Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling

Opatowski, Lulla; Baguelin, Marc; Eggo, Rosalind M

doi:10.1371/journal.ppat.1006770

Cited by 111 publications

(100 citation statements)

References 198 publications

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“…Many studies have demonstrated the risk of superinfection by S. pneumoniae and S. aureus during influenza, with a significant increase in the number of medical visits, drug prescriptions, and hospital admissions for respiratory disease [34][35][36]. Influenza-related complications seem to be more common in children with underlying chronic severe diseases, which is why health authorities worldwide have long recommended that these children receive the influenza vaccine every year.…”

Section: Influenza Vaccinationmentioning

confidence: 99%

Vaccination against Paediatric Respiratory Pathogens

et al. 2019

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Acute respiratory infections (ARIs) are extremely common in children, especially those under 5 years old. They can lead to complications, super-infection, respiratory failure, and even compromised respiratory function in adulthood. For some of the responsible pathogens, vaccines are available. This review reports current issues about vaccines against the main respiratory pathogens to highlight the available strategies to reduce the burden of paediatric respiratory disease. The optimal use of influenza, pneumococcal, pertussis and measles vaccines is required in order to reduce ARI burden. Vaccination coverage rates must be improved to achieve the full benefits of these vaccines. Recently, advances in the knowledge of respiratory syncytial virus structural biology and immunology as well as the development of new techniques to generate vaccine candidates have increased the number of promising vaccines even against this harmful pathogen.

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Section: Influenza Vaccinationmentioning

confidence: 99%

Vaccination against Paediatric Respiratory Pathogens

et al. 2019

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“…coinfection or the presence of multiple unrelated viruses is quite common in the respiratory tract (1)(2)(3)(4). Viruses involved in coinfections have the potential for interactions within the host that could affect replication dynamics, immune responses, and disease pathogenesis (5,6). A substantial amount of research has focused on virus and bacterium coinfections (virus/bacterium coinfections), as it is common for a viral infection in the respiratory tract to enhance susceptibility of the host to a subsequent bacterial infection (7).…”

mentioning

confidence: 99%

Attenuation of Influenza A Virus Disease Severity by Viral Coinfection in a Mouse Model

González

Ijezie

Balemba

et al. 2018

J Virol

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Influenza viruses and rhinoviruses are responsible for a large number of acute respiratory viral infections in human populations and are detected as copathogens within hosts. Clinical and epidemiological studies suggest that coinfection by rhinovirus and influenza virus may reduce disease severity and that they may also interfere with each other's spread within a host population. To determine how coinfection by these two unrelated respiratory viruses affects pathogenesis, we established a mouse model using a minor serogroup rhinovirus (rhinovirus strain 1B [RV1B]) and mouse-adapted influenza A virus (A/Puerto Rico/8/1934 [PR8]). Infection of mice with RV1B 2 days before PR8 reduced the severity of infection by a low or medium, but not high, dose of PR8. Disease attenuation was associated with an early inflammatory response in the lungs and enhanced clearance of PR8. However, coinfection by RV1B did not reduce PR8 viral loads early in infection or inhibit replication of PR8 within respiratory epithelia or Inflammation in coinfected mice remained focal compared to diffuse inflammation and damage in the lungs of mice infected by PR8. The timing of RV1B coinfection was a critical determinant of protection, suggesting that sufficient time is needed to induce this response. Finally, disease attenuation was not unique to RV1B: dose-dependent coinfection by a murine coronavirus (mouse hepatitis virus strain 1 [MHV-1]) also reduced the severity of PR8 infection. Unlike RV1B, coinfection with MHV-1 reduced early PR8 replication, which was associated with upregulation of beta interferon (IFN-β) expression. This model is critical for understanding the mechanisms responsible for influenza disease attenuation during coinfection by unrelated respiratory viruses. Viral infections in the respiratory tract can cause severe disease and are responsible for a majority of pediatric hospitalizations. Molecular diagnostics have revealed that approximately 20% of these patients are infected by more than one unrelated viral pathogen. To understand how viral coinfection affects disease severity, we inoculated mice with a mild viral pathogen (rhinovirus or murine coronavirus), followed 2 days later by a virulent viral pathogen (influenza A virus). This model demonstrated that rhinovirus can reduce the severity of influenza A virus, which corresponded with an early but controlled inflammatory response in the lungs and early clearance of influenza A virus. We further determined the dose and timing parameters that were important for effective disease attenuation and showed that influenza disease is also reduced by coinfection with a murine coronavirus. These findings demonstrate that coinfecting viruses can alter immune responses and pathogenesis in the respiratory tract.

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“…Thus, the inclusion of RSV in the model not only showed the burden of the pathogen in the youngest age group but also improved our estimates for influenza. Opatowski et al stated the important role of considering cocirculating pathogens in mathematical modelling, and to our knowledge, only few studies included both influenza and RSV in burden estimates …”

Section: Discussionmentioning

confidence: 99%

“…Opatowski et al stated the important role of considering cocirculating pathogens in mathematical modelling, and to our knowledge, only few studies included both influenza and RSV in burden estimates. [14][15][16][17] Our model has still some limitations: we continue to have the difficulty that viral samples in the sentinel are taken from ILI patients while we are assessing the total burden of consultations to ARI. Thus, we have assumed that the distribution of INV subtypes/lineages and RSV among ARI cases is similar to that among ILI patients.…”

Section: Discussionmentioning

confidence: 99%

Estimation of influenza‐ and respiratory syncytial virus‐attributable medically attended acute respiratory infections in Germany, 2010/11‐2017/18

Heiden

Buchholz

Buda

2019

Influenza Resp Viruses

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Background The burden of influenza in primary care is difficult to assess, since most patients with symptoms of a respiratory infection are not tested. The case definition of “medically attended acute respiratory infection” (MAARI) in the German physician sentinel is sensitive; however, it requires modelling techniques to derive estimates of disease attributable to influenza and respiratory syncytial virus (RSV). Objectives The objective of this paper was to review and extend our previously published model in order to estimate the burden of RSV and the differential burden of the two influenza B lineages (Victoria, Yamagata) as well as both influenza A subtypes on primary care visits. Methods Data on MAARI and virological results of respiratory samples (virological sentinel) were available from 2010/11 until 2017/18. We updated the previously published generalized additive regression model to include RSV. Results We found that the proportion of MAARI due to RSV is substantial only in the 0‐1‐ and 2‐4‐year‐old age groups (0‐1 years old: median 7.5%, range 4.0%‐14.8%; 2‐4 years old: median 6.5%, range 4.0%‐10.3%); in the 0‐1 years old age group, RSV leads in almost all seasons to a higher burden than any influenza type or subtype, but this is reversed in the age group 2‐4 years old. Conclusions We succeeded in rearranging our previously published model on MAARI to incorporate RSV as well as the two influenza B lineages (Victoria, Yamagata) in the time period 2010 to 2018.

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Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling

Cited by 111 publications

References 198 publications

Vaccination against Paediatric Respiratory Pathogens

Vaccination against Paediatric Respiratory Pathogens

Attenuation of Influenza A Virus Disease Severity by Viral Coinfection in a Mouse Model

Estimation of influenza‐ and respiratory syncytial virus‐attributable medically attended acute respiratory infections in Germany, 2010/11‐2017/18

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