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Keiji Fukuda

Publications and source records attributed to Keiji Fukuda.

28 records · Page 2Linked to original sources
PubMed2003

Impact of influenza on young children and the shaping of United States influenza vaccine policy.

BACKGROUND: In 2002 the Advisory Committee on Immunization Practices (ACIP) began encouraging annual influenza vaccination of children 6 to 23 months of age, when feasible. METHODS: Literature and issues related to annual influenza vaccination of young children were reviewed. RESULTS: The ACIP first encouraged influenza vaccination of children 6 to 23 months of age in 2002 because recent studies showed that influenza-related hospital admissions were substantially higher among healthy children <2 years than among healthy older children or young adults. However, the ACIP deferred a full recommendation for several reasons, including limited safety and efficacy data on trivalent inactivated influenza virus in the 6- to 23-month age group, the need for more education of parents and physicians and concerns over the stability and adequacy of the vaccine supply. CONCLUSIONS: The risk of hospital admission from influenza-related causes is high in young children and similar to the risk in the elderly and other high risk groups for whom annual influenza vaccination is already recommended. Data from additional studies, especially those on vaccine safety and efficacy, will be important for proceeding to a full recommendation for annual influenza vaccination of children 6 to 23 months.

Adolescent↗
PubMed2002

Surveillance for influenza--United States, 1997-98, 1998-99, and 1999-00 seasons.

PROBLEM/CONDITION: In the United States, influenza epidemics occur nearly every winter and are responsible for substantial morbidity and mortality, including an average of approximately 114,000 hospitalizations and 20,000 deaths/year. REPORTING PERIOD: This report summarizes both actively and passively collected U.S. influenza surveillance data from October 1997 through September 2000. DESCRIPTION OF SYSTEM: During each October-May in the period covered, CDC received weekly reports from 1) approximately 120 World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories in the United States regarding influenza virus isolations; 2) approximately 230, 375, and 430 sentinel physicians during 1997-98, 1998-99, and 1999-00, respectively, regarding their total number of patient visits and the number of visits for influenza-like illness (ILI); and 3) state and territorial epidemiologists regarding estimates of local influenza activity. WHO collaborating laboratories also submitted influenza isolates to CDC for antigenic analysis. Throughout the year, the vital statistics offices in 122 cities reported weekly on deaths related to pneumonia and influenza (P&I). RESULTS: During the 1997-98 influenza season, influenza A(H3N2) was the most frequently isolated influenza virus type/subtype. Influenza A(H1N1) and B viruses were reported infrequently. The proportion of respiratory specimens testing positive for influenza peaked at 28% in late January. The longest period of sustained excess mortality (when the percentage of deaths attributed to P&I exceeded the epidemic threshold) was 10 consecutive weeks. P&I mortality peaked at 9.8% in January. Visits for ILI to sentinel physicians exceeded baseline levels for 7 weeks and peaked at 5% in mid-January through early February. A total of 45 state epidemiologists reported regional or widespread activity at the peak of the season. During the 1998-99 season, influenza A(H3N2) viruses predominated; however, influenza B viruses were also identified throughout the United States. Influenza A(H1N1) viruses were identified rarely. The proportion of respiratory specimens testing positive for influenza peaked at 28% in early February. P&I mortality exceeded the epidemic threshold for 12 consecutive weeks and peaked at 9.7% in early March. Visits for ILI to sentinel physicians exceeded baseline levels for 7 weeks and peaked at 5% in early through mid-February. Forty-three state epidemiologists reported regional or widespread activity at the peak of the season. During the 1999-00 season, influenza A(H3N2) viruses predominated, but influenza A(H1N1) and B viruses also were identified. The proportion of respiratory specimens testing positive for influenza peaked at 31% in mid- to late December. The proportion of deaths attributed to P&I exceeded the epidemic threshold for 13 consecutive weeks and peaked at 11.2% in mid-January. Visits to sentinel physicians for ILI exceeded baseline levels 4 consecutive weeks and peaked at 6% in late December. Forty-four state epidemiologists reported regional or widespread activity at the peak of the season. INTERPRETATION: Influenza A(H1N1), A(H3N2), and B viruses circulated during 1997-2000, but influenza A(H3N2) was the most frequently reported virus type/subtype during all three seasons. Influenza A(H3N2) is the virus type/subtype most frequently associated with excess P&I mortality. Influenza activity during all three seasons occurred at moderate to severe levels, and excess P&I mortality was reported during > or = 10 weeks each year. PUBLIC HEALTH ACTIONS: CDC conducts active national surveillance during each October-May to detect the emergence and spread of influenza virus variants and to monitor influenza-related morbidity and mortality. Surveillance data are provided weekly throughout the influenza season to public health officials, WHO, and health-care providers and are used to guide vaccine strain selection, prevention and control activities, and patient care. Influenza vaccination is the most effective means for reducing the yearly effect of influenza. Typically, one or two of the influenza vaccine component viruses are updated each year so that vaccine strains will closely match circulating viruses. Surveillance data will continue to be used to select vaccine strains and to monitor the match between vaccine strains and the currently circulating viruses.

Disease Outbreaks↗
PubMed2002

Preparing for pandemic influenza: the need for enhanced surveillance.

In the US, planning for the next influenza pandemic is occurring in parallel at the national, state and local levels. Certain issues, such as conducting surveillance and purchasing pandemic vaccine, require co-ordination at the national level. However, most prevention and control actions will be implemented at the state and local levels, which vary widely in terms of population demographics, culture (e.g. rural versus urban) and available resources. In 1995, a survey by the Council of State and Territorial Epidemiologists (CSTE) found that only 29 (59%) states perceived a need to develop a specific influenza pandemic plan for their jurisdiction. Since then, the process of developing state and local plans has gained considerable momentum. Integration of these efforts with the national planning process has been facilitated by: (1) the mutual involvement of state and federal staff in both processes; (2) the sharing of draft documents; (3) the ongoing occurrence of local and national co-ordinating meetings; (4) the provision of financial resources by the federal government. So far, approximately 12 states either have drafted or begun drafting a state and local influenza pandemic plan. One of the benefits of the collaborative planning process has been the development of new working relationships and partnerships among several agencies at the state, local and national levels. Such efforts will improve our collective ability to rapidly investigate and control other emerging or re-emerging public health threats in the 21st century, be it a bioterrorist event, pandemic influenza, or any other catastrophic health event.

Animals↗
PubMed2002

Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

This report updates the 2001 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (MMWR 2001;50 [No. RR-4]:1-44). The 2002 recommendations include new or updated information regarding 1) the timing of influenza vaccination by risk group; 2) influenza vaccine for children aged 6-23 months; 3) the 2002-2003 trivalent vaccine virus strains: A/Moscow/10/99 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Hong Kong/330/2001-like strains; and 4) availability of certain influenza vaccine doses with reduced thimerosal content. A link to this report and other information related to influenza can be accessed at the website for the Influenza Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC, at http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm.

Acetamides↗
PubMed2002

Risk of influenza A (H5N1) infection among poultry workers, Hong Kong, 1997-1998.

In 1997, outbreaks of highly pathogenic influenza A (H5N1) among poultry coincided with 18 documented human cases of H5N1 illness. Although exposure to live poultry was associated with human illness, no cases were documented among poultry workers (PWs). To evaluate the potential for avian-to-human transmission of H5N1, a cohort study was conducted among 293 Hong Kong government workers (GWs) who participated in a poultry culling operation and among 1525 PWs. Paired serum samples collected from GWs and single serum samples collected from PWs were considered to be anti-H5 antibody positive if they were positive by both microneutralization and Western blot testing. Among GWs, 3% were seropositive, and 1 seroconversion was documented. Among PWs, approximately 10% had anti-H5 antibody. More-intensive poultry exposure, such as butchering and exposure to ill poultry, was associated with having anti-H5 antibody. These findings suggest an increased risk for avian influenza infection from occupational exposure.

Adolescent↗
PubMed2002

Influenza.

Influenza remains an important cause of morbidity and mortality in the United States. Although signs and symptoms of individual influenza cases are nonspecific, the epidemiology is characteristic, and a clinical diagnosis can be made accurately during epidemics. Several tests can be used to confirm influenza infection. Antiviral medications may be used for both treatment and prophylaxis, but prevention of influenza is most reliably achieved through vaccination.

Antiviral Agents↗
PubMed2002

Preparation of optically active allothreonine via optical resolution by replacing crystallization.

An attempt was made to use a simple procedure to obtain D- and L-allothreonine (D- and L-aThr), which are non-proteinogenic alpha-amino acids and are useful as chiral reagents in asymmetric syntheses. DL-aThr that exists as a conglomerate was optically resolved by replacing crystallization with L-alanine (L-Ala) as an optically active co-solute. D-aThr was preferentially crystallized from an aqueous solution of DL-aThr in the presence of L.-Ala, as was L-aThr in the presence of D-Ala. Furthermore, a diasteroisomeric mixture of D-aThr and L-threonine (L-Thr) and one of L-aThr and D-Thr were prepared, respectively, by epimerization of L- and D-Thr using salicylaldehyde as the catalyst in acetic acid. Based on the result of the replacing crystallization, D- and L-aThr were separated from aqueous solutions of the diastereoisomeric mixtures in the presence of L- and D-Ala. The partially resolved D- and L-aThr were recrystallized from water to yield the corresponding enantiomers in optically pure forms.

Stereoisomerism↗
PubMed2002

Lack of evidence for human-to-human transmission of avian influenza A (H9N2) viruses in Hong Kong, China 1999.

In April 1999, isolation of avian influenza A (H9N2) viruses from humans was confirmed for the first time. H9N2 viruses were isolated from nasopharyngeal aspirate specimens collected from two children who were hospitalized with uncomplicated, febrile, upper respiratory tract illnesses in Hong Kong during March 1999. Novel influenza viruses have the potential to initiate global pandemics if they are sufficiently transmissible among humans. We conducted four retrospective cohort studies of persons exposed to these two H9N2 patients to assess whether human-to-human transmission of avian H9N2 viruses had occurred. No serologic evidence of H9N2 infection was found in family members or health-care workers who had close contact with the H9N2-infected children, suggesting that these H9N2 viruses were not easily transmitted from person to person.

Animals↗
PubMed2002

Medical care capacity for influenza outbreaks, Los Angeles.

In December 1997, media reported hospital overcrowding and "the worst [flu epidemic] in the past two decades" in Los Angeles County (LAC). We found that rates of pneumonia and influenza deaths, hospitalizations, and claims were substantially higher for the 1997-98 influenza season than the previous six seasons. Hours of emergency medical services (EMS) diversion (when emergency departments could not receive incoming patients) peaked during the influenza seasons studied; the number of EMS diversion hours per season also increased during the seasons 1993-94 to 1997-98, suggesting a decrease in medical care capacity during influenza seasons. Over the seven influenza seasons studied, the number of licensed beds decreased 12%, while the LAC population increased 5%. Our findings suggest that the capacity of health-care systems to handle patient visits during influenza seasons is diminishing.

Disease Outbreaks↗