Rationnel : La pandémie de grippe A(H1N1)pdm09 a induit un grand nombre d’hospitalisation d’enfants en soins intensifs pédiatriques (SIP). L’objectif de cette étude a été de comparer l’incidence et la mortalité des enfants admis en SIP durant l’automne 2009 entre le Canada et la France, deux pays qui diffèrent essentiellement par l’immunisation de la population contre ce virus (première vague en été et taux de couverture vaccinale supérieur à 50% au Canada ; pas de vague estivale et couverture vaccinale de 18% en France). Méthodes : Nous avons comparé deux cohortes nationales qui ont inclue tous les patients avec une infection A(H1N1)pdm09 documentée, admis en SIP au Canada et en France entre le 1er Octobre 2009 et le 31 janvier 2010. Résultats : Au Canada, 160 enfants (incidence=2,63/100000 enfants) en 6 semaines ont été hospitalisés en SIP comparé aux 125 enfants (incidence=1,15/100000 enfants) en 11 semaines en France (p<0,001). Le taux de vaccination avant l’admission était inférieur à 25% parmi les enfants en situation critique dans les deux pays. La gravité à l’admission en SIP et le taux de mortalité ont été similaires au Canada et en France (4,4% en France vs 6,5% au Canada, p=0,45, respectivement). Au Canada, la vaccination contre le virus H1N1pdm09 a été associée avec une diminution du recours à la ventilation invasive (Odd Ratio 0.30, intervalle de confiance à 95% [0,11-0,83], p=0,02). Au Canada comparé à la France, les durées médianes de séjour en SIP et de ventilation invasive ont été plus courtes (2,9 vs 3 jours, p=0,03 et 4 vs 6 jours, p=0,02, respectivement). Conclusion : Les enfants canadiens et français critiquement malades ont été beaucoup moins nombreux à recevoir le vaccin contre le virus influenza A (H1N1)pdm09 en comparaison avec l’ensemble des enfants dans ces deux populations. Au Canada, où la couverture vaccinale a été élevée, le risque d’avoir une détresse respiratoire sévère était moins important parmi les enfants en situation critique ayant été vaccinés avant l’admission. / Background: The pandemic influenza A (H1N1)pdm09 resulted in a large number of admissions to pediatric intensive care units (PICUs). The objective of the study was to compare the incidence and mortality rate of children admitted to PICU in autumn 2009 between France and Canada, two countries that essentially differed by their population immunization to this virus (first pandemic wave in summer and vaccine coverage >50% in Canada; no wave in summer and vaccine coverage of 18% in France). Methods: We compared two national cohorts that included all patients with documented H1N1pdm09 infection, admitted to a PICU in Canada and in France between October 1st 2009 and January 31st 2010. Results: In Canada, 160 children (incidence=2.63/100,000 children) in 6 weeks were hospitalized in PICU compared to 125 children (incidence=1.15/100,000) in 11 weeks in France (p<0.001). Prior vaccination was under 25% among critically ill children in both countries. Severity of illness at PICU admission and mortality rates were similar in Canada and France (6.5%, vs 4.4 p=0.45, respectively). In Canada, H1N1pdm09 vaccination was associated with a decreased risk of requiring invasive ventilation (Odd Ratio 0.30, 95%Confidence Interval 0.11-0.83, p=0.02). In Canada as compared to France, median PICU length of stay and invasive ventilation durations were shorter (2.9 vs 3 days, p=0.03 and 4 vs 6 days, p=0.02, respectively). Conclusion: Critically ill Canadian and French children were much less likely to have received prior vaccination against influenza A (H1N1) pdm09 in comparison to all children in the populations. In Canada, where vaccination rate was higher, the risk of severe respiratory failure was less among those critically ill children receiving prior vaccination.

Master of Science / Department of Diagnostic Medicine/Pathobiology / Wenjun Ma / With introduction of the 2009 pandemic H1N1 virus (pH1N1) into swine herds, reassortment between the pH1N1 and endemic swine influenza viruses (SIVs) has been reported worldwide. Recently, reassortant H3N2 and H1N2 variant SIVs that contain the M gene from pH1N1 virus and the remaining seven genes from North American triple-reassortant (TR) SIVs have emerged. These variant viruses have caused more than 300 cases of human infections and one death in the USA, creating a major public health concern. To date, the pathogenicity and transmissibility of H1N2 variant viruses in pigs has not been investigated. Through passive surveillance, we have isolated two genotypes of reassortant H1N2 viruses with pH1N1 genes from diseased pigs in Kansas. Full genome sequence and phylogenetic analysis showed that one is a swine H1N2 variant virus (swH1N2v) with the M gene from pH1N1; the other is a reassortant H1N2 virus (2+6 rH1N2) with six internal genes from pH1N1 and the two surface genes from endemic North American TR H1N2 SIVs. Furthermore, we determined the pathogenicity and transmissibility of the swH1N2v, a human H1N2 variant (huH1N2v), and the 2+6 rH1N2 in pigs using an endemic TR H1N2 SIV (eH1N2) isolated in 2011 as a control. All four viruses were able to infect pigs and replicate in the lungs. Both H1N2 variant viruses caused more severe lung lesions in infected pigs when compared to the eH1N2 and 2+6 rH1N2 viruses. Although all four viruses are transmissible in pigs and were detected in the lungs of contact animals, the swH1N2v shed more efficiently than the other three viruses in the respective sentinel animals. The huH1N2v displayed delayed and inefficient nasal shedding in sentinel animals. Taken together, the human and swine H1N2 variant viruses are more pathogenic and the swH1N2v more transmissible in pigs and could pose a threat to public and animal health.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-05-19T12:03:19Z No. of bitstreams: 1 2016 - Pablo Amauri Carvalho de Ara?jo e Souza.pdf: 3429164 bytes, checksum: c1da6eb8bb41fc96de0b7e5ca2a9570f (MD5) / Made available in DSpace on 2017-05-19T12:03:19Z (GMT). No. of bitstreams: 1 2016 - Pablo Amauri Carvalho de Ara?jo e Souza.pdf: 3429164 bytes, checksum: c1da6eb8bb41fc96de0b7e5ca2a9570f (MD5) Previous issue date: 2016-06-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This work highlights the importance of well administrated vaccination as prophylactic activity, making it a key element of mathematical modeling about the spreading of an infection by Influenza H1N1 virus in a human population. The model counts with Optimal Control theory to achieve a vaccination strategy that balance infection?s prevention and your own cost in a hypothetical population exposed to a virus. The numerical solutions of ordinary differential equations systems generated by model is given via Finite Difference Method, that reveals the populational dynamics during the time while the vaccine is distributed, in various different situations of virus exposition and vaccination cost. / Este trabalho ressalta a import?ncia da vacina??o bem administrada como atividade profil?tica, tornando-a elemento chave da modelagem matem?tica do espalhamento da infec??o pelo v?rus Influenza H1N1 em uma popula??o humana. O modelo conta com a teoria de Controle ?timo para alcan?ar uma estrat?gia de vacina??o, que equilibre a preven??o da infec??o e seu pr?prio custo em uma popula??o hipot?tica exposta ao v?rus. As solu??es num?ricas dos sistemas de equa??es diferenciais ordin?rias gerados pelo modelo ficam a cargo do M?todo das Diferen?as Finitas, revelando a din?mica populacional no per?odo de tempo em que a vacina ? distribu?da, em distintas situa??es de exposi??o ao v?rus e custo da vacina??o.

<p><strong>Title</strong>:      Kriskommunikation på 140 tecken; En kvantitativ innehållsanalys om media och myndigheters traditionella roller vid pandemikrisen A(H1N1) via SVT Rapport och Krisinformation.se:s twitterflöden.</p><p><strong>Author</strong>:                         Arne Wetterholm & Petter Westlund</p><p><strong>Tutor</strong>:                         Mats Eriksson</p><p><strong>Course</strong>:                         Medie- & Kommunikationsvetenskap C, inriktning PR</p><p><strong>Semester</strong>:                         Autumn 2009</p><p><strong>Purpose</strong>:      The purpose of this study is to analyse how twitter-feeds has been reporting the A(H1N1) pandemics. Do authorities and media keep their classical approach towards new crisis in a new media channel like Twitter.</p><p><strong> </strong></p><p><strong>Method & material</strong>:      The analysis is conducted through a quantitative research method where two Twitter feeds will be used as the main source of the material. The 50 latest messages of the feeds in both Twitter microblogs Krisinformation.se and SVT PlayRapport will be represented in the material.</p><p> </p><p><strong>Theories</strong>:      The theoretical background consists of Jan van Dijk and Manuel Castells theories of the network society. The theories of classical approach on authorities and media are also a part of the theoretical background along with theories about the modern web.</p><p> </p><p><strong>Main results</strong>:      The main results of this study points towards a continuous approach of both authorities and media in the Twitter feeds. That means that new opportunities of crisis information don’t mean new approaches for authorities and media when reporting a crisis.</p><p> </p><p><strong>Keywords</strong>:     crisis information, crisis communication,  Twitter, SVT, Rapport, Krisinformation.se, kriskommunikation, A(H1N1), nya influensan, svininfluensan, swine inluenza, microblog, mikroblogg, kvantitativ, quantitative, innehållsanalys, context analysis.</p>

The recent experience with the 2009 H1N1 pandemic has drawn attention to the need to better understand the public’s response to emergently released vaccines (ERV). This study applied a mixed methods approach to examine the causal pathways underlying the vaccination behaviour during a public health emergency. The integrated evidence from empirical and theoretical-based findings highlights a number of factors to consider in interventions to improve vaccination rates with an ERV. These factors include: 1) providing clear risk messages around the disease and the ERV, 2) improving accessibility to the vaccine, 3) encouraging primary healthcare providers to provide recommendations for vaccination, 4) implementing strategies to increase seasonal influenza vaccination prior to the next public health emergency, 5) developing strategies to target sub-populations more reluctant to accept an ERV. Developing theory-based interventions that are behaviour-specific may be more likely to result in behaviour change within the public in future emergency vaccination campaigns.

This thesis reports on the use of Twitter during the 2009 H1N1 pandemic to explore its use as an “infoveillance” approach complementary to traditional surveys and content analysis.  This study aimed to: 1) report on the use of “H1N1” versus “swine flu”, 2) conduct a qualitative analysis of tweet content, and 3) assess the feasibility of Twitter as a real-time content, sentiment, and public attention trend tracking tool. A manual content analysis of tweets revealed that H1N1 resources were the most commonly shared.  Few tweets provided inaccurate information.  News websites were the most popular resources while official agencies were rarely referenced directly.  Our automated analysis correlated well with manual results and showed that Twitter activity was influenced by external events. This study describes the character and quality of Twitter communications during the H1N1 pandemic, and illustrates the potential of using social media to conduct real-time “infodemiology” studies for public health.

This thesis reports on the use of Twitter during the 2009 H1N1 pandemic to explore its use as an “infoveillance” approach complementary to traditional surveys and content analysis.  This study aimed to: 1) report on the use of “H1N1” versus “swine flu”, 2) conduct a qualitative analysis of tweet content, and 3) assess the feasibility of Twitter as a real-time content, sentiment, and public attention trend tracking tool. A manual content analysis of tweets revealed that H1N1 resources were the most commonly shared.  Few tweets provided inaccurate information.  News websites were the most popular resources while official agencies were rarely referenced directly.  Our automated analysis correlated well with manual results and showed that Twitter activity was influenced by external events. This study describes the character and quality of Twitter communications during the H1N1 pandemic, and illustrates the potential of using social media to conduct real-time “infodemiology” studies for public health.

Title:      Kriskommunikation på 140 tecken; En kvantitativ innehållsanalys om media och myndigheters traditionella roller vid pandemikrisen A(H1N1) via SVT Rapport och Krisinformation.se:s twitterflöden. Author:                         Arne Wetterholm &amp; Petter Westlund Tutor:                         Mats Eriksson Course:                         Medie- &amp; Kommunikationsvetenskap C, inriktning PR Semester:                         Autumn 2009 Purpose:      The purpose of this study is to analyse how twitter-feeds has been reporting the A(H1N1) pandemics. Do authorities and media keep their classical approach towards new crisis in a new media channel like Twitter.   Method &amp; material:      The analysis is conducted through a quantitative research method where two Twitter feeds will be used as the main source of the material. The 50 latest messages of the feeds in both Twitter microblogs Krisinformation.se and SVT PlayRapport will be represented in the material.   Theories:      The theoretical background consists of Jan van Dijk and Manuel Castells theories of the network society. The theories of classical approach on authorities and media are also a part of the theoretical background along with theories about the modern web.   Main results:      The main results of this study points towards a continuous approach of both authorities and media in the Twitter feeds. That means that new opportunities of crisis information don’t mean new approaches for authorities and media when reporting a crisis.   Keywords:     crisis information, crisis communication,  Twitter, SVT, Rapport, Krisinformation.se, kriskommunikation, A(H1N1), nya influensan, svininfluensan, swine inluenza, microblog, mikroblogg, kvantitativ, quantitative, innehållsanalys, context analysis.

Despite the benefits of applying methods of geographic information science (GIScience), the use of such methods in health service planning and provision remains greatly underutilized. Spread of epidemic diseases is a constant threat to mankind and the globalization of the world increases the risk for global attacks from multi-resistant bacteria or deadly virus strains. Therefore, research is needed to better understand how GIScience could be used in epidemiologic analyses and other health applications. This thesis is divided into two parts; one for epidemiologic analyses and one for neighbourhood studies. The overall objective of the epidemiologic part of this research is to understand more about the spatial spread of past pandemics and to find out if there are any common patterns. This overall objective is divided into four specific research objectives; 1) to describe the spatial spread of the Russian Influenza in Sweden, 2) to create models of propagation of the Black Death in Sweden, 3) to establish spatiotemporal characteristics common to past pandemics in Sweden and 4) to visualize the spatiotemporal occurrence of salmonella among animal herds in Sweden. This thesis also discusses some other aspects of health related to place. Are differences in neighbourhood deprivation related to the amount of presence of goods and services? Is the way cities are planned affecting the behaviour within the local population regarding spontaneous walking and physical activity? The specific research objectives for this part are to define how deprivation is related to presence of goods and services in Sweden and to create walkability indices over the city of Stockholm including a quality test of these indices. Case data reported by physicians were used for the epidemiologic studies. The pandemics discussed covered the entire world, but our data is from Sweden only and as regards the Black Death there was no case data at all. The data for the goods and services analyses are from all of Sweden, whereas the walkability indices are based on data from the city of Stockholm. Various methods have been used to clean, structure and geocode the data, including hand written reports on case data, maps of poor geometric quality, information from databases on climate, demography, diseases, goods and services, income data and more, to make this data feasible for spatial analysis, modeling and visualization. Network analysis was used to model food transports in the 14th century as well as walking in the city of Stockholm today. Proximity analysis was used to assess the spatio-temporal spread of the Russian Influenza. The impact of climatological factors on the propagation of the Asian Influenza was analyzed and geographically weighted mean (GWM) calculations were used to discover common characteristics in the spatio-temporal spread of three past pandemics. Among the results generated in the epidemiologic study the following should be noted in particular; the local peaking periods of the Asian Influenza were preceded by falling temperature, the total peaking period for the three pandemics (Russian, Asian and A(H1N1)pdm09) was approximately 10 weeks and their weekly GWM followed a path from southwest to northeast (opposite direction for the A(H1N1)pdm09). From the neighborhood studies one can note that compared to the results measured and reported by tested individuals there is a positive (small but significant) association between neighborhood walkability and physical activity outcomes. The main contribution of this work is that it gives epidemiologists and public health specialists new ideas, not only on how to formulate, model, analyze and visualize different health related research questions but also ideas on how new procedures could be implemented in their daily work. Once the data reporting is organized in a suitable manner there is a multitude of options on how to present important and critical information to officials and policy makers. / <p>QC 20140313</p>

Rationnel : La pandémie de grippe A(H1N1)pdm09 a induit un grand nombre d’hospitalisation d’enfants en soins intensifs pédiatriques (SIP). L’objectif de cette étude a été de comparer l’incidence et la mortalité des enfants admis en SIP durant l’automne 2009 entre le Canada et la France, deux pays qui diffèrent essentiellement par l’immunisation de la population contre ce virus (première vague en été et taux de couverture vaccinale supérieur à 50% au Canada ; pas de vague estivale et couverture vaccinale de 18% en France). Méthodes : Nous avons comparé deux cohortes nationales qui ont inclue tous les patients avec une infection A(H1N1)pdm09 documentée, admis en SIP au Canada et en France entre le 1er Octobre 2009 et le 31 janvier 2010. Résultats : Au Canada, 160 enfants (incidence=2,63/100000 enfants) en 6 semaines ont été hospitalisés en SIP comparé aux 125 enfants (incidence=1,15/100000 enfants) en 11 semaines en France (p<0,001). Le taux de vaccination avant l’admission était inférieur à 25% parmi les enfants en situation critique dans les deux pays. La gravité à l’admission en SIP et le taux de mortalité ont été similaires au Canada et en France (4,4% en France vs 6,5% au Canada, p=0,45, respectivement). Au Canada, la vaccination contre le virus H1N1pdm09 a été associée avec une diminution du recours à la ventilation invasive (Odd Ratio 0.30, intervalle de confiance à 95% [0,11-0,83], p=0,02). Au Canada comparé à la France, les durées médianes de séjour en SIP et de ventilation invasive ont été plus courtes (2,9 vs 3 jours, p=0,03 et 4 vs 6 jours, p=0,02, respectivement). Conclusion : Les enfants canadiens et français critiquement malades ont été beaucoup moins nombreux à recevoir le vaccin contre le virus influenza A (H1N1)pdm09 en comparaison avec l’ensemble des enfants dans ces deux populations. Au Canada, où la couverture vaccinale a été élevée, le risque d’avoir une détresse respiratoire sévère était moins important parmi les enfants en situation critique ayant été vaccinés avant l’admission. / Background: The pandemic influenza A (H1N1)pdm09 resulted in a large number of admissions to pediatric intensive care units (PICUs). The objective of the study was to compare the incidence and mortality rate of children admitted to PICU in autumn 2009 between France and Canada, two countries that essentially differed by their population immunization to this virus (first pandemic wave in summer and vaccine coverage >50% in Canada; no wave in summer and vaccine coverage of 18% in France). Methods: We compared two national cohorts that included all patients with documented H1N1pdm09 infection, admitted to a PICU in Canada and in France between October 1st 2009 and January 31st 2010. Results: In Canada, 160 children (incidence=2.63/100,000 children) in 6 weeks were hospitalized in PICU compared to 125 children (incidence=1.15/100,000) in 11 weeks in France (p<0.001). Prior vaccination was under 25% among critically ill children in both countries. Severity of illness at PICU admission and mortality rates were similar in Canada and France (6.5%, vs 4.4 p=0.45, respectively). In Canada, H1N1pdm09 vaccination was associated with a decreased risk of requiring invasive ventilation (Odd Ratio 0.30, 95%Confidence Interval 0.11-0.83, p=0.02). In Canada as compared to France, median PICU length of stay and invasive ventilation durations were shorter (2.9 vs 3 days, p=0.03 and 4 vs 6 days, p=0.02, respectively). Conclusion: Critically ill Canadian and French children were much less likely to have received prior vaccination against influenza A (H1N1) pdm09 in comparison to all children in the populations. In Canada, where vaccination rate was higher, the risk of severe respiratory failure was less among those critically ill children receiving prior vaccination.