Influenza neurologic complications
Avindra Nath, Joseph R. Berger in Clinical Neurovirology, 2020
In addition to the H5N1 subtype infecting humans, other avian influenzas have been transmitted to humans without reassortment. The subtypes H6N1, H7N1, H7N3, H7N7, and H7N9, H10N8, have infected humans in Australia, Canada, China, Italy, Mexico, the Netherlands, the United Kingdom, and the United States [199]. However, CNS symptoms have only been suspected in H7N9 infections. In 2013, China reported 158 laboratory-confirmed cases of H7N9 infections in humans, including 52 deaths (33% fatality rate) [200]. Most of the patients developed influenza-like illness initially which progressed to respiratory distress syndrome leading to hospitalization [201,202]. Several complications were also noted such as encephalopathy, rhabdomyolysis, septic shock, respiratory failure, refractory hypoxemia, acute renal dysfunction, multiple organ dysfunction, and bacterial and fungal infections [203–205]. Disease sequelae is similar to H5N1 infection in humans with a median time from onset to hospitalization of about 4 and a half days and a median time to death of approximately 11 days [202].
Influenza virus
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
Infections with a number of different agents (mostly viruses) can result in presentation with an ‘influenza-like illness.’ Infection with respiratory syncytial virus, especially in the elderly, is the most common mimic of influenza virus infection. Other possibilities include human metapneumovirus, adenoviruses, and Mycoplasma pneumoniae. Clinical ‘end-of-thebed’ diagnosis is therefore neither sensitive nor specific enough for practical purposes – with the advent of antiviral drugs that are absolutely specific for influenza viruses, accurate diagnosis is necessary to ensure that these drugs are used appropriately and effectively. As the efficacy of these drugs is dependent on initiation of their use as soon as possible after infection, there is a need for rapidity as well as accuracy.
Cutaneous Manifestations of Deep Fungal Infections in HIV Disease
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
The majority (60%) of individuals infected with C. immitis remain asymptomatic. The remaining individuals often present with a mild influenza-like illness, with symptoms of fever, drenching night sweats, cough, pleuritic chest pain, fatigue, and anorexia. The synonym ‘desert rheumatism’ arises from the fact that arthralgia and myalgia are usually prominent symptoms. Chest radiographic findings are seen in half of all cases and include peripneumonic pulmonary effusions and infiltrates with ipsilateral hilar adenopathy. The majority of symptoms clear within a 2–3 week period; however, the associated fatigue and residual symptoms may last for several weeks to months. Five percent of patients will have residual pulmonary lesions or complications, whereas less than 1% will go on to develop extrapulmonary disease.60 Patients with progressive disease develop pulmonary nodules and cavities; a large inoculum can result in diffuse pulmonary involvement and pneumonia. Hematogenous spread of the fungus with dissemination leads to the extrapulmonary manifestations of coccidioidomycosis.60
The healthcare seeking rate of individuals with influenza like illness: a meta-analysis
Published in Infectious Diseases, 2018
Wang Ma, Xiang Huo, Minghao Zhou
Influenza like illness (ILI) is a set of common symptoms caused by a variety of viruses and bacteria, such as influenza, respiratory syncytial viruses (RSV) and pneumococcus [1]. The definitions of ILI used by the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) are similar (body temperature ≥38 °C with either cough or sore throat in the absence of an alternative diagnosis) [2,3]. Some studies used other definitions, some did not specify body temperature or require specific respiratory and/or systemic symptoms [4]. ILI has been widely used as an indicator for symptomatic surveillance of influenza viruses and other respiratory pathogens, based on sentinels of healthcare facilities [5,6]. ILI activity can help to reflect the activity of influenza virus and other respiratory pathogens and may detect an epidemic early [7].
New and emerging pharmacological treatment options for acromegaly
Published in Expert Opinion on Pharmacotherapy, 2021
Ximene Antunes, Leandro Kasuki, Mônica R. Gadelha
A phase I study to assess the safety, tolerability and pharmacokinetics of single and multiple subcutaneous doses of ATL1103 in healthy male subjects was performed, and the results were published in 2011 (https://www.asx.com.au/asxpdf/20111207/pdf/4234016x2cj5xn.pdf). This trial was divided into two stages. In stage A, 24 subjects were randomized to receive placebo or a single dose of ATL1103 (25, 75, 250 or 400 mg). In stage B, 12 subjects were randomized to receive multiple doses (six) administered over three weeks (on days 1, 3, 5, 7, 14 and 21). Twenty-four treatment-emergent AEs were reported in stage A, all reported as mild or moderate. The most commonly reported symptoms were pain at the injection site, headache and influenza-like illness. In stage B, 25 treatment-emergent AEs were described, and all were reported as mild, with the most common events related to injection site reactions. A pharmacodynamics study showed a decrease in IGF-I levels from day 14 to day 28, with a significant reduction of 7% versus baseline by day 21 (p = 0.034).
Neuraminidase inhibitors and single dose baloxavir are effective and safe in uncomplicated influenza: a meta-analysis of randomized controlled trials
Published in Expert Review of Clinical Pharmacology, 2021
Sofía Tejada, Alexandre M. Tejo, Yolanda Peña-López, Carlos G. Forero, Xavier Corbella, Jordi Rello
Among the strengths, our study was based on RCT and may help to update clinical practice guidelines. Moreover, the studies period covers before and after the 2009 pandemic influenza. Although influenza-like illness was considered as an eligible criterion, our analysis was limited to laboratory-confirmed episodes of influenza. Further RCTs are required to assess the efficacy in the post-pandemic epidemiology. Our findings cannot be extrapolated to administration in other settings, such as severe hospitalized episodes and immunocompromised patients. An RCT involving patients at high risk of influenza complications (ClinicalTrials.gov number NCT02949011) and an open-label, phase II RCT with severe influenza in immunocompromised hosts (ClinicalTrials.gov number NCT04712539) are ongoing. In children between one and twelve years-old, JapicCTI-173,811 and JapicCTI-163,417 are open-label RCTs conducted in Japan and the MiniSTONE-2 (ClinicalTrials.gov number NCT03629184) is a phase III RCT assessing safety and efficacy of baloxavir use. A phase II, open-label, one arm trial (ClinicalTrials.gov number NCT03653364) is in progress to evaluate safety of baloxavir in children with less than one-year-old.