disease detectionElaine Nsoesie, PhD, is a research fellow at Boston Children’s Hospital’s HealthMap, Harvard Medical School and Virginia Bioinformatics Institute. In this post, which originally appeared on HealthMap’s Disease Daily, Nsoesie looks at the trend of detecting disease digitally by monitoring mentions on social media. She delves into one of the major limitations of this technique—namely telling those who are curious about a disease apart from those who actually have it.

There are plenty of studies about tracking diseases (such as influenza) using digital data sources, which is awesome! However, many of these studies focus solely on matching the trends in the digital data sources (for example, searches on disease-related terms, or how frequently certain disease-related terms are mentioned on social media over time, etc.) to data from official sources such as the Centers for Disease Control and Prevention. Although this approach is useful in telling us about the possible utility of these data, there are several limitations. One of the main limitations is the difficulty in distinguishing between data generated by healthy individuals and individuals who are actually sick. In other words, how can we tell whether someone who searches Google or Wikipedia for influenza is sick or just curious about the flu?

Researchers at Penn State University have developed a system that seeks to deal with this limitation. We spoke to the lead author, Todd Bodnar, about the study titled, On the Ground Validation of Online Diagnosis with Twitter and Medical Records.

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What your dinner cancellation on OpenTable says about the flu

An empty restaurant table. Can measuring restaurant cancellations tell us something about flu outbreaks?You wake up feeling like someone has taken a jackhammer to your head. You’re feverish, aching all over and your stomach is doing somersaults. There’s no doubt about it: You have the flu.

You also have reservations for dinner tonight. So after a mug of tea and an ibuprofen, you grope for your phone and cancel the reservations you’d made through OpenTable.

That cancellation might be a signal to public health officials of a flu outbreak. Because, according to a study by HealthMap’s John Brownstein, PhD, and Elaine Nsoesie, PhD, reservation data from OpenTable could offer another view into the seasonal spread of the flu.

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More than a feeling: Making flu surveillance truly participatory

3D reconstruction of an influenza virus
A flu virus. (CDC)
Disease surveillance has long been the purview of state public health departments, the U.S. Centers for Disease Control and Prevention (CDC) and other agencies that collect reports from doctors, clinics and laboratories.

That disease control model is being turned on its head by projects like Boston Children’s Hospital’s HealthMap, which scours the web for information related to disease outbreaks. HealthMap’s Flu Near You goes a step further by encouraging people to report their own flu-related symptoms and help track flu emergence and spread.

To date, though, efforts like these have been limited to the digital sphere—part of the growing field of digital epidemiology. They don’t rely on blood, spit and mucus to get their data—it’s all in bits and based solely on symptoms.

But even that is changing, thanks to a new Flu Near You initiative called GoViral. GoViral brings everyone directly into the flu surveillance process by allowing them to not just report how they’re feeling, but to test themselves for flu at home and submit their results.

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Does vaccinating preschoolers for the flu make a difference? A natural experiment says, “Yes!”

Preschoolers are often the first to catch the flu every year. Vaccinating children in this age group may help the whole family avoid the flu. (Luke & Courtney Barrett/Flickr)

When anyone in my house gets a cold or other bug, often we all look at my three-year old son, the one in preschool, and ask, “What did you bring home?” While it may seem unfair, our reaction reflects the conventional wisdom: That children of preschool age are often the vector for the colds, flu, sniffles, coughs, stomach bugs, etc., that make their way through the family every year.

Science does bear this out, especially with regards to the flu. A 2005 study by Children’s Hospital Boston researchers strongly suggested that otherwise healthy 3 and 4 year olds were prime drivers of flu epidemics, often displaying flu-like symptoms as early as late September.

Acknowledging preschoolers’ increased risk of getting sick from the flu, the Advisory Committee on Immunization Practices (ACIP) – the national body that sets vaccination policies in the U.S. – updated its influenza vaccine recommendations in 2006 to include vaccination of children between ages 2 and 4. Now, John Brownstein, who leads the Computational Epidemiology Group in the Children’s Hospital Informatics Program (CHIP) and took part in the 2005 study, demonstrates that the policy change has had quite an effect.

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Toward a flu vaccine that endures through the seasons

While it's not done this way anymore, getting a flu vaccine every year can still be a pain. Stephen Harrison is working on a vaccine strategy that would protect against flu strains from multiple seasons. (Photo: cdc e-health/Flickr)

Every year, the flu tries to outwit humanity. By shifting parts of its outer coat, the virus renders the flu vaccine from the previous year obsolete, bringing another season of misery. And every year, we fight back with a new vaccine, finding a new chink in the virus’s armor and giving ourselves another brief window of protection.

But if Stephen Harrison, chief of Children’s Division of Molecular Medicine, is right, we might be able to train our immune systems to look past the flu virus’s annual trickery and build up resistance that spans multiple seasons. That could reduce the need to develop, produce, and distribute a new flu vaccine nearly every year, a process of selection, growth, packaging, and distribution that can take upwards of seven months.

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Worried where the flu is? There’s an app for that

Photo: @alviseni/Flickr

Before you know it, flu season – that miserable time of sneezing, snuffling, coughing, and generally feeling blah – will be upon us again. And as with anything, the best way to deal with the flu is to be prepared for it.

But when, exactly, is the right time to start stocking up on tissues and looking for vaccination clinics? You could go with the conventional wisdom: Get the annual flu vaccine in the fall and spend the next five months avoiding anyone with bleary eyes and a runny nose.

Or, to try to get a more targeted read on when the flu will appear in your town, you could turn to the power of the web. In 2008 – a few months before H1N1 influenza appeared on the scene – Google launched Google Flu Trends, which mined user search data to gauge flu activity on a national, state, and even (in some cases) city level.

The H1N1 outbreak proved to be a tipping point for online disease tracking tools. Recognizing this, the US Center for Disease Control and Prevention (CDC) is getting into the act with the CDC Flu App Challenge. A contest run through Challenge.gov, the Flu App Challenge encourages developers to come up with “an innovative use of technology to raise awareness of influenza and/or educate consumers on ways to prevent and treat the flu.” Submitted apps – for the web, for desktop computers, for mobile devices – use publicly available data feeds, including at least one maintained by the CDC, to promote healthy behavior for flu prevention. All of the submitted apps are eligible for several awards, including a People’s Choice Award chosen by public vote.

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