Stories about: influenza

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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Predicting influenza outbreaks faster with a digitally-empowered wearable device

Influenza viruses. Outbreaks can be predicted using digital health tools like Thermia.The Thermia online health educational tool, developed at Boston Children’s Hospital, has enabled one-month-faster prediction of seasonal influenza outbreaks in China, via its digital integration with a commercially-available wearable thermometer. The findings appear in a new study published in the American Journal of Public Health.

 “The fact that we were able to predict influenza outbreaks faster than China’s national surveillance programs really shows the capacity for everyday, wearable digital health devices to track the spread of disease at the population level,” says the study’s lead author Yulin Hswen, who is a research fellow in Boston Children’s Computational Epidemiology Group and a doctoral candidate at the Harvard T. H. Chan School of Public Health.

China has 620 million mobile internet users who can theoretically access the standalone Thermia application from any computer, smartphone or even the Amazon Alexa assistant.

Although the Boston Children’s team has previously demonstrated that social media can be used to track disease, this is the first time they’ve shown that outbreaks can be predicted through an integrated wearable device and online tool.

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Real-time influenza tracking with electronic health records

influenza tracking
Data captured from healthcare visits could be a tool for medical surveillance.

Early influenza detection and the ability to predict outbreaks are critical to public health. Reliable estimates of when influenza will peak can help drive proper timing of flu shots and prevent health systems from being blindsided by unexpected surges, as happened in the 2012-2013 flu season.

The Centers for Disease Control and Prevention collects accurate data, but with a time lag of one to two weeks. Google Flu Trends began offering real-time data in 2008, based on people’s Internet searches for flu-related terms. But it ultimately failed, at least in part because not everyone who searches “flu” is actually sick. As of last year, Google instead now sends its search data to scientists at the CDC, Columbia University and Boston Children’s Hospital.

Now, a Boston Children’s-led team demonstrates a more accurate way to pick up flu trends in near-real-time — at least a week ahead of the CDC — by harnessing data from electronic health records (EHRs).

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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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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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Influenza, MRSA and why flu vaccination can save children’s lives

Influenza A H1N1 model (scherle.com/Wikimedia)

What caused previously healthy children to die during the 2009 H1N1 influenza pandemic?  Yesterday, the journal Pediatrics published the results of a study I conducted with the Pediatric Acute Lung Injury and Sepsis Investigator’s (PALISI) Network. Results have been widely reported, by the New York Times, the Washington Post, USA Today and TIME, among many others, provoking a lot of reader commentary, questions and, I fear, some misconceptions.

Methicillin-resistant S. aureus (MRSA)(CDC)

Our study collected data on 838 children with 2009 H1N1 infection admitted across 35 pediatric intensive care units (ICUs) in the U.S. Most of these children were severely ill, the majority requiring mechanical ventilator support for respiratory failure, and 9 percent died. Many  (70 percent) had underlying illnesses like asthma or neurologic conditions that increased their risk. But among those who were previously healthy, the chief risk factor for death was co-infection with methicillin-resistant Staphylococcus aureus, or MRSA. It increased the risk of mortality 8-fold.

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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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Personalized medicine in asthma: Finding the right targets

Asthma triggered by the influenza virus works through pathways not targeted by existing drugs. (Photo: Cynthia Goldsmith)

A case of the flu almost always exacerbates asthma, and often spells hospitalization for asthmatic children. But why is flu so dangerous, and why are flu-induced exacerbations so hard to control?

New research reveals that these attacks arise via a previously unrecognized physiologic pathway that appears to bypass existing asthma drugs.

“Virtually everyone who comes into the hospital with asthma has a viral infection, because we just can’t treat it well,” says Dale Umetsu, the study’s senior investigator and an immunologist at Children’s Hospital Boston. “If we could find better therapies that specifically target this pathway, we might be able to help these patients.”

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