Yeon-Ha Kim, Aee Lee Kim
Evaluating Standardized Job Competencies for Managing Students at Risk for Anaphylaxis in Elementary School Nurses
Healthcare (Basel, Switzerland)
201718 influenza season usa high incidence influenza illness mortality however apparent antigenic change identified dominant h3n2 viruses severity season could solely attributed vaccine mismatch aimed investigate whether altered virus properties resulting gene reassortment underlying causes increased case number disease severity associated 201718 influenza season samples included collected patients influenza prospectively recruited 201617 201718 influenza seasons johns hopkins hospital emergency departments baltimore md usa well archived samples johns hopkins health system sites among 647 recruited patients influenza virus infection 411 patients wholegenome sequences available johns hopkins center excellence influenza research surveillance network 201617 201718 seasons phylogenetic trees constructed based viral wholegenome sequences representative viral isolates two seasons characterised immortalised cell lines human nasal epithelial cell cultures patients demographic data clinical outcomes analysed unique h3n2 reassortment events observed resulting two predominant strains 201718 season ha clade 3c2a2 clade 3c3a novel gene segment constellations containing gene segments ha clade 3c2a1 viruses reassortant re3c2a2 viruses replicated faster kinetics higher peak titre compared parental 3c2a2 3c2a1 viruses 48 h vs 72 h furthermore patients infected reassortant 3c2a2 viruses higher influenza severity scores patients infected parental 3c2a2 viruses median 300 iqr 100400 vs 150 100200 p0018 findings suggest increased severity 201718 influenza season due part two intrasubtypes cocirculating h3n2 reassortant viruses fitness advantages parental viruses information could help inform future vaccine development public health policies center excellence influenza research response us national science technology council chang gung memorial hospital taiwan