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Influenza and pregnancy

G Skalley, S Rodríguez-Villar
Threatening refractory metabolic acidosis due to short-term starvation nondiabetic ketoacidosis is rarely reported. Severe ketoacidosis due to starvation itself is a rare occurrence, and more so in pregnancy with a concomitant stressful clinical situation. This case report presents a nondiabetic woman admitted in intensive care for respiratory failure type 1 during the third trimester of pregnancy with a severe metabolic acidosis refractory to medical treatment. We diagnosed the patient with acute starvation ketoacidosis based on her history and the absence of other causes of high anion gap metabolic acidosis after doing a rigorous analysis of her acid-base disorder...
February 27, 2018: Revista Española de Anestesiología y Reanimación
Sushena Krishnaswamy, Allen C Cheng, Euan M Wallace, Jim Buttery, Michelle Giles
The role of maternal vaccination in reducing neonatal morbidity and mortality is expanding but uptake remains suboptimal. While the barriers to uptake have been well described, women from minority groups have not been well represented in previous studies. In this study we examine the facilitators and barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds in Melbourne, Australia. 537 women attending antenatal care completed a survey; 69% were born overseas...
March 1, 2018: Human Vaccines & Immunotherapeutics
Bahaa Abu Raya, Manish Sadarangani
Invasive meningococcal disease causes meningitis and septicemia worldwide with highest rates of disease occurring in children <2 years of age, and in particular young infants. Vaccination during pregnancy has been a successful strategy for prevention of other infections in young infants, most notably tetanus, pertussis and influenza. However, few studies of meningococcal vaccines in pregnancy have been undertaken, and none include the most commonly used current vaccines to prevent disease by capsular groups A, B, C, W and Y...
February 27, 2018: Human Vaccines & Immunotherapeutics
Edwin P Armitage, Janko Camara, Sulayman Bah, Alice S Forster, Ed Clarke, Beate Kampmann, Thushan I de Silva
BACKGROUND: The burden of influenza is increasingly recognised in Africa. The WHO recommends introducing influenza vaccination to high-risk groups: pregnant women, children <5 years, and the elderly. The Gambia currently has no influenza vaccination policy, but the NASIMMUNE study, a clinical trial of intranasal live attenuated influenza vaccines (LAIV) in young children provided an opportunity to study maternal attitudes towards LAIV for the first time in sub-Saharan Africa. We assess acceptability of LAIV, influenza knowledge and attitudes towards influenza vaccination in Gambian women...
February 23, 2018: Vaccine
Alisa Kachikis, Linda O Eckert, Janet Englund
Maternal immunization for prevention of morbidity and mortality of pregnant women and their neonates due to infectious diseases is ongoing worldwide. The complexity of vaccine research and development in this population is challenging. Not only do vaccines for pregnant women require evidence of immunogenicity, potency, stability, and limited reactogenicity, they must also provide efficacy in decreasing morbidity for the pregnant woman, her fetus, and the neonate, demonstrate safety or lack of evidence of harm, and offer benefit or potential benefit of vaccination during pregnancy...
February 23, 2018: Viral Immunology
Lakshmi Sukumaran, Natalie L McCarthy, Elyse O Kharbanda, Gabriela Vazquez-Benitez, Heather S Lipkind, Lisa Jackson, Nicola P Klein, Allison L Naleway, David L McClure, Rulin C Hechter, Alison T Kawai, Jason M Glanz, Eric S Weintraub
BACKGROUND: The Advisory Committee on Immunization Practices currently recommends pregnant women receive influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. There are limited studies of the long-term safety in infants for vaccines administered during pregnancy. We evaluate whether maternal receipt of influenza and Tdap vaccines increases the risk of infant hospitalization or death in the first 6 months of life. METHODS: We included singleton, live birth pregnancies in the Vaccine Safety Datalink between 2004 and 2014...
February 20, 2018: Pediatrics
Joanne Katz, Janet A Englund, Mark C Steinhoff, Subarna K Khatry, Laxman Shrestha, Jane Kuypers, Luke C Mullany, Helen Y Chu, Steven C LeClerq, Naoko Kozuki, James M Tielsch
Background: Maternal influenza vaccination protects mothers and their infants in low resource settings but little is known about whether the protection varies by gestational age at vaccination. Methods: Women of childbearing age in rural southern Nepal were surveilled for pregnancy, consented and randomized to receive maternal influenza vaccination or placebo, with randomization stratified on gestational age (17-25 or 26-34 weeks). Enrollment occurred in two annual cohorts and vaccinations occurred from April 2011 through September 2013...
February 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Marta C Nunes, Shabir A Madhi
The influenza virus circulates yearly and causes global epidemics. Influenza infection affects all age groups and causes mild to severe illness, and young infants are at particular risk for serious disease. The most effective measure to prevent influenza disease is vaccination; however, no vaccine is licensed for use in infants younger than 6 months old. Thus, there is a crucial need for other preventive strategies in this high-risk age group. Influenza vaccination during pregnancy protects both the mothers and the young infants against influenza infection...
2018: F1000Research
Luz Maria Vilca, Cristina Martínez, Miriam Burballa, Magda Campins
Objective Maternal care providers (MCPs), obstetrician-gynaecologists and midwives are uniquely placed to increase maternal vaccination acceptance. We aimed to assess their knowledge, attitudes and practices regarding influenza and pertussis vaccination during pregnancy. Methods We conducted an online survey among MCPs working at "Attention to Sexual and Reproductive Health" (ASSIR) Units in Catalonia region. The survey included questions about current recommendations of influenza and pertussis immunization during pregnancy, reasons for not routinely recommending vaccination and several strategies to increase vaccination uptake...
February 7, 2018: Maternal and Child Health Journal
Jamie Koerner, Alicia B Forinash, Abigail M Yancey, Jessica Brinkmeyer, Spencer Dingman, Collin Miller, Judy Thompson, Laura Bergin, Julia D López, Amy Ravin
BACKGROUND: Infants younger than 6 months of age are at high risk for contracting pertussis because of not being fully vaccinated. The Advisory Committee on Immunization Practices (ACIP) recommends vaccinating all pregnant women with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) between 27 and 36 weeks to offer passive immunity to the infant to help protect them until they are able to receive the full pertussis series. OBJECTIVE: To assess and compare compliance with the 2013 ACIP recommendation of vaccinating pregnant women with Tdap at 27 to 36 weeks' gestation in 2 obstetric clinics...
February 1, 2018: Annals of Pharmacotherapy
Sushena Krishnaswamy, Euan M Wallace, Jim Buttery, Michelle L Giles
Maternal vaccination is a safe and effective strategy to reduce maternal and neonatal morbidity and mortality from pertussis and influenza. However, despite recommendations for maternal vaccination since 2010, uptake remains suboptimal. Barriers to uptake have been studied widely and include lack of integration of vaccination into routine pregnancy care and access to vaccination services. Standing orders for administration of vaccines without the need for a physician review or prescription have been demonstrated to improve uptake as part of multi-model interventions to increase antenatal influenza and post-partum pertussis vaccination...
January 30, 2018: Vaccine
Indu Malhotra, A Desiree LaBeaud, Nathan Morris, Maxim McKibben, Peter Mungai, Eric Muchiri, Christopher L King, Charles H King
Background: Antenatal exposure to parasites can affect infants' subsequent responses to vaccination. The present study investigated how maternal prenatal infections and newborns' anti-parasite cytokine profiles relate to IgG responses to standard vaccination during infancy. Methods: 450 Kenyan women were tested for parasitic infections during pregnancy. Their newborns' responses to malaria, schistosome, and filaria antigens were assessed in cord blood (CB) lymphocytes...
January 30, 2018: Journal of Infectious Diseases
Vittorio Demicheli, Tom Jefferson, Eliana Ferroni, Alessandro Rivetti, Carlo Di Pietrantonj
BACKGROUND: The consequences of influenza in adults are mainly time off work. Vaccination of pregnant women is recommended internationally. This is an update of a review published in 2014. Future updates of this review will be made only when new trials or vaccines become available. Observational data included in previous versions of the review have been retained for historical reasons but have not been updated due to their lack of influence on the review conclusions. OBJECTIVES: To assess the effects (efficacy, effectiveness, and harm) of vaccines against influenza in healthy adults, including pregnant women...
February 1, 2018: Cochrane Database of Systematic Reviews
Lucy K Somerville, Kerri Basile, Dominic E Dwyer, Jen Kok
Data from previous seasonal epidemics and pandemics have confirmed that pregnant women are at increased risk for severe influenza virus infection. Complications including fetal loss, higher rates of hospitalization and maternal death are most notable during the late gestational period. Antiviral therapy and influenza vaccination are recommended in pregnant women as both are effective and safe. This review discusses the epidemiology, pathophysiology, treatment and prevention of influenza virus infection in pregnancy, with a focus on recent developments...
February 2018: Future Microbiology
Mallory Ellingson, Allison T Chamberlain
OBJECTIVE: Prenatal providers are pregnant women's most trusted sources of health information, and a provider's recommendation is a strong predictor of maternal vaccine receipt. However, other ways women prefer receiving vaccine-related information from prenatal providers, aside from face-to-face conversations, is unclear. This study explores what secondary communication methods are preferred for receiving maternal vaccine-related information. STUDY DESIGN: Obstetric patients at four prenatal clinics around Atlanta, Georgia received a 27-item survey between May 5th, 2016 and June 15th, 2016...
January 9, 2018: Human Vaccines & Immunotherapeutics
Ivo Vojtek, Ilse Dieussaert, T Mark Doherty, Valentine Franck, Linda Hanssens, Jacqueline Miller, Rafik Bekkat-Berkani, Walid Kandeil, David Prado-Cohrs, Andrew Vyse
Pregnancy and the post-partum period are associated with elevated risks to both mother and infant from infectious disease. Vaccination of pregnant women, also called maternal immunization, has the potential to protect pregnant women, fetuses, and infants from several vaccine-preventable diseases. Maternal immunoglobulin G antibodies are actively transferred through the placenta to provide passive immunity to newborns during the first months of life, until the time for infant vaccinations or until the period of greatest susceptibility has passed...
January 8, 2018: Annals of Medicine
Clint Pecenka, Spy Munthali, Paul Chunga, Ann Levin, Win Morgan, Philipp Lambach, Niranjan Bhat, Kathleen M Neuzil, Justin R Ortiz, Raymond Hutubessy
BACKGROUND: This costing study in Malawi is a first evaluation of a Maternal Influenza Immunization Program Costing Tool (Costing Tool) for maternal immunization. The tool was designed to help low- and middle-income countries plan for maternal influenza immunization programs that differ from infant vaccination programs because of differences in the target population and potential differences in delivery strategy or venue. METHODS: This analysis examines the incremental costs of a prospective seasonal maternal influenza immunization program that is added to a successful routine childhood immunization and antenatal care program...
2017: PloS One
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 US Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year olds between 2000 (2...
December 24, 2017: American Journal of Obstetrics and Gynecology
Melonie Heron
Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2015...
November 2017: National Vital Statistics Reports
Won Suk Choi, Min Joo Choi, Ji Yoon Noh, Joon Young Song, Woo Joo Kim, Dae Won Park, Jacob Lee, Yu Bin Seo, Ji Hyeon Baek, Sooran Choi, Hee Jin Cheong
Background/Aims: Unlike Western countries, the 2009 pandemic influenza infection among pregnant women was reported as mild in a previous interim study in South Korea. However, several mortalities were reported thereafter, suggesting that nationwide data were lacking. Methods: This case-control study covers the entire 2009 pandemic inf luenza period, from May 2009 to February 2010. The clinical and economic data of pregnant (case) and age-matched non-pregnant (control) women with influenza A (H1N1) pdm09 virus (H1N1pdm09) infection were retrospectively collected from nine hospitals in South Korea...
December 15, 2017: Korean Journal of Internal Medicine
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