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by Marijana Domazet, Monday, 26 August 2013 | Categories: Influenza

The controversy about whether or not pregnant women should get flu vaccination is one of the most long-standing discussions that appear to occur during flu season every year. Now a recent study suggests that pregnant women and their unborn infant would benefit from flu vaccination. Here we consider the implications of the study.

Although there have been multiple studies indicating that there are no significant risks for pregnant women to get flu vaccinations, many women have been concerned that the vaccination will go through the placenta and harm the unborn infant. This line of reasoning mainly stems from other facts about what can pass from the mother to the unborn infant. A good example of that is cortisol, which is a stress hormone that is able to pass through the placenta and affect the unborn infant’s health (as the infant does not have appropriate immune system mechanisms to handle cortisol). However, there are no reliable studies that have indicated that this would be the case for flu vaccinations.

The current study, which was published in Obstetrics and Gynaecology, analysed data of 74 000 women who at some stage in their pregnancy had received a flu vaccination. The researchers then compared these outcomes to matched controls that had not had a flu vaccination but were around the same age and had similar pregnancy start date. It is also worth noting that the control sample consisted of 300 000 women. The key findings indicated that there was a relationship between women who were vaccinated and pre-existing health problems before pregnancy such as diabetes and high blood pressure. However, upon following up those women, it appeared that there was no effect on whether they had any pregnancy complications, vascular problems or urinary tract infections. A subset of the data also suggested that vaccination was associated with a decreased risk of gestational diabetes.

One thing that we found particularly interesting when reading this study was the fact that the researchers aimed to give explanations behind their findings that did not patronise women who had considered whether the flu vaccination was necessary. For instance, although the findings were statistically robust, the researchers still explained that women who were vaccinated were likely to have had pre-existing conditions, which led doctors to recommend the vaccinations and healthy diets (all of which could have affected the development of other conditions).

Having said that, we still feel like the key take home message from the current study is that there now is robust evidence that demonstrates the importance of pregnant women getting vaccinated. As such, it is our hope that this study dissolves the yearly vaccination discussions.

We would like to point out that we have always supported UK published guidance that has advocated pregnant women to have the seasonal flu vaccination. Here is a link to the NHS page on this matter.

by Marijana Domazet, Monday, 29 July 2013 | Categories: Influenza

When it comes to influenza and vaccinations, it should come as no surprise that certain populations are considered particularly vulnerable, and that there are populations who get affected by it other ways such as individuals that are allergic to components of vaccinations and individuals with needle phobias. Yet despite this knowledge, and despite the fact that vaccinations are needed on a yearly basis, it appears that little has been done to enable tailoring of vaccinations to individual needs. However, this might now be changing in the US.

We were recently made aware of research from Mayo Clinic Vaccine Research Group, where six new types of immunisation have been launched. These include an injection with four strains of influenza, which can also be taken in the form of nasal sprays, two new vaccines without egg proteins, a vaccine specifically developed for the elderly and a vaccine that can be delivered via a very small needle for those with a needle phobia. These vaccinations offer an adapted approach for the elderly, individuals with egg allergies and individuals with needle phobias.

Whilst some critics have raised concerns that the new multitude of choice may lead to confusion amongst patients, others have suggested that this development is long overdue. We are curious to see where this development will lead, and whether it will come to the UK.

by Marijana Domazet, Thursday, 04 July 2013 | Categories: Influenza

We previously wrote about the H7N9 virus that had been detected in China , which was important but not alarming. Back then the research suggested that early detection was key to successfully treat the illness with oseltamivir. This has now been confirmed by a study, which was recently published in the Lancet.

In the study, the researchers analysed results from all patients that had presented to their hospital with flu-like symptoms. Of those, 14 were confirmed to have bird-flu with two being immune to treatment. In order to obtain a full picture of the infected participants’ symptoms, the researchers analysed a wide range of data including haematological results, radiological data, and biochemical and microbiological investigations. The key findings indicated that all of the participants had gotten their infection via cross-species infection, and that treatment within two days of onset was associated with better outcomes than treatment started late. Based on this, the researchers maintained the importance of treating suspected or confirmed cases as soon as possible. In addition to that, the team urged more research to be carried out to look into the pathogenesis of H7N9.

The current study is a step forward in the research of this topic. However, the fact that two participants were immune to the treatment also highlights an important gap in current knowledge that warrants further research. Given that there are many on-going studies that are yet to be published, we have no doubt that there soon will be more information to provide a fuller picture of the H7N9 virus.

by Robert MacKay, Monday, 24 June 2013 | Categories: Influenza

The latest outbreak of the bird flu in China has been reported to have killed more than a third hospitalised patients. The H7N9 strain, which flared up on February this year, has had a higher death rate amongst hospitalised patients than the H1N1 ‘swine flu’ of 2009-2010 (which was responsible for the death of 21% hospitalised patients). It is known, however, that only 54 patients were hospitalised for ‘swine flu’ between 2009 and 2010. Also, the H7N9 had a lower death rate than the H5N1 from 2003, which killed 60% of hospitalised patients. In sum, the statistical risk of death from the latest strain of bird flu (H7N9) was reported to be between 0.16 and 2.8%.

Hence, the virus is not as serious as it was previously thought to be. Reports state that out of all 131 patients with recorded infections, 129 were admitted into hospitals and 39 died. These infections all flared up in China and there was only one case reported in Taiwan. At the moment, the virus can only spread from birds to humans. However the main fear is that one day it could adapt and transform in a way that it could be transmittable from humans to humans.

Scientists say that, although there is a stall in the number of new infections, a new wave of flu can be expected in the autumn. Since new infections have not been reported as of now, scientists now suggest authorities be ready to continue to monitor the number of infected patients and enforce novel healthcare measures to contain a possible new surge of infections.

by Robert MacKay, Tuesday, 04 June 2013 | Categories: Influenza

A new study has highlighted the possibility of battling future pandemic flu viruses through gene therapy. The study, published in Science Transnational Medicine, has provided an insight into how mice and ferrets respond to pandemic viruses after having been treated.

The treatment consisted of an intranasal delivery of a fluid containing a gene that replicates an antibody proven to be effective against the strains of lethal flu viruses. The strains that were used in the experiment were two from the H1N1 virus and three from the H5N1 virus. The two viruses have caused pandemic flus in the past, including the most severe human outbreak in 1918. They were delivered in median lethal dose for mice and in lethal dose for ferrets.

The result was that the animals left untreated had to be put down as the viruses started replicating, while the mice and ferrets that were treated with this technique before having been exposed to the virus, attained full protection.

This technique might one day be very useful for humans, as it provides an alternative to drugs. However, it is important to bear in mind that this applies only as a treatment for strains of flu for which an antibody is exists. Also, further studies are necessary to establish whether humans will react in similar ways to this treatment technique. More information can be found at this site.

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