Efficacy of a complex program for controlling influenza in a large industrial city

The epidemiological and economic effectiveness of the realization of the complex three-year (1980-1982) program for the control of influenza in Perm is shown. The coverage of 46-51% of the city population, including working people, pensioners and children, with immunization carried out with the use of live and inactivated vaccines made it possible to decrease morbidity rate 2.12 times in comparison with the average data for many years. The greatest effect was achieved at large industrial enterprises where, simultaneously with vaccination covering 90% of the employees, urgent prophylaxis with remantadin and the early treatment of influenza patients were carried out. Due to these measures the morbidity rate and the number of disability days per 100 employees decreased 3-6 times.     

Results of introducing a comprehensive system of influenza control in the population of Severodvinsk

A complex differentiated system of influenza control, based on scientific principles, was introduced into practice during 1976-1980 in Severodvinsk. The main component of this system was the mass prophylactic immunization of the population of the city, including children and elderly persons, with live and inactivated vaccines manufactured in the USSR. At the period of influenza epidemics remantadin was used for the urgent prophylaxis and treatment of influenza. As a result, influenza morbidity in Severodvinsk was reduced 1.5-2 times in comparison with that in the neighboring control cities. The cases of pneumonia and bronchitis, the most severe postinfluenza complications, decreased in number 1.8 and 1.4 times, respectively. The proportion of influenza A in the structure of acute respiratory diseases decreased by one-half. These results demonstrate the effectiveness of the prophylactic and therapeutic measures carried out in the city.     

The use of influenza vaccines and remantadine for protection against influenza in industrial enterprises

The effectiveness of inactivated and live influenza vaccines and remantidin was studied in persons with different annual morbidity rate in influenza and acute respiratory diseases (ARD). After three and more years of immunization with the inactivated vaccine the number of seroconversions to viruses A (H1N1) and A (H3N2) in vaccinees decreased, respectively, from 75.0 to 26.0% and from 79.3 to 38.8%, and after an interval of two years or the alternation of inactivated and live vaccines the number of seroconversions increased to 57.9-64.0%. The significant decrease of morbidity rate in influenza and ARD were observed only in persons, having had frequent ARD in their medical history and immunized with live and inactivated vaccines simultaneously or separately with the alternation of these vaccines every year (the effectiveness index being equal to 1.7-1.8). At the period of epidemic the controlled administration of remantadin to persons with contraindications to immunization ensured the decrease of morbidity rate in influenza 1.5-1.8 times; in vaccinees, highly susceptible to ARD, the administration of remantadin decreased morbidity rate 2.3 times.     

Virus-inhibiting properties of the carbonyl-conjugated pentaene roseofungin

The antiinfluenza activity of roseofungin, a polyenic macrolide antibiotic was studied in vitro on surviving fragments of the chick embryo chorionallantoic membranes and in ovo on growing chick embryos. It was shown that the antibiotic activity against influenza A and B viruses was sufficiently high. The activity of roseofungin against influenza A virus did not differ from that of remantadin, the most active inhibitor of influenza virus reproduction. However, the activity of roseofungin against influenza B virus was an advantage of this antibiotic over remantadin, which had practically no effect on this virus type. A statistically significant protective effect of roseofungin (p less than 0.05) was shown on the animals with experimental influenza. The study on the antiviral activity of roseofungin against the DNA-containing variolovaccine virus revealed that it markedly inhibited the plague reduction. Roseofungin had a pronounced inhibitory effect on cell neoplastic transformation induced by the RNA-containing oncogenic virus of Rous sarcoma.     

Prophylactic and therapeutic efficacies of Ingavirin, a novel Russian chemotherapeutic, with respect to influenza pathogen A (H5N1)

The experimental study of the Ingavirin efficacy against the influenza virus A (H5N1) on intranasally-infected albino mice vs. Tamiflue and Arbidol showed that when used for the prophylaxis, urgent prophylaxis and therapy it was effective in the protectiom of the animals from death. The efficient dose for the prophylaxis of the influenza infection was 5 mg/kg (protective efficacy of 46.7%) and for the urgent prophylaxis and therapy it was 15 mg/kg (protective efficacy of 40.0 and 35.0% respectively).     

Live enteroviral vaccines for the emergency nonspecific prevention of mass respiratory diseases during fall-winter epidemics of influenza and acute respiratory diseases]

The results of the 3-year controlled trials of a new method of nonspecific urgent prophylaxis of influenza and acute respiratory diseases (ADR) by immunization of healthy adults with standard live enterovirus oral vaccines, introduced in 2-3 administrations at intervals of 7-10 days, at the initial stages of autumn and winter epidemics are presented. Observations, carried out in three republics, covered more than 150,000 persons immunized with enterovirus interferonogenic vaccines. A considerable decrease in morbidity rate among the vaccinees was achieved (on the average, by 3.2 times) in comparison to that among nonimmunized subjects. The method of nonspecific prophylaxis with live enterovirus interferonogenic vaccines is recommended during outbreaks of diseases induced simultaneously by several causative agents of influenza and ARD, as well as by pathogenic enterovirus strains.     

Molecular and genetic analysis of influenza A viruses isolated in Russia, based on the neuraminidase and M2 protein gene sequence

The results of molecular analysis of 15 influenza A(H3N2) and 17-A(H1N1) epidemic strains isolated in the Russian Federation in 1995-2007 are described. The analysis on the M2 and neuraminidase influenza A virus genes was performed. The M2 sequences analysis among the remantadin resistant viruses demonstrated the S31N substitution in all strains. Besides S31N substitution, additional mutations were detected in both proteins. Mutations associated with S31N substitution were detected in each virus subtype, which may be considered as new markers for the identification of remantadin-resistant strains. The sequencing of the NA segments from all viruses showed no amino acid substitutions known to cause resistance to neuraminidase inhibitors, which indicates susceptibility to NA inhibitors among the strains.     

Antiviral action of carbonyl-conjugated pentaene macrolides

Clear antiviral activity of carbonyl-conjugated pentaene macrolides, such as flavofungin, mycothicin, brunefungin and flavopentin was shown on models with infectious and oncogenic viruses. The antibiotics were active against influenza A and B virus. The effect was most pronounced in the in vitro and in ovo systems. On a model of experimental influenza infection of mice with the lethal outcome, antiinfluenzal activity of flavofungin was comparable to that of remantadin. However, unlike the latter one flavofungin and brunefungin inhibited the growth of influenza B virus. The drugs had a pronounced inhibitory effect on variolavaccine virus and prevented formation of foci of cell neoplastic transformation infected with various strains of Rous sarcoma virus.     

Triazavirin prophylactic efficacy against influenza virus A (H5N1)

The experimental study of the prophylactic efficacy of Triazaverin against the experimental form of the influenza virus A (H5N1) on albino mice intranasally infected with the influenza virus A/Chicken/Kurgan/Russia/02/05 vs. the reference drugs Tamiflu, Remantadin and Arbidol showed that in doses of 1 to 100 mg/kg it was efficient in the animal protection from death. The drug was also efficient in the urgent prophylaxis. Triazaverin effectively inhibited the influenza A virus multiplication in the lungs of the albino mice.     

Kinetics of 3H-remantadine accumulation and excretion in the tissues of pregnant mice and their fetuses

The authors studied the pharmacodynamics of remantadin in fetuses, liver, kidneys and spleen of pregnant mice after a single oral administration of 3H-remantadin in a dose of 2.8 mg/kg. Thirty to 60 min after the drug administration the fetuses and tissues showed the maximal amount of the drug penetrating an organ. The greatest amount of remantadin was detected in the liver, the least amount in the kidneys and fetuses. The drug half-life in organs and fetuses did not exceed 2 hours. Twelve hours after the drug administration the kidneys and spleen demonstrated remantadin traces (less than 0.1%), the fetuses showed 0.2% and the liver about 0.7% of the drug. It is concluded that remantadin is marked by good placenta permeability and that it is completely eliminated from the fetus.     

Economic consequences of postinfarction prophylaxis with beta blockers: cost effectiveness of metoprolol.

Treatment with certain beta adrenoceptor blocking agents after myocardial infarction reduces mortality and the incidence of reinfarction. Data from a randomised placebo controlled study of the beta 1 selective blocker metoprolol given as secondary prophylaxis were therefore analysed for the possible cost effectiveness of extending this treatment to the general population of patients with myocardial infarction. Metoprolol 100 mg twice daily and matching placebo were given to 154 and 147 patients, respectively, for three years. During this period drug costs for the beta blocker, digitalis, and diuretics were analysed as well as costs of readmission for cardiac problems and indirect costs arising from sick leave or early retirement. Active treatment with metoprolol significantly reduced costs of readmission as well as indirect costs. The net effect per patient over the three years was a reduction of roughly kr 19,000 (1930 pounds). These results suggest that beta blocker treatment given as secondary prophylaxis after myocardial infarction is highly cost effective.     

Modern features of the epidemiology and prophylaxis of influenza

Modern concepts concerning influenza pandemics and epidemics in different countries of the world are presented. The influenza epidemics of the last decade in different countries of the world and their specific features linked with the "drifting" variability of influenza virus have been analyzed. Information on influenza morbidity during the last 30 years is given; on the basis of this information the role of vaccinal prophylaxis and mainly the mass vaccination of school children and students, is shown. The results of the efficacy of such vaccines as live influenza vaccine, American split vaccine, Russian live recombinant vaccine and Grippovac (1995-1996), as well as new-generation vaccine Grippol (1998), are presented. The prospects of the combined use of specific and unspecific prophylaxis have been determined.     

Use of interferon inducers in treating viral diseases

The results obtained in the experimental and clinical study of the preparations of mephenamine acid and levamisole with respect to their interferonogenic and interferon-stimulating action and their therapeutic effectiveness in influenza and virus hepatitis are presented. The study has revealed that mephenamine acid, along with its capacity for stimulating the processes of interferon formation in the body, produces a pronounced curative effect, prevents the development of postinfluenza complications much more effectively than levamisole and remantadin and accelerates the processes of reparation in virus hepatitis.     

The effectiveness of using the Vaxigrip vaccine from the firm of Pasteur Mérieux Connaught for influenza prevention in organized groups of adults

The results of the study of the effectiveness of using vaccine Vaxigrip for the prophylaxis of influenza in organized groups of adults are presented. The vaccine was found to have high epidemiological effectiveness (the epidemiological index was 2.6), moderate reactogenicity and pronounced immunological activity (the protection level was 89.0-100.0%). The vaccine may be recommended for the prophylaxis of influenza among adults.     

RWJ-270201 (BCX-1812): a novel neuraminidase inhibitor for influenza.

The influenza virus neuraminidase (NA) is important in the pathogenesis of infection and, thus, is an attractive target for agents used in the treatment and prophylaxis of influenza. This article describes preclinical and early clinical data related to RWJ-270201 (BCX-1812), a novel, orally active NA inhibitor that was rationally designed for having potent and selective activity against influenza A and B viruses. RWJ-270201 is a unique NA inhibitor with a cyclopentane ring structure and high selectivity for the influenza NA. RWJ-270201 has efficacy comparable to or better than earlier NA inhibitors against a wide range of influenza A and B isolates, including recently emerged and avian strains, both in vitro and in a lethal murine model of influenza. Based on the high selectivity and efficacy of RWJ-270201 against both type A and B influenza strains in preclinical studies as well as murine pharmacodynamic studies supporting the potential for once-daily administration, clinical trials were initiated in order to determine the tolerability and antiviral activity of RWJ-270201 in humans. To date, clinical studies have indicated that RWJ-270201 is well tolerated and has antiviral activity in human experimental influenza models when administered orally once daily.     

The efficacy of exogenous and endogenous interferonization in preventing influenza]

In this work the results of using interferon (IFN), Dibasol and the combination of these preparations for the urgent prophylaxis of influenza and acute respiratory diseases (ARD) among the employees of the Gamaleia Research Institute of Epidemiology and Microbiology (USSR Acad. Med. Sci.) are summarized. Reaferon and Dibasol decrease ARD morbidity 2 times and leukocytic IFN decreases it 1.4 times, while the combined administration of Dibasol and IFN has proved to be ineffective. Reaferon is mainly a prophylactic remedy; it has been found to bring about almost no decrease in the number of patients at the peak of morbidity, while pronouncedly decreasing it in two weeks after the administration of the preparation. Dibasol has a curative effect, sharply interrupting the beginning rise of morbidity. Reaferon normalizes the characteristics of the IFN status, decreasing the amount of circulating IFN and enhancing the capacity of leukocytes for producing alpha-IFN and gamma-IFN. For the prophylaxis of respiratory infections the use of Reaferon is advisable 3-4 weeks prior to the beginning of the epidemic and then, when the first cases of infection are registered, the course of prophylaxis with Dibasol should be carried out.     

Preventive measure of massive spreading of influenza and acute respiratory viral infections

Influenza and acute respiratory viral infections (ARVI) continue to be one of the most actual medical and social-economic problem. But problem of high incidence of ARVI often regarded as problem of influenza only. Information about methods of prognosis of massive spreading of ARVI complex and universal system of their prophylaxis including influenza is presented in the article.     

Prophylaxis or treatment? Optimal use of an antiviral stockpile during an influenza pandemic

We introduce a novel mathematical model that effectively incorporates contact tracing in a realistic distribution mechanism for antiviral drugs in an influenza pandemic scenario. A strategy focused on targeted provision of post-exposure prophylaxis, rather than treatment, will provide the greatest chance of minimising the impact of an influenza pandemic. Targeted post-exposure prophylaxis delays the onset of the pandemic and for a wide range of parameter values, a delay of the order of 6-18 months may be achievable. This may provide enough time to develop and distribute a vaccine. In contrast, a treatment based strategy typically does not delay the onset of a pandemic by an appreciable amount and, in general, is not capable of significantly reducing the attack rate from baseline.     

Antiviral activity of the long chain pentraxin PTX3 against influenza viruses

Proteins of the innate immune system can act as natural inhibitors of influenza virus, limiting growth and spread of the virus in the early stages of infection before the induction of adaptive immune responses. In this study, we identify the long pentraxin PTX3 as a potent innate inhibitor of influenza viruses both in vitro and in vivo. Human and murine PTX3 bound to influenza virus and mediated a range of antiviral activities, including inhibition of hemagglutination, neutralization of virus infectivity and inhibition of viral neuraminidase. Antiviral activity was associated with binding of the viral hemagglutinin glycoprotein to sialylated ligands present on PTX3. Using a mouse model we found PTX3 to be rapidly induced following influenza infection and that PTX3-/- mice were more susceptible than wild-type mice to infection by PTX3-sensitive virus strains. Therapeutic treatment of mice with human PTX3 promoted survival and reduced viral load in the lungs following infection with PTX3-sensitive, but not PTX3-resistant, influenza viruses. Together, these studies describe a novel antiviral role for PTX3 in early host defense against influenza infections both in vitro and in vivo and describe the therapeutic potential of PTX3 in ameliorating disease during influenza infection.     

Comparison of therapeutic effects of antibiotics of the tetracycline group in the treatment of anthrax caused by a strain inheriting tet-gene of plasmid pBC16]

In vivo and in vitro efficacy of tetracyclines was studied with respect to anthracic infection induced by a tetracycline-resistant resistant strain containing plasmid pBC16. The plasmid-containing strain was resistant to tetracycline, doxycycline and minocycline, the MICs exceeding those for the initial strain 500, 640 and 80 times, respectively. There was no therapeutic effect of tetracycline and doxycycline in the treatment and urgent prophylaxis of anthracic infection caused by the tetracycline-resistant strain of Bacillus anthracis. High therapeutic efficacy of minocycline in the average therapeutic concentrations was shown irrespective of the contaminating doses and strains. Minocycline was recommended for treatment and urgent prophylaxis of anthracic infection caused by tetracycline-resistant B. anthracis strains.