2016-2021
2016-2021 Respiratory Virus Surveillance Results in Children with Acute Respiratory Disease
United States
The US Centers for Disease Control and Prevention released surveillance data on infections and medical visits in children for several respiratory and enteroviruses in a weekly report released yesterday.
It turns out that although influenza virus and new coronavirus are highly contagious, it is not these two viruses that actually appear in the emergency department and hospitalization. The most common one has no vaccine available yet, but There are already preventive medicines abroad.
One
U.S. vs. China
This report includes Influenza Virus, Respiratory Syncytial VirusRespiratory Syncytial Virusin the United States from December 2016 to August 2021 /strong> (RSV), Human metapneumovirus (HMPV), Parainfluenza virus type 1-3 (HPIV1-3), Adenovirus (Adenovirus), human rhinovirus and enterovirus (RV/EV), and new coronavirus (SARS-CoV-2) annual cycles.
(cold knowledge: Rhinovirus belongs to the genus Enterovirus)
The study covered a total of 90,085 minors <18 years of age, of whom 51,441 were included in the report, 75% of whom were younger than 5 years old. Of these minors, 43% were hospitalized, including 37% of children under the age of 1.
Across all care settings (including outpatient, emergency, and inpatient), at least one viral pathogen was detected in 32,259 (63%) samples and one in 4,492 (9%) samples For the above viral pathogens, 19,182 (37%) specimens had no viral pathogens detected.
The most frequently detected pathogens were RV/EV (14,906; 31%) and RSV (8,461; 17%). RSV was most frequently detected in inpatient settings (24%), and influenza was detected in the ED (not erectile dysfunction, but ED)Most (11%), while RV/EV was in outpatient setting (39%).
Coronavirus, during the COVID-19 pandemic (March 2020-August 31, 2021), 1171 (7%) children received SARS-CoV-2 Positive test results, of which 411 (35%) were outpatients.
During the 2020-2021 surveillance season (September 15, 2020-August 31, 2021), compared to previous seasons, in inpatient and emergency settings, with the exception of HPIV1- 3 (8%) and RV/EV (36%), the proportion of total positive test results for seasonal viruses was lower (P
Research data from some regions in China also found that RSV infection is indeed a high proportion of clinical practice. A 2015 meta-analysis pointed out that RSV infection in children with acute respiratory tract infection in China It accounted for 26.5%; another 2020 meta-analysis data showed that among Chinese children with acute lower respiratory tract infection, the overall positive rate of RSV was about 16%.
Simply put, it is not only influenza and COVID-19 that need attention, but also respiratory syncytial virus infection.
Two
About the flu, COVID-19 and RSV vaccines
Speaking of influenza virus, new coronavirus, and enterovirus, the general first reaction is that the risk can be reduced by vaccination. The immunization procedures of different vaccines are as follows:
Influenza vaccine: According to guideline recommendations, children 6 months – 8 years old receive 2 doses of influenza vaccine for the first time (the 2-dose schedule in the United States covers live attenuated Vaccines, Chinese guidelines recommend only 1 dose of live attenuated vaccine), and then 1 dose every year; people ≥ 9 years old are vaccinated once a year (not to say that it has to be a whole year, and new ones can be used).
COVID-19 vaccine: 2 doses for minors 3 – 17 years old.
Enterovirus 71 (EV71) vaccine: The EV71 vaccine in my country can only prevent hand, foot and mouth disease caused by EV71 infection, but cannot prevent other enteroviruses Infection, 2 doses are required for the whole process, and there is no need for a third dose (in addition, it should be noted that the enterovirus in the United States is mainly D68 rather than EV71, so the EV71 vaccine is only mentioned here by the way).
Although there has been an inactivated whole virus vaccine for RSV, it is unfortunate that children who have received this vaccine have developed a so-called “vaccine-associated enhanced respiratory disease” (VAERD), where re-infection with RSV after vaccination with RSV turned out to be more severe, and this phenomenon was attributed to the Arthus reaction.
Of course, the RSV vaccine was then dropped.
Nevertheless, there is a preventive medicine (not a vaccine) against RSV that is very much to look forward to.
This is a type of antibody called Nirsevimab (nirsevimab, translated blindly, I don’t know what the official translation of this thing is called, directly It was approved by the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) last month for the prevention of RSV infection in newborns and infants.
A pooled analysis of Phase 2b and 3 clinical trials of this mAb showed 77.4% of 77.4% of term infants and preterm infants ≥28 weeks old. Protective efficacy on hospitalization due to RSV infection; Phase 3 clinical study data in 21 countries and regions show that the use of this monoclonal antibody in term and preterm infants compared with placebo , lower respiratory tract infections including bronchitis and pneumonia were 74.5% lower, showing very good efficacy.
Someone sent me a private message a few days ago, saying that there may be an RSV vaccine landing in China soon, maybe even this kind of medicine.
Of course, compared to 2019-nCoV, influenza virus, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, rhinovirus, and other enteroviruses have no approved vaccines or vaccines yet. Preventive biological products, so it is very important to pay attention to hand hygiene.
Three
About prophylactic antibody products
Come back and talk about prophylactic antibody products.
In fact, it is not only vaccines containing pathogenic antigens that can prevent disease, but also antibody products.
Antibody products are actually more expensive than vaccines prepared from antigens, but the advantage is that they can take effect quickly, and may have better safety than vaccines, and even Works on both prophylactic and therapeutic ends.
Taking the new crown antibody product as an example, the combination of tixagevimab and cilgavimab monoclonal antibody often seen in the news some time ago is an effective prophylactic monoclonal antibody products. Regrettably, the bottomless mutation of the new coronavirus has threatened the effectiveness of such monoclonal antibody products, such as the BA.4.6 subline highlighted by the US FDA a few days ago.
Therefore, scientific research teams at home and abroad are developing monoclonal antibody products targeting neutralizing antibodies against conserved epitopes of the new coronavirus. At present, 4 kinds of antibodies have been seen that can effectively neutralize a variety of Omics. Rong mutant strains and even sabei viruses such as SARS virus may become effective therapeutic or even preventive drugs in the future.
Of course, considering the metabolic rate of the monoclonal antibody, if the monoclonal antibody is to be prepared into a long-term effective preventive medicine, the structure of the antibody needs to be edited to slow down its half-life, Extend the effective time.
All in all, if you want to effectively prevent the invasion of pathogens, sanitary protection and biological products including vaccines and monoclonal antibodies are essential, but combined with the pathogen itself and the difficulty of research and development, Overall, vaccines are still the most stable general direction.
(PS: Regarding disease treatment, listen to the clinician)
May the world be free from epidemics!
=Pill=
Disclaimer: This article is created for personal interests, only to allow more ordinary people to have a clearer understanding of vaccines. The content and opinions do not represent any organization, unit, or institution, and do not accept any form of sponsorship. , the materials used are all from the public network or paid for purchase. If the content is wrong, please do more self-criticism (not).