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Biomedical subjects

Flor M Munoz

Publications and source records attributed to Flor M Munoz.

13 recordsLinked to original sources
PubMed2006

Medically attended pediatric influenza during the resurgence of the Victoria lineage of influenza B virus.

OBJECTIVES: During the 2002-2003 season, a new variant of influenza B co-circulated with influenza A viruses. This study examines the characteristics and outcomes of children with influenza A and B virus infection vs. other acute respiratory illnesses. METHODS: A retrospective chart review was performed on children with laboratory-confirmed influenza infection, and influenza negative acute respiratory illnesses that prompted a hospital visit. RESULTS: Children with influenza were more often previously healthy and presenting with upper respiratory symptoms, while influenza negative patients typically had underlying medical conditions, and lower respiratory tract disease. Children with influenza B were older, were more likely to be in school, and presented with myositis more frequently than those with influenza A. A third of children with influenza A, and 42% with influenza B required hospitalization. The highest hospitalization rates were in infants under one year. No healthy children, and only 15% of those with chronic medical problems, had received influenza vaccine. Vaccine efficacy was estimated to be 82.6%. CONCLUSIONS: Most children with influenza were previously healthy. Overall, a third of children with influenza required hospitalization. Influenza A and B were clinically indistinguishable, except for older age and higher incidence of myositis in patients with influenza B. Influenza vaccine coverage in both healthy and high-risk children was low.

Adolescent↗
PubMed2006

Pertussis in infants, children, and adolescents: diagnosis, treatment, and prevention.

Pertussis, or "whooping cough," caused by the gram-negative pleomorphic bacillus Bordetella pertussis, is a highly contagious, potentially life-threatening respiratory tract illness that has re-emerged worldwide as a cause of substantial morbidity and mortality in infants, children, and adolescents, despite high vaccination rates. Increased awareness and reporting, in addition to the availability of better diagnostic tests, partially explain the recent resurgence of pertussis. However, waning immunity after childhood immunization has resulted in a growing pool of susceptible adolescents and adults who are capable of transmitting pertussis to vulnerable unvaccinated or incompletely vaccinated infants. An acellular pertussis vaccine booster for adolescents has been recommended in the United States and other industrialized countries. Active immunization and early diagnosis are crucial in the management of pertussis.

Adolescent↗
PubMed2005

Safety of influenza vaccination during pregnancy.

OBJECTIVE: The purpose of this study was to evaluate the safety of influenza vaccine that is administered in the second or third trimester of gestation. STUDY DESIGN: A retrospective electronic database search of 5 influenza seasons (July 1, 1998, to June 30, 2003) was performed at a large multispecialty clinic in Houston, Texas. Immunization rates were calculated, and outcomes of pregnancy were compared between a cohort of healthy women who received influenza vaccine and a control group of healthy unvaccinated women who were matched by age, month of delivery, and type of medical insurance. RESULTS: Among 7183 eligible mother-infant pairs, only 252 pregnant women (3.5%) received the influenza vaccine. Women with medical insurance were more likely to be vaccinated, although the rates for women with chronic underlying conditions were similar to those of healthy women, regardless of insurance status. The mean gestational age at the time of influenza vaccination was 26.1 weeks (range, 14-39 weeks). No serious adverse events occurred within 42 days of vaccination, and there was no difference between the groups in the outcomes of pregnancy (including cesarean delivery and premature delivery) and infant medical conditions from birth to 6 months of age. CONCLUSION: Influenza vaccine that was administered in the second or third trimester of gestation was safe in this study population.

Adult↗
PubMed2004

Prevalence of pertussis antibodies in maternal delivery, cord, and infant serum.

BACKGROUND: Passively acquired maternal antibodies protect infants from many pathogens. With increasing reports of infant pertussis, we evaluated pertussis antibodies in maternal-infant paired sera from 1999-2000. METHODS: Antibodies to pertussis toxin (PT), filamentous hemagglutinin (FHA), and fimbrial proteins (FIM) were measured by validated IgG-specific enzyme-linked immunosorbant assay (ELISA) in 64 maternal-umbilical cord serum pairs and in 61 of 64 infant sera. Geometric mean concentrations (GMCs) of pertussis antibodies and cord : maternal GMC ratios were calculated. RESULTS: Mean maternal age and gestation were 29.7 years (range, 19-42) and 39.3 weeks (range, 35.6-40.9), and 81% of mothers were white. GMCs of maternal antibodies at delivery (ELISA units/mL) were 2.4 for PT, 6.9 for FHA, and 13 for FIM. Cord GMCs were 169%, 178%, and 157% of maternal delivery values for PT, FHA, and FIM, respectively, demonstrating active placental transfer (P<.001). Pertussis-specific IgG values for each antigen decayed to below the threshold of detection by age 2 months. CONCLUSIONS: Despite efficient placental transfer, low maternal pertussis antibody levels and their rapid decay in infant sera leave infants with little humoral protection against pertussis. These data support the rationale for maternal or neonatal immunization, with acellular pertussis vaccines, to prevent life-threatening pertussis in early infancy.

Adhesins, Bacterial↗
PubMed2004

Antibodies to type III group B streptococcal polysaccharide in breast milk.

We compared concentrations of type III group B streptococcal capsular polysaccharide (CPS)-specific IgG and IgA in archived 2-month-postpartum breast milk from 9 women with > or =1 microg/ml and 9 with < 1 microg/ml type III CPS-specific IgG in serum. Type III CPS-specific antibodies were not detectable consistently but were measurable in breast milk from some women in both groups, indicating their potential for a role in prevention or amelioration of late onset group B streptococcal disease.

Adult↗
PubMed2004

Technology evaluation: FluINsure, ID Biomedical.

ID Biomedical (formerly Intellivax International) is developing a trivalent nasal influenza vaccine, FluINsure, for the potential treatment of influenza. The vaccine is currently in phase II clinical trials.

Administration, Intranasal↗
PubMed2003

Safety and immunogenicity of respiratory syncytial virus purified fusion protein-2 vaccine in pregnant women.

A randomized, double-blind, placebo controlled study was carried out to determine the safety and immunogenicity of RSV PFP-2 vaccine (Wyeth-Lederle Vaccines, NY) in 35 healthy women in the third trimester of pregnancy and their offspring. Infants were followed during their first RSV season for occurrence and severity of respiratory illnesses. RSV-PFP-2 vaccine was safe and well tolerated by pregnant women. Mild pain at the site of injection occurred in 65% of PFP-2 and 13% of placebo recipients (P=0.005). There were no systemic reactions, fever, or serious adverse events associated with vaccine administration in mothers. All 35 infants were born healthy, and there were no differences among the groups in perinatal or neonatal outcomes, growth and development in the first year of life. During the RSV season, there was no increase in the frequency or morbidity associated with respiratory tract illnesses in infants of vaccine recipients. 15/20 (75%) vaccine recipients had a response to PFP-2 by Western blot vs. 0/15 placebo recipients (P<0.01). 19/20 (95%) vaccine recipients had a > or =4 fold rise in IgG ELISA Ab after immunization with PFP-2 vs. 0/15 placebo recipients (P<0.01). Geometric mean concentrations of IgG ELISA Ab were 4 fold higher in infants of vaccine recipients at birth, 2 and 6 months after delivery than in infants of placebo recipients (P<0.01). A modest (0.5log2) increase in neutralization Ab was observed in vaccine recipients and their infants. The half-life of maternal antibodies in infants was > or =3 weeks. There was no evidence of enhanced T-cell or cytokine activity in infants of vaccine recipients vs. infants of placebo recipients. Vaccine specific anti-F IgA and IgG concentrations in breast milk were higher in mothers who received RSV-PFP-2.

Adult↗
PubMed2003

Influenza virus infection in infancy and early childhood.

Infants and young children have the highest influenza infection and hospitalisation rates in paediatrics. The immaturity of the infant's immune system and the absence of prior immunity and exposure to the virus are potential contributors. Although most children that suffer from influenza infection are otherwise healthy, an underlying chronic medical condition further increases the risk for complications. Annual immunisation with influenza vaccine is recommended for any child 6 months of age and older in whom prevention of disease is desirable, particularly for those with underlying medical conditions. Offering influenza vaccine to pregnant women who will deliver during the influenza season can potentially reduce the frequency and severity of influenza disease in infants less than 6 months of age. Family members, including other children and all other close contacts, should also receive influenza vaccine to reduce transmission to children at risk and infants in the first 6 months of life.

Animals↗
PubMed2002

The impact of influenza in children.

The highest infection rates with influenza virus occur in young children because of their lack of prior immunity and prior exposure to the virus. Most children with influenza virus infection are healthy otherwise. Previously healthy children who have influenza in their first year of life have a substantial risk for developing serious disease. An underlying chronic medical condition further increases this risk. Infants, young children, and children with underlying conditions have the highest rates of outpatient medical visits and hospitalizations for acute respiratory disease during influenza epidemics. Secondary bacterial infections, antibiotic use, and other complications of influenza are consequences of influenza virus infection in children of all ages. Annual immunization with influenza vaccine is recommended for any child older than 6 months of age in whom prevention of disease is desirable, and particularly in those with underlying medical conditions. The consequences of infection in infants younger than 6 months of age can be modified by maternal immunization currently recommended for women in the second or third trimester of pregnancy during the influenza season. Family members, including siblings, and all other close contacts should receive influenza vaccine to reduce the possibility of transmission to children at risk. Immunization of all children has a positive impact on the occurrence of influenza infection and its complications, both in those at greater risk and in the entire population.

Age Distribution↗