TY - JOUR T1 - Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. JF - Euro Surveill Y1 - 2023 A1 - Adlhoch, Cornelia A1 - Concepción Delgado-Sanz A1 - AnnaSara Carnahan A1 - Larrauri, Amparo A1 - Odette Popovici A1 - Nathalie Bossuyt A1 - Isabelle Thomas A1 - Jan Kynčl A1 - Pavel Slezak A1 - Mia Brytting A1 - Raquel Guiomar A1 - Monika Redlberger-Fritz A1 - Jackie Maistre Melillo A1 - Tanya Melillo A1 - Arianne B van Gageldonk-Lafeber A1 - Sierk D Marbus A1 - O'Donnell, Joan A1 - Domegan, Lisa A1 - Joana Gomes Dias A1 - Sonja J Olsen KW - Aged KW - Antiviral Agents KW - Enzyme Inhibitors KW - Guanidines KW - Hospital Mortality KW - Humans KW - Influenza, Human KW - Neuraminidase KW - Oseltamivir KW - Treatment Outcome KW - Zanamivir AB -

BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.

VL - 28 CP - 4 M3 - 10.2807/1560-7917.ES.2023.28.4.2200340 ER - TY - JOUR T1 - Influenza versus other respiratory viruses – assessing severity among hospitalised children, Belgium, 2011 to 2020. JF - Eurosurveillance Y1 - 2023 A1 - Natalie Fischer A1 - S Moreels A1 - Nicolas Dauby A1 - Marijke Reynders A1 - Evelyn Petit A1 - Gerard, Michèle A1 - Lacor, Patrick A1 - Siel Daelemans A1 - Bénédicte Lissoir A1 - Xavier Holemans A1 - Koen Magerman A1 - Jouck, Door A1 - Marc Bourgeois A1 - Bénédicte Delaere A1 - Sophie Quoilin A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Nathalie Bossuyt A1 - Cyril Barbezange VL - 28 CP - 29 M3 - 10.2807/1560-7917.ES.2023.28.29.2300056 ER - TY - JOUR T1 - Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium JF - Archives of Public Health Y1 - 2023 A1 - Madeleine Guyot A1 - Ingrid Pelgrims A1 - Raf Aerts A1 - Keune, Hans A1 - Roy Remmen A1 - Eva M De Clercq A1 - Isabelle Thomas A1 - Sophie O. Vanwambeke, KW - Brussels KW - Mental health KW - Non-response KW - Urban Environment AB -

Background

This paper aims at analysing the impact of partial non-response in the association between urban environment and mental health in Brussels. The potential threats of the partial non-response are biases in survey estimates and statistics. The effect of non-response on statistical associations is often overlooked and evidence in the research literature is lacking.

Methods

Data from the Belgian Health Interview Survey 2008 and 2013 were used. The association between non-response and potential determinants was explored through logistic regressions.

Results

Participants with low income, low educational levels, lower or higher age or in households with children were less likely to respond. When adjusting for socio-economic variables, non-response was higher in areas which are less vegetated, more polluted or more urbanised. Because the determinants of non-response and depressive disorders were similar, it is reasonable to assume that there will be more people with mental health problems among the non-respondents. And because more non-responses were found in low vegetation areas, the protective association between green spaces and mental health may be underestimated.

Conclusion

Our capacity to measure the association between the urban environment and health is affected by non-response in surveys. The non-random spatial and socio-economic distribution of this bias affects the research findings.

VL - 81 CP - 1 M3 - 10.1186/s13690-023-01118-y ER - TY - JOUR T1 - Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022. JF - Influenza Other Respir Viruses Y1 - 2023 A1 - Margaux M I Meslé A1 - Sinnathamby, Mary A1 - Piers Mook A1 - Richard Pebody A1 - Anissa Lakhani A1 - Maria Zambon A1 - Odette Popovici A1 - Mihaela Lazar A1 - Ljubović, Amela Dedeić A1 - Vukmir, Nina Rodić A1 - Altaş, Ayşe Başak A1 - Emine Avci A1 - Katarzyna Łuniewska A1 - Karol Szymański A1 - Greta Gargasiene A1 - Svajune Muralyte A1 - Džiugytė, Aušra A1 - Graziella Zahra A1 - Ana Rita Gonçalves A1 - Tania Spedaliero A1 - Fournier, Guillaume A1 - Daniel Alvarez-Vaca A1 - Petrović, Goranka A1 - Irena Tabain A1 - Katarina Prosenc A1 - Maja Socan A1 - Jelena Protic A1 - Dragana Dimitrijevic A1 - Alina Druc A1 - Mariana Apostol A1 - Kate Karolina Kalasnikova A1 - Sergejs Nikisins A1 - Janine Reiche A1 - Cai, Wei A1 - Adam Meijer A1 - Anne Teirlinck A1 - Larrauri, Amparo A1 - Inmaculada Casas A1 - Vincent Enouf A1 - Sophie Vaux A1 - Lomholt, Frederikke Kristensen A1 - Ramona Trebbien A1 - Helena Jirincova A1 - Helena Sebestova A1 - Mónika Rózsa A1 - Zsuzsanna Molnár A1 - Gudrun Aspelund A1 - Gudrun Erna Baldvinsdottir A1 - Simon Cottrell A1 - Moore, Catherine A1 - Kossyvakis, Athanasios A1 - Mellou, Kassiani A1 - Olga Sadikova A1 - Johanna Kristina Tamm A1 - Nathalie Bossuyt A1 - Isabelle Thomas A1 - Edita Staroňová A1 - Lyudmila Kudasheva A1 - Boris Pleshkov A1 - Niina Ikonen A1 - Otto Helve A1 - Emma Dickson A1 - Tanya Curran A1 - Kseniya Komissarova A1 - Kirill Stolyarov A1 - Veronika Vysotskaya A1 - Natallia Shmialiova A1 - Rakočević, Božidarka A1 - Danijela Vujošević A1 - Romella Abovyan A1 - Shushan Sargsyan A1 - Khatuna Zakhashvili A1 - Ann Machablishvili A1 - Oksana Koshalko A1 - Iryna Demchyshyna A1 - Michal Mandelboim A1 - Aharona Glatman-Freedman A1 - Rory Gunson A1 - Karanwal, Shivani A1 - Raquel Guiomar A1 - Ana Paula Rodrigues A1 - Charlene Bennett A1 - Domegan, Lisa A1 - Arijana Kalaveshi A1 - Jakupi, Xhevat A1 - Ovliyakulova, Gurbangul A1 - Neli Korsun A1 - Nadezhda Vladimirova KW - COVID-19 KW - Humans KW - Pandemics KW - Population Surveillance KW - Respiratory Syncytial Virus Infections KW - Respiratory Syncytial Virus, Human KW - SARS-CoV-2 KW - Seasons AB -

BACKGROUND: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022.

METHODS: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons.

RESULTS: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic.

CONCLUSION: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.

VL - 17 CP - 11 M3 - 10.1111/irv.13219 ER - TY - RPRT T1 - Surveillance des infections à influenza. Rapport épidémiologique saison 2019-2020 Y1 - 2023 A1 - Nathalie Bossuyt A1 - Natalia Bustos Sierra A1 - Kris Doggen A1 - Robrecht De Schreye A1 - Sébastien Fierens A1 - S Moreels A1 - M. Vermeulen A1 - B. Vos A1 - Cyril Barbezange A1 - François Dufrasne A1 - Sarah Denayer A1 - Isabelle Thomas KW - INFLUENZA AB -

La saison 2019-2020 a connu une épidémie de grippe d’une durée de 8 semaines et d'intensité modérée. Le pic de l'activité grippale est survenu au cours de la semaine 6 de 2020 (du 27 janvier au 02 février 2020). On n'a pas observé d'infections plus sévères (avec complications) qu'au cours d'une saison grippale moyenne.

Au cours de la première semaine de mars 2020 (semaine 10), les premières infections par le virus du SARS-CoV-2 ont été détectées en Belgique[1]. La propagation de ce nouveau virus a provoqué un deuxième pic de consultations pour des symptômes grippaux chez les généralistes au cours de la semaine 10 (du 2 au 8 mars 2020).

Les mesures de distance strictes qui sont entrées en vigueur à partir du 14 mars 2020 et la stratégie de dépistage du COVID-19 ont eu un impact négatif sur le fonctionnement de la surveillance de la grippe, en raison de la surcharge des prestataires de soins de santé, des consultations à distance,…

 

[1] Le patient rapatrié de Wuhan le 04/02/2020 n’est plus pris en compte.

PB - Sciensano CY - Bruxelles, Belgique ER - TY - RPRT T1 - Surveillance van griepinfecties. Epidemiologische rapport seizoen 2019-2020 Y1 - 2023 A1 - Nathalie Bossuyt A1 - Natalia Bustos Sierra A1 - Kris Doggen A1 - Robrecht De Schreye A1 - Sébastien Fierens A1 - S Moreels A1 - M. Vermeulen A1 - B. Vos A1 - Cyril Barbezange A1 - François Dufrasne A1 - Sarah Denayer A1 - Isabelle Thomas KW - INFLUENZA AB -

Het seizoen van 2019-2020 kende een 8 weken durende influenza epidemie van matige intensiteit. De piek in de influenza activiteit viel tijdens week 6 van 2020 (27 januari t/m 02 februari 2020). Er werden niet meer ernstige (verwikkelde) infecties gezien dan in een gemiddeld griepseizoen.


Tijdens de eerste week van maart 2020 (week 10) werden in België de eerste besmettingen met het SARS-CoV-2 virus vastgesteld[1]. De verspreiding van dit nieuwe virus veroorzaakte tijdens week 10 (2 t/m 8 maart 2020) een tweede piek in consultaties voor griepklachten bij de huisarts.

 

De strenge afstands en gezondheidsmaatregelen die ingingen op vanaf 14 maart 2020 en de teststrategie voor COVID-19 hadden een negatieve invloed op de werking van de griepsurveillances, door overbelasting van de zorgverleners, consultaties op afstand,…

 

[1] Gerepatrieerde patiënt uit Wuhan (04/02/2020) niet mee gerekend.

PB - Sciensano CY - Brussel, België ER - TY - RPRT T1 - Virological surveillance of influenza in Belgium, season 2019-2020 Y1 - 2023 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Steven Van Gucht A1 - Jeannine Weyckmans A1 - Ilham Fdillate A1 - Reinout van Eycken A1 - Assia Hamouda A1 - Nathalie Bossuyt A1 - Sophie Quoilin A1 - Dieter Van Cauteren KW - INFLUENZA KW - respiratory virus KW - Surveillance KW - virology AB -

The 2019-2020 winter season was characterized by the occurrence after the flu epidemic of the COVID-19 pandemic.  The Influenza epidemic in Belgium lasted 6 weeks and was a flu season of moderate intensity characterized by the co-circulation of A(H1N1)pdm09 and A(H3N2), with the predominance of A(H1N1). The epidemic threshold was crossed at  week 4-2020 (January 13 to January 19, 2020 with an incidence of 245 consultations /100.000 inhabitants and the peak was reached in week 5 with 550 consultations/100.000 inhabitants. After week 5- 2020, the incidence of ILI consultations decreased but remained above the threshold for several weeks likely due to the COVID-19 epidemic with a new ILI peak  at week 13 exceeding the influenza peak seen in  week 5  (Fig. 1). The emergence of COVID-19, spreading through respiratory transmission, required the implementation of physical distancing measures likely contributed to an abrupt decline of the influenza season.

The majority of the H1N1 viruses fell in the 6B.1A5A subgroup represented by the reference strain A/Norway/3433/2018.

About half of the sequenced A(H3N2) viruses belonged to the clade 3C.2a1 and the remaining belonged to the  clade 3C.3a close the vaccine strain for the northern hemisphere A/Kansas/14/2017.

Most of  the seqenced influenza B-Victoria viruses were triple-deletion variants similar to B/Washington/02/2019.  

Respiratory  samples were also analysed for other respiratory viruses. In the ILI population,  70 % of the patients were positive for at least one respiratory virus (including Influenza and co-infections). In the  SARI population, 52% of the patients were positive for at least one respiratory viruses (including influenza, SARS-COV-2, other respiratory viruses  or different combination of co-infection). From week 10 , the first SARS-CoV-2 patient were diagnosed.

These patients were mostly adults and children above 14 years old.

Severity was moderate in comparison to the previous season and comparable to previous seasons.

None of the analyzed strains presented mutations known to be associated to resistance to antivirals neuraminidase inhibitors (Oseltamivir et Zanamivir).

PB - Sciensano CY - Brussels, Belgium M3 - https://doi.org/10.25608/43gy-qs94 ER - TY - RPRT T1 - Virological surveillance report of the NRC influenza for season 2020-2021 Y1 - 2023 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Sarah Denayer A1 - Jeannine Weyckmans A1 - Assia Hamouda A1 - Reinout van Eycken A1 - Ilham Fdillate A1 - Steven Van Gucht KW - INFLUENZA KW - respiratory virus KW - Surveillance KW - virology AB -

Amidst the COVID-19 pandemic, the sentinel surveillance resumed slowly in the season 2020-2021. Only the severe acute respiratory infections (SARI) allowed to properly evaluate the circulation of respiratory viruses during the 2020-2021 season. The season was characterized by the absence of an influenza virus epidemic, and the return of parainfluenza viruses and respiratory syncytial viruses detected mainly in children. SARS-CoV-2 continued to intensively circulate and was mainly detected in adults and older adults. Other respiratory viruses such as metapneumoviruses, seasonal coronaviruses, rhino- and enteroviruses, and adenoviruses were also detected, without clear epidemic wave.

PB - Sciensano CY - Brussels, Belgium M3 - https://doi.org/10.25608/y0b7-s054 ER - TY - JOUR T1 - Efficacy and safety of camostat mesylate in early COVID-19 disease in an ambulatory setting: a randomized placebo-controlled phase II trial. JF - Int J Infect Dis Y1 - 2022 A1 - Els Tobback A1 - Sophie Degroote A1 - Sabine Buysse A1 - Liesbeth Delesie A1 - Lucas Van Dooren A1 - Sophie Vanherrewege A1 - Cyril Barbezange A1 - Veronik Hutse A1 - Marta Romano A1 - Isabelle Thomas A1 - Padalko, Elizaveta A1 - S. Callens A1 - Marie-Angélique De Scheerder KW - COVID-19 KW - Double-Blind Method KW - Esters KW - Guanidines KW - Humans KW - SARS-CoV-2 KW - Treatment Outcome AB -

OBJECTIVES: This study aimed to assess the efficacy and safety of 300 mg camostat mesylate three times daily in a fasted state to treat early phase COVID-19 in an ambulatory setting.

METHODS: We conducted a phase II randomized controlled trial in symptomatic (maximum 5 days) and asymptomatic patients with confirmed COVID-19 infection. Patients were randomly assigned in a 2:1 ratio to receive either camostat mesylate or a placebo. Outcomes included change in nasopharyngeal viral load, time to clinical improvement, the presence of neutralizing antibodies, and safety.

RESULTS: Of 96 participants randomized between November 2020 and June 2021, analyses were performed on the data of 90 participants who completed treatment (N = 61 camostat mesylate, N = 29 placebo). The estimated mean change in cycle threshold between day 1 and day 5 between the camostat and placebo group was 1.183 (P = 0.511). The unadjusted hazard ratio for clinical improvement in the camostat group was 0.965 (95% confidence interval, 0.480-1.942, P = 0.921 by Cox regression). The percentage distribution of the 50% neutralizing antibody titer at day 28 visit and frequency of adverse events were similar between the two groups.

CONCLUSION: Under this protocol, camostat mesylate was not found to be effective as an antiviral drug against SARS-CoV-2.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04625114; November 12, 2020.

VL - 122 M3 - 10.1016/j.ijid.2022.06.054 ER - TY - JOUR T1 - A general approach to identify low-frequency variants within influenza samples collected during routine surveillance. JF - Microb Genom Y1 - 2022 A1 - Laura Van Poelvoorde A1 - Thomas Delcourt A1 - Marnik Vuylsteke A1 - Sigrid C.J. De Keersmaecker A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Saelens, Xavier A1 - Nancy Roosens A1 - Kevin Vanneste KW - COVID-19 KW - Genome, Viral KW - Humans KW - Influenza A Virus, H3N2 Subtype KW - Influenza, Human KW - SARS-CoV-2 AB -

Influenza viruses exhibit considerable diversity between hosts. Additionally, different quasispecies can be found within the same host. High-throughput sequencing technologies can be used to sequence a patient-derived virus population at sufficient depths to identify low-frequency variants (LFV) present in a quasispecies, but many challenges remain for reliable LFV detection because of experimental errors introduced during sample preparation and sequencing. High genomic copy numbers and extensive sequencing depths are required to differentiate false positive from real LFV, especially at low allelic frequencies (AFs). This study proposes a general approach for identifying LFV in patient-derived samples obtained during routine surveillance. Firstly, validated thresholds were determined for LFV detection, whilst balancing both the cost and feasibility of reliable LFV detection in clinical samples. Using a genetically well-defined population of influenza A viruses, thresholds of at least 10 genomes per microlitre and AF of ≥5 % were established as detection limits. Secondly, a subset of 59 retained influenza A (H3N2) samples from the 2016-2017 Belgian influenza season was composed. Thirdly, as a proof of concept for the added value of LFV for routine influenza monitoring, potential associations between patient data and whole genome sequencing data were investigated. A significant association was found between a high prevalence of LFV and disease severity. This study provides a general methodology for influenza LFV detection, which can also be adopted by other national influenza reference centres and for other viruses such as SARS-CoV-2. Additionally, this study suggests that the current relevance of LFV for routine influenza surveillance programmes might be undervalued.

VL - 8 CP - 9 M3 - 10.1099/mgen.0.000867 ER - TY - JOUR T1 - Validity of self-reported air pollution annoyance to assess long-term exposure to air pollutants in Belgium JF - Environmental Research Y1 - 2022 A1 - Ingrid Pelgrims A1 - Brecht Devleesschauwer A1 - Hans Keune A1 - Tim S. Nawrot A1 - Roy Remmen A1 - Nelly D. Saenen A1 - Isabelle Thomas A1 - Vanessa Gorasso A1 - Johan Van der Heyden A1 - Delphine De Smedt A1 - Eva M De Clercq KW - air pollution KW - Environmental annoyance KW - exposure assessment KW - health interview survey AB -

In epidemiological studies, assessment of long term exposure to air pollution is often estimated using air pollution measurements at fixed monitoring stations, and interpolated to the residence of survey participants through Geographical Information Systems (GIS). However, obtaining georeferenced address data from national registries requires a long and cumbersome administrative procedure, since this kind of personal data is protected by privacy regulations. This paper aims to assess whether information collected in health interview surveys, including air pollution annoyance, could be used to build prediction models for assessing individual long term exposure to air pollution, removing the need for data on personal residence address.

Analyses were carried out based on data from the Belgian Health Interview Survey (BHIS) 2013 linked to GIS-modelled air pollution exposure at the residence place of participants older than 15 years (n = 9347). First, univariate linear regressions were performed to assess the relationship between air pollution annoyance and modelled exposure to each air pollutant. Secondly, a multivariable linear regression was performed for each air pollutant based on a set of variables selected with elastic net cross-validation, including variables related to environmental annoyance, socio-economic and health status of participants. Finally, the performance of the models to classify individuals in three levels of exposure was assessed by means of a confusion matrix.

Our results suggest a limited validity of self-reported air pollution annoyance as a direct proxy for air pollution exposure and a weak contribution of environmental annoyance variables in prediction models. Models using variables related to the socio-economic status, region, urban level and environmental annoyance allow to predict individual air pollution exposure with a percentage of error ranging from 8% to 18%. Although these models do not provide very accurate predictions in terms of absolute exposure to air pollution, they do allow to classify individuals in groups of relative exposure levels, ranking participants from low over medium to high air pollution exposure. This model represents a rapid assessment tool to identify groups within the BHIS participants undergoing the highest levels of environmental stress.

VL - 210 M3 - 10.1016/j.envres.2022.113014 ER - TY - JOUR T1 - Whole-Genome Sequence Approach and Phylogenomic Stratification Improve the Association Analysis of Mutations With Patient Data in Influenza Surveillance JF - Frontiers in Microbiology Y1 - 2022 A1 - Laura Van Poelvoorde A1 - Kevin Vanneste A1 - Sigrid C.J. De Keersmaecker A1 - Isabelle Thomas A1 - Nina Van Goethem A1 - Steven Van Gucht A1 - Xavier Saelens A1 - Nancy Roosens VL - 13 M3 - 10.3389/fmicb.2022.809887 ER - TY - JOUR T1 - Whole-Genome Sequence Approach and Phylogenomic Stratification Improve the Association Analysis of Mutations With Patient Data in Influenza Surveillance. JF - Front Microbiol Y1 - 2022 A1 - Laura Van Poelvoorde A1 - Kevin Vanneste A1 - Sigrid C.J. De Keersmaecker A1 - Nancy Roosens ED - Isabelle Thomas ED - Steven Van Gucht AB -

Each year, seasonal influenza results in high mortality and morbidity. The current classification of circulating influenza viruses is mainly focused on the hemagglutinin gene. Whole-genome sequencing (WGS) enables tracking mutations across all influenza segments allowing a better understanding of the epidemiological effects of intra- and inter-seasonal evolutionary dynamics, and exploring potential associations between mutations across the viral genome and patient's clinical data. In this study, mutations were identified in 253 Influenza A (H3N2) clinical isolates from the 2016-2017 influenza season in Belgium. As a proof of concept, available patient data were integrated with this genomic data, resulting in statistically significant associations that could be relevant to improve the vaccine and clinical management of infected patients. Several mutations were significantly associated with the sampling period. A new approach was proposed for exploring mutational effects in highly diverse Influenza A (H3N2) strains through considering the viral genetic background by using phylogenetic classification to stratify the samples. This resulted in several mutations that were significantly associated with patients suffering from renal insufficiency. This study demonstrates the usefulness of using WGS data for tracking mutations across the complete genome and linking these to patient data, and illustrates the importance of accounting for the viral genetic background in association studies. A limitation of this association study, especially when analyzing stratified groups, relates to the number of samples, especially in the context of national surveillance of small countries. Therefore, we investigated if international databases like GISAID may help to verify whether observed associations in the Belgium A (H3N2) samples, could be extrapolated to a global level. This work highlights the need to construct international databases with both information of viral genome sequences and patient data.

VL - 13 M3 - 10.3389/fmicb.2022.809887 ER - TY - JOUR T1 - Association between urban environment and mental health in Brussels, Belgium JF - BMC Public Health Y1 - 2021 A1 - Ingrid Pelgrims A1 - Brecht Devleesschauwer A1 - Madeleine Guyot A1 - Keune, Hans A1 - Tim S. Nawrot A1 - Roy Remmen A1 - Nelly D. Saenen A1 - Sonia Trabelsi A1 - Isabelle Thomas A1 - Raf Aerts A1 - Eva M De Clercq KW - air pollution KW - Building morphology KW - Environmental epidemiology KW - Green space KW - Mental health KW - noise AB -

Background: Mental health disorders appear as a growing problem in urban areas. While common mental health disorders are generally linked to demographic and socioeconomic factors, little is known about the interaction with the urban environment. With growing urbanization, more and more people are exposed to environmental stressors potentially contributing to increased stress and impairing mental health. It is therefore important to identify features of the urban environment that affect the mental health of city dwellers. The aim of this study was to define associations of combined long-term exposure to air pollution, noise, surrounding green at different scales, and building morphology with several dimensions of mental health in Brussels. Methods: Research focuses on the inhabitants of the Brussels Capital Region older than 15 years. The epidemiological study was carried out based on the linkage of data from the national health interview surveys (2008 and 2013) and specifically developed indicators describing each participant’s surroundings in terms of air quality, noise, surrounding green, and building morphology. These data are based on the geographical coordinates of the participant’s residence and processed using Geographical Information Systems (GIS). Mental health status was approached through several validated indicators: the Symptom Checklist-90-R subscales for depressive, anxiety and sleeping disorders and the 12-Item General Health Questionnaire for general well-being. For each mental health outcome, single and multi-exposure models were performed through multivariate logistic regressions. Results: Our results suggest that traffic-related air pollution (black carbon, NO2, PM10) exposure was positively associated with higher odds of depressive disorders. No association between green surrounding, noise, building morphology and mental health could be demonstrated. Conclusions: These findings have important implications because most of the Brussel’s population resides in areas where particulate matters concentrations are above the World Health Organization guidelines. This suggests that policies aiming to reduce traffic related-air pollution could also reduce the burden of depressive disorders in Brussels

VL - 21 CP - 1 M3 - 10.1186/s12889-021-10557-7 ER - TY - JOUR T1 - Deepening of In Silico Evaluation of SARS-CoV-2 Detection RT-qPCR Assays in the Context of New Variants JF - Genes Y1 - 2021 A1 - Mathieu Gand A1 - Kevin Vanneste A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Arnaud Capron A1 - Philippe Herman A1 - Nancy Roosens A1 - Sigrid C.J. De Keersmaecker KW - SARS-CoV-2; COVID-19; variants; detection; RT-qPCR; in silico specificity evaluation; bioinformatics tool; WGS data; mismatches; primers and probes AB -

For 1 year now, the world is undergoing a coronavirus disease-2019 (COVID-19) pandemic due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most widely used method for COVID-19 diagnosis is the detection of viral RNA by RT-qPCR with a specific set of primers and probe. It is important to frequently evaluate the performance of these tests and this can be done first by an in silico approach. Previously, we reported some mismatches between the oligonucleotides of publicly available RT-qPCR assays and SARS-CoV-2 genomes collected from GISAID and NCBI, potentially impacting proper detection of the virus. In the present study, 11 primers and probe sets investigated during the first study were evaluated again with 84,305 new SARS-CoV-2 unique genomes collected between June 2020 and January 2021. The lower inclusivity of the China CDC assay targeting the gene N has continued to decrease with new mismatches detected, whereas the other evaluated assays kept their inclusivity above 99%. Additionally, some mutations specific to new SARS-CoV-2 variants of concern were found to be located in oligonucleotide annealing sites. This might impact the strategy to be considered for future SARS-CoV-2 testing. Given the potential threat of the new variants, it is crucial to assess if they can still be correctly targeted by the primers and probes of the RT-qPCR assays. Our study highlights that considering the evolution of the virus and the emergence of new variants, an in silico (re-)evaluation should be performed on a regular basis. Ideally, this should be done for all the RT-qPCR assays employed for SARS-CoV-2 detection, including also commercial tests, although the primer and probe sequences used in these kits are rarely disclosed, which impedes independent performance evaluation.

VL - 12 CP - 4 M3 - 10.3390/genes12040565 ER - TY - JOUR T1 - Evaluation of the added value of viral genomic information for predicting severity of influenza infection JF - BMC Infectious Diseases Y1 - 2021 A1 - Nina Van Goethem A1 - Annie Robert A1 - Nathalie Bossuyt A1 - Laura Van Poelvoorde A1 - Sophie Quoilin A1 - Sigrid C.J. De Keersmaecker A1 - Brecht Devleesschauwer A1 - Isabelle Thomas A1 - Kevin Vanneste A1 - Nancy Roosens A1 - Herman Van Oyen VL - 21 CP - 1 M3 - 10.1186/s12879-021-06510-z ER - TY - JOUR T1 - Monitoring of human coronaviruses in Belgian primary care and hospitals, 2015-20: a surveillance study. JF - Lancet Microbe Y1 - 2021 A1 - Nathalie Fischer A1 - Nicolas Dauby A1 - Nathalie Bossuyt A1 - Marijke Reynders A1 - Gerard, Michèle A1 - Lacor, Patrick A1 - Siel Daelemans A1 - Bénédicte Lissoir A1 - Xavier Holemans A1 - Koen Magerman A1 - Door Jouck A1 - Marc Bourgeois A1 - Bénédicte Delaere A1 - Sophie Quoilin A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Lorenzo Subissi AB -

Background: Seasonal human coronaviruses (hCoVs) broadly circulate in humans. Their epidemiology and effect on the spread of emerging coronaviruses has been neglected thus far. We aimed to elucidate the epidemiology and burden of disease of seasonal hCoVs OC43, NL63, and 229E in patients in primary care and hospitals in Belgium between 2015 and 2020.

Methods: We retrospectively analysed data from the national influenza surveillance networks in Belgium during the winter seasons of 2015-20. Respiratory specimens were collected through the severe acute respiratory infection (SARI) and the influenza-like illness networks from patients with acute respiratory illness with onset within the previous 10 days, with measured or reported fever of 38°C or greater, cough, or dyspnoea; and for patients admitted to hospital for at least one night. Potential risk factors were recorded and patients who were admitted to hospital were followed up for the occurrence of complications or death for the length of their hospital stay. All samples were analysed by multiplex quantitative RT-PCRs for respiratory viruses, including seasonal hCoVs OC43, NL63, and 229E. We estimated the prevalence and incidence of seasonal hCoV infection, with or without co-infection with other respiratory viruses. We evaluated the association between co-infections and potential risk factors with complications or death in patients admitted to hospital with seasonal hCoV infections by age group. Samples received from week 8, 2020, were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Findings: 2573 primary care and 6494 hospital samples were included in the study. 161 (6·3%) of 2573 patients in primary care and 371 (5·7%) of 6494 patients admitted to hospital were infected with a seasonal hCoV. OC43 was the seasonal hCoV with the highest prevalence across age groups and highest incidence in children admitted to hospital who were younger than 5 years (incidence 9·0 [95% CI 7·2-11·2] per 100 000 person-months) and adults older than 65 years (2·6 [2·1-3·2] per 100 000 person-months). Among 262 patients admitted to hospital with seasonal hCoV infection and with complete information on potential risk factors, 66 (73·3%) of 90 patients who had complications or died also had at least one potential risk factor (p=0·0064). Complications in children younger than 5 years were associated with co-infection (24 [36·4%] of 66; p=0·017), and in teenagers and adults (≥15 years), more complications arose in patients with a single hCoV infection (49 [45·0%] of 109; p=0·0097). In early 2020, the Belgian SARI surveillance detected the first SARS-CoV-2-positive sample concomitantly with the first confirmed COVID-19 case with no travel history to China.

Interpretation: The main burden of severe seasonal hCoV infection lies with children younger than 5 years with co-infections and adults aged 65 years and older with pre-existing comorbidities. These age and patient groups should be targeted for enhanced observation when in medical care and in possible future vaccination strategies, and co-infections in children younger than 5 years should be considered during diagnosis and treatment. Our findings support the use of national influenza surveillance systems for seasonal hCoV monitoring and early detection, and monitoring of emerging coronaviruses such as SARS-CoV-2.

Funding: Belgian Federal Public Service Health, Food Chain Safety, and Environment; Belgian National Insurance Health Care (Institut national d'assurance maladie-invalidité/Rijksinstituut voor ziekte-en invaliditeitsverzekering); and Regional Health Authorities (Flanders Agentschap zorg en gezondheid, Brussels Commission communautaire commune, Wallonia Agence pour une vie de qualité).

VL - 2 CP - 3 M3 - 10.1016/S2666-5247(20)30221-4 ER - TY - JOUR T1 - Persistence of IgG response to SARS-CoV-2. JF - Lancet Infect Dis Y1 - 2021 A1 - Els Duysburgh A1 - Laure Mortgat A1 - Cyril Barbezange A1 - Katelijne Dierick A1 - Nathalie Fischer A1 - Heyndrickx, Leo A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Vuylsteke, Bea A1 - Ariën, Kevin K A1 - I Desombere KW - Antibodies, Neutralizing KW - Antibodies, Viral KW - COVID-19 KW - Health Personnel KW - Host-Pathogen Interactions KW - Humans KW - Immunoglobulin G KW - SARS-CoV-2 KW - Seroepidemiologic Studies VL - 21 CP - 2 M3 - 10.1016/S1473-3099(20)30943-9 ER - TY - JOUR T1 - Persistence of IgG response to SARS-CoV-2 JF - The Lancet Infectious Diseases Y1 - 2021 A1 - Els Duysburgh A1 - Laure Mortgat A1 - Cyril Barbezange A1 - Katelijne Dierick A1 - Nathalie Fischer A1 - Heyndrickx, Leo A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Vuylsteke, Bea A1 - Ariën, Kevin K A1 - I Desombere VL - 21 CP - 2 M3 - 10.1016/S1473-3099(20)30943-9 ER - TY - JOUR T1 - Poor antibody response to BioNTech/Pfizer COVID-19 vaccination in SARS-CoV-2 naïve residents of nursing homes. JF - Clin Infect Dis Y1 - 2021 A1 - Pieter Pannus A1 - Kristof Y Neven A1 - Stéphane De Craeye A1 - Heyndrickx, Leo A1 - Sara Vande Kerckhove A1 - Daphnée Georges A1 - Johan Michiels A1 - Antoine Francotte A1 - Marc Van den Bulcke A1 - Maan Zrein A1 - Steven Van Gucht A1 - Marie-Noëlle Schmickler A1 - Mathieu Verbrugghe A1 - André Matagne A1 - Isabelle Thomas A1 - Katelijne Dierick A1 - Joshua A Weiner A1 - Margaret E Ackerman A1 - Stanislas Goriely A1 - Maria Goossens A1 - Ariën, Kevin K A1 - I Desombere A1 - Arnaud Marchant AB -

BACKGROUND: Residents of nursing homes (NH) are at high risk of COVID-19 related morbidity and death and may respond poorly to vaccination because of old age and frequent comorbidities.

METHODS: Seventy-eight residents and 106 staff members, naïve or previously infected with SARS-CoV-2, were recruited in NH in Belgium before immunization with two doses of 30µg BNT162b2 mRNA vaccine at day 0 and day 21. Binding antibodies (Ab) to SARS-CoV-2 receptor binding domain (RBD), spike domains S1 and S2, RBD Ab avidity, and neutralizing Ab against SARS-CoV-2 wild type and B.1.351 were assessed at days 0, 21, 28, and 49.

RESULTS: SARS-CoV-2 naïve residents had lower Ab responses to BNT162b2 mRNA vaccination than naïve staff. These poor responses involved lower levels of IgG to all spike domains, lower avidity of RBD IgG, and lower levels of Ab neutralizing the vaccine strain. No naïve resident had detectable neutralizing Ab to the B.1.351 variant. In contrast, SARS-CoV-2 infected residents had high responses to mRNA vaccination, with Ab levels comparable to infected staff. Cluster analysis revealed that poor vaccine responders not only included naïve residents but also naïve staff, emphasizing the heterogeneity of responses to mRNA vaccination in the general population.

CONCLUSIONS: The poor Ab responses to mRNA vaccination observed in infection naïve residents and in some naïve staff members of NH suggest suboptimal protection against breakthrough infection, especially with variants of concern. These data support the administration of a third dose of mRNA vaccine to further improve protection of NH residents against COVID-19.

M3 - 10.1093/cid/ciab998 ER - TY - JOUR T1 - Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study. JF - BMJ Open Y1 - 2021 A1 - Laure Mortgat A1 - Kristien Verdonck A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Heyndrickx, Leo A1 - Nathalie Fischer A1 - Vuylsteke, Bea A1 - Ines Kabouche A1 - Ariën, Kevin K A1 - I Desombere A1 - Els Duysburgh KW - Adult KW - Belgium KW - COVID-19 KW - Female KW - Health Personnel KW - hospitals KW - Humans KW - incidence KW - prevalence KW - Prospective Studies KW - SARS-CoV-2 KW - Seroepidemiologic Studies KW - Vaccination AB -

OBJECTIVES: To describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April-December 2020.

DESIGN: Prospective cohort study. Follow-up was originally planned until September and later extended.

SETTING: Multicentre study, 17 hospitals.

PARTICIPANTS: 50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April-May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit.

OUTCOME MEASURES: A semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire.

RESULTS: Among all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion.

CONCLUSIONS: The seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy.

TRIAL REGISTRATION NUMBER: NCT04373889.

VL - 11 CP - 6 M3 - 10.1136/bmjopen-2021-050824 ER - TY - JOUR T1 - Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort studyObjectivesDesignSettingParticipantsOutcome measuresResultsConclusionsTrial registration number JF - BMJ Open Y1 - 2021 A1 - Laure Mortgat A1 - Kristien Verdonck A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Heyndrickx, Leo A1 - Nathalie Fischer A1 - Vuylsteke, Bea A1 - Ines Kabouche A1 - Ariën, Kevin K A1 - I Desombere A1 - Els Duysburgh VL - 11 CP - 6 M3 - 10.1136/bmjopen-2021-050824 ER - TY - JOUR T1 - The prior infection with SARS-CoV-2 study (PICOV) in nursing home residents and staff - study protocol description and presentation of preliminary findings on symptoms. JF - Arch Public Health Y1 - 2021 A1 - Maria Goossens A1 - Kristof Y Neven A1 - Pieter Pannus A1 - Cyril Barbezange A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Katelijne Dierick A1 - Marie-Noëlle Schmickler A1 - Mathieu Verbrugghe A1 - Nele Van Loon A1 - Ariën, Kevin K A1 - Arnaud Marchant A1 - Stanislas Goriely A1 - I Desombere AB -

BACKGROUND: The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented itself as one of the most important health concerns of the 2020's, and hit the geriatric population the hardest. The presence of co-morbidities and immune ageing in the elderly lead to an increased susceptibility to COVID-19, as is the case for other influenza-like illnesses (ILI) or acute respiratory tract infections (ARI). However, little is known, about the impact of a previous or current infection on the other in terms of susceptibility, immune response, and clinical course. The aim of the "Prior Infection with SARS-COV-2" (PICOV) study is to compare the time to occurrence of an ILI or ARI between participants with a confirmed past SARS-CoV-2 infection (previously infected) and those without a confirmed past infection (naïve) in residents and staff members of nursing homes. This paper describes the study design and population characteristics at baseline.

METHODS: In 26 Belgian nursing homes, all eligible residents and staff members were invited to participate, resulting in 1,226 participants. They were classified as naïve or previously infected based on the presence of detectable SARS-CoV-2 antibodies and/or a positive RT-qPCR result before participation in the study. Symptoms from a prior SARS-CoV-2 infection between March and August 2020 were compared between previously infected residents and staff members.

RESULTS: Infection naïve nursing home residents reported fewer symptoms than previously infected residents: on average 1.9 and 3.1 symptoms, respectively (p = 0.016). The same effect was observed for infection naïve staff members and previously infected staff members (3.1 and 6.1 symptoms, respectively; p <0.0001). Moreover, the antibody development after a SARS-CoV-2 infection differs between residents and staff members, as previously infected residents tend to have a higher rate of asymptomatic cases compared to previously infected staff members (20.5% compared to 12.4%; p <0.0001).

CONCLUSIONS: We can postulate that COVID-19 disease development and symptomatology are different between a geriatric and younger population. Therefore, the occurrence and severity of a future ILI and/or ARI might vary from resident to staff.

VL - 79 CP - 1 M3 - 10.1186/s13690-021-00715-z ER - TY - JOUR T1 - Residing in urban areas with higher green space is associated with lower mortality risk: A census-based cohort study with ten years of follow-up JF - Environment International Y1 - 2021 A1 - Mariska Bauwelinck A1 - Casas, Lidia A1 - Tim S. Nawrot A1 - Nemery, Benoit A1 - Sonia Trabelsi A1 - Isabelle Thomas A1 - Raf Aerts A1 - Wouter Lefebvre A1 - Charlotte Vanpoucke A1 - An Van Nieuwenhuyse A1 - Deboosere, Patrick A1 - Vandenheede, Hadewijch KW - COPD KW - Greenness KW - Greenspace KW - Ischemic heart disease KW - Perception KW - population-based AB -

Background

Epidemiological studies suggest that residing close to green space reduce mortality rates. We investigated the relationship between long-term exposure to residential green space and non-accidental and cardio-respiratory mortality.

Methods

We linked the Belgian 2001 census to population and mortality register follow-up data (2001–2011) among adults aged 30 years and older residing in the five largest urban areas in Belgium (n = 2,185,170 and mean follow-up time 9.4 years). Residential addresses were available at baseline. Exposure to green space was defined as 1) surrounding greenness (2006) [normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index (MSAVI2)] within buffers of 300 m, 500 m, and 1000 m; 2) surrounding green space (2006) [Urban Atlas (UA) and CORINE Land Cover (CLC)] within buffers of 300 m, 500 m, and 1000 m; and 3) perceived neighborhood green space (2001). Cox proportional hazards models with age as the underlying time scale were used to probe into cause-specific mortality (non-accidental, respiratory, COPD, cardiovascular, ischemic heart disease (IHD), and cerebrovascular). Models were adjusted for several sociodemographic variables (age, sex, marital status, country of birth, education level, employment status, and area mean income). We further adjusted our main models for annual mean (2010) values of ambient air pollution (PM2.5, PM10, NO2 and BC, one at a time), and we additionally explored potential mediation with the aforementioned pollutants.

Results

Higher degrees of residential green space were associated with lower rates of non-accidental and respiratory mortality. In fully adjusted models, hazard ratios (HR) per interquartile range (IQR) increase in NDVI 500 m buffer (IQR: 0.24) and UA 500 m buffer (IQR: 0.31) were 0.97 (95%CI 0.96–0.98) and 0.99 (95%CI 0.98–0.99) for non-accidental mortality, and 0.95 (95%CI 0.93–0.98) and 0.97 (95%CI 0.96–0.99) for respiratory mortality. For perceived neighborhood green space, HRs were 0.93 (95%CI 0.92–0.94) and 0.94 (95%CI 0.91–0.98) for non-accidental and respiratory mortality, respectively. The observed lower mortality risks associated with residential exposure to green space were largely independent from exposure to ambient air pollutants.

Conclusion

We observed evidence for lower mortality risk in associations with long-term residential exposure to green space in most but not all studied causes of death in a large representative cohort for the five largest urban areas in Belgium. These findings support the importance of the availability of residential green space in urban areas.

VL - 148 M3 - 10.1016/j.envint.2020.106365 ER - TY - JOUR T1 - Spotlight influenza: Extending influenza surveillance to detect non-influenza respiratory viruses of public health relevance: analysis of surveillance data, Belgium, 2015 to 2019. JF - Euro Surveill Y1 - 2021 A1 - Lorenzo Subissi A1 - Nathalie Bossuyt A1 - Marijke Reynders A1 - Gerard, Michèle A1 - Nicolas Dauby A1 - Lacor, Patrick A1 - Siel Daelemans A1 - Bénédicte Lissoir A1 - Xavier Holemans A1 - Koen Magerman A1 - Door Jouck A1 - Marc Bourgeois A1 - Bénédicte Delaere A1 - Sophie Quoilin A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Cyril Barbezange KW - Belgium KW - Child KW - Humans KW - Infant KW - Influenza, Human KW - Orthomyxoviridae KW - public health KW - Respiratory Tract Infections KW - Sentinel Surveillance KW - Viruses AB -

BackgroundSeasonal influenza-like illness (ILI) affects millions of people yearly. Severe acute respiratory infections (SARI), mainly influenza, are a leading cause of hospitalisation and mortality. Increasing evidence indicates that non-influenza respiratory viruses (NIRV) also contribute to the burden of SARI. In Belgium, SARI surveillance by a network of sentinel hospitals has been ongoing since 2011.AimWe report the results of using in-house multiplex qPCR for the detection of a flexible panel of viruses in respiratory ILI and SARI samples and the estimated incidence rates of SARI associated with each virus.MethodsWe defined ILI as an illness with onset of fever and cough or dyspnoea. SARI was defined as an illness requiring hospitalisation with onset of fever and cough or dyspnoea within the previous 10 days. Samples were collected in four winter seasons and tested by multiplex qPCR for influenza virus and NIRV. Using catchment population estimates, we calculated incidence rates of SARI associated with each virus.ResultsOne third of the SARI cases were positive for NIRV, reaching 49.4% among children younger than 15 years. In children younger than 5 years, incidence rates of NIRV-associated SARI were twice that of influenza (103.5 vs 57.6/100,000 person-months); co-infections with several NIRV, respiratory syncytial viruses, human metapneumoviruses and picornaviruses contributed most (33.1, 13.6, 15.8 and 18.2/100,000 person-months, respectively).ConclusionEarly testing for NIRV could be beneficial to clinical management of SARI patients, especially in children younger than 5 years, for whom the burden of NIRV-associated disease exceeds that of influenza.

VL - 26 CP - 38 M3 - 10.2807/1560-7917.ES.2021.26.38.2001104 ER - TY - RPRT T1 - Surveillance des infections à influenza. Rapport épidémiologique saison 2018-2019 Y1 - 2021 A1 - Nathalie Bossuyt A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Natalia Bustos Sierra A1 - Dieter Van Cauteren A1 - Melissa Vermeulen KW - Grippe KW - ILI KW - infections respiratoires KW - INFLUENZA KW - SARI PB - Sciensano CY - Bruxelles ER - TY - RPRT T1 - Surveillance van griepinfecties. Epidemiologisch rapport seizoen 2018-2019 Y1 - 2021 A1 - Nathalie Bossuyt A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Dieter Van Cauteren A1 - Melissa Vermeulen A1 - Natalia Bustos Sierra PB - Sciensano CY - Brussel ER - TY - JOUR T1 - Whole-genome-based phylogenomic analysis of the Belgian 2016-2017 influenza A(H3N2) outbreak season allows improved surveillance. JF - Microb Genom Y1 - 2021 A1 - Laura Van Poelvoorde A1 - Bert Bogaerts A1 - Fu, Qiang A1 - Sigrid C.J. De Keersmaecker A1 - Isabelle Thomas A1 - Nina Van Goethem A1 - Steven Van Gucht A1 - Raf Winand A1 - Saelens, Xavier A1 - Nancy Roosens A1 - Kevin Vanneste KW - Belgium KW - Hemagglutinin Glycoproteins, Influenza Virus KW - Humans KW - Influenza A Virus, H3N2 Subtype KW - Influenza, Human KW - Phylogeny KW - Public Health Surveillance KW - whole genome sequencing AB -

Seasonal influenza epidemics are associated with high mortality and morbidity in the human population. Influenza surveillance is critical for providing information to national influenza programmes and for making vaccine composition predictions. Vaccination prevents viral infections, but rapid influenza evolution results in emerging mutants that differ antigenically from vaccine strains. Current influenza surveillance relies on Sanger sequencing of the haemagglutinin (HA) gene. Its classification according to World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) guidelines is based on combining certain genotypic amino acid mutations and phylogenetic analysis. Next-generation sequencing technologies enable a shift to whole-genome sequencing (WGS) for influenza surveillance, but this requires laboratory workflow adaptations and advanced bioinformatics workflows. In this study, 253 influenza A(H3N2) positive clinical specimens from the 2016-2017 Belgian season underwent WGS using the Illumina MiSeq system. HA-based classification according to WHO/ECDC guidelines did not allow classification of all samples. A new approach, considering the whole genome, was investigated based on using powerful phylogenomic tools including beast and Nextstrain, which substantially improved phylogenetic classification. Moreover, Bayesian inference via beast facilitated reassortment detection by both manual inspection and computational methods, detecting intra-subtype reassortants at an estimated rate of 15 %. Real-time analysis (i.e. as an outbreak is ongoing) via Nextstrain allowed positioning of the Belgian isolates into the globally circulating context. Finally, integration of patient data with phylogenetic groups and reassortment status allowed detection of several associations that would have been missed when solely considering HA, such as hospitalized patients being more likely to be infected with A(H3N2) reassortants, and the possibility to link several phylogenetic groups to disease severity indicators could be relevant for epidemiological monitoring. Our study demonstrates that WGS offers multiple advantages for influenza monitoring in (inter)national influenza surveillance, and proposes an improved methodology. This allows leveraging all information contained in influenza genomes, and allows for more accurate genetic characterization and reassortment detection.

VL - 7 CP - 9 M3 - 10.1099/mgen.0.000643 ER - TY - JOUR T1 - Capturing respiratory syncytial virus season in Belgium using the influenza severe acute respiratory infection surveillance network, season 2018/19. JF - Euro Surveill Y1 - 2020 A1 - Lorenzo Subissi A1 - Nathalie Bossuyt A1 - Marijke Reynders A1 - Gerard, Michèle A1 - Nicolas Dauby A1 - Marc Bourgeois A1 - Bénédicte Delaere A1 - Sophie Quoilin A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Cyril Barbezange KW - ADOLESCENT KW - Adult KW - Aged KW - Belgium KW - Child KW - Child, Preschool KW - Female KW - Fever KW - Hospitalization KW - Humans KW - incidence KW - Infant KW - Influenza, Human KW - Male KW - middle aged KW - Pilot Projects KW - Respiratory Syncytial Virus Infections KW - Respiratory Syncytial Virus, Human KW - Respiratory Tract Infections KW - Risk Factors KW - Seasons KW - Sentinel Surveillance KW - Young adult AB -

BackgroundRespiratory syncytial virus (RSV) is a common cause of severe respiratory illness in young children (< 5 years old) and older adults (≥ 65 years old) leading the World Health Organization (WHO) to recommend the implementation of a dedicated surveillance in countries.AimWe tested the capacity of the severe acute respiratory infection (SARI) hospital network to contribute to RSV surveillance in Belgium.MethodsDuring the 2018/19 influenza season, we started the SARI surveillance for influenza in Belgium in week 40, earlier than in the past, to follow RSV activity, which usually precedes influenza virus circulation. While the WHO SARI case definition for influenza normally used by the SARI hospital network was employed, flexibility over the fever criterion was allowed, so patients without fever but meeting the other case definition criteria could be included in the surveillance.ResultsBetween weeks 40 2018 and 2 2019, we received 508 samples from SARI patients. We found an overall RSV detection rate of 62.4% (317/508), with rates varying depending on the age group: 77.6% in children aged < 5 years (253/326) and 34.4% in adults aged ≥ 65 years (44/128). Over 90% of the RSV-positive samples also positive for another tested respiratory virus (80/85) were from children aged < 5 years. Differences were also noted between age groups for symptoms, comorbidities and complications.ConclusionWith only marginal modifications in the case definition and the period of surveillance, the Belgian SARI network would be able to substantially contribute to RSV surveillance and burden evaluation in children and older adults, the two groups of particular interest for WHO.

VL - 25 CP - 39 M3 - 10.2807/1560-7917.ES.2020.25.39.1900627 ER - TY - JOUR T1 - Next-Generation Sequencing: An Eye-Opener for the Surveillance of Antiviral Resistance in Influenza JF - Trends in Biotechnology Y1 - 2020 A1 - Laura Van Poelvoorde A1 - Xavier Saelens A1 - Isabelle Thomas A1 - Nancy Roosens KW - antiviral resistance KW - INFLUENZA KW - Next-generation sequencing KW - Surveillance AB -

Next-generation sequencing (NGS) can enable a more effective response to a wide range of communicable disease threats, such as influenza, which is one of the leading causes of human morbidity and mortality worldwide. After vaccination, antivirals are the second line of defense against influenza. The use of currently available antivirals can lead to antiviral resistance mutations in the entire influenza genome. Therefore, the methods to detect these mutations should be developed and implemented. In this Opinion, we assess how NGS could be implemented to detect drug resistance mutations in clinical influenza virus isolates.

VL - 38 CP - 4 M3 - 10.1016/j.tibtech.2019.09.009 ER - TY - RPRT T1 - SARS-CoV-2 prevalence, seroprevalence and seroconversion among healthcare workers in Belgium during the 2020 COVID-19 outbreak (SARS-CoV-2 HCW): amended protocol Y1 - 2020 A1 - Laure Mortgat A1 - Lydia Gisle A1 - Rana Charafeddine A1 - Ariën, Kevin K A1 - Cyril Barbezange A1 - Stefaan Demarest A1 - I Desombere A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Vuylsteke, Bea A1 - Els Duysburgh KW - Belgium KW - COVID-19 KW - HEALTHCARE WORKERS KW - hospital KW - SARS-CoV-2 KW - Seroprevalence KW - well-being PB - Sciensano CY - Brussels, Belgium ER - TY - RPRT T1 - SARS-CoV-2 prevalence, seroprevalence and seroconversion among healthcare workers in Belgium during the 2020 Covid-19 outbreak: Study protocol Y1 - 2020 A1 - Laure Mortgat A1 - K. Arien A1 - Cyril Barbezange A1 - I Desombere A1 - Veronik Hutse A1 - Isabelle Thomas A1 - B. Vuylsteke A1 - Els Duysburgh KW - Coronavirus KW - COVID-19 KW - HEALTHCARE WORKERS KW - SARS-CoV-2 KW - sero-prevalence study PB - Sciensano CY - Brussels, Belgium ER - TY - JOUR T1 - Urban environment and mental health: the NAMED project, protocol for a mixed-method study JF - BMJ Open Y1 - 2020 A1 - Laura Lauwers A1 - Sonia Trabelsi A1 - Ingrid Pelgrims A1 - Hilde Bastiaens A1 - Eva M De Clercq A1 - Ariane Guilbert A1 - Madeleine Guyot A1 - Michael Leone A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Roy Remmen A1 - Nelly Saenen A1 - Isabelle Thomas A1 - Keune, Hans AB -

Introduction Mental health issues appear as a growing problem in modern societies and tend to be more frequent in big cities. Where increased evidence exists for positive links between nature and mental health, associations between urban environment characteristics and mental health are still not well understood. These associations are highly complex and require an interdisciplinary and integrated research approach to cover the broad range of mitigating factors. This article presents the study protocol of a project called Nature Impact on Mental Health Distribution that aims to generate a comprehensive understanding of associations between mental health and the urban residential environment.

Methods and analysis Following a mixed-method approach, this project combines quantitative and qualitative research. In the quantitative part, we analyse among the Brussels urban population associations between the urban residential environment and mental health, taking respondents’ socioeconomic status and physical health into account. Mental health is determined by the mental health indicators in the national Health Interview Survey (HIS). The urban residential environment is described by subjective indicators for the participant’s dwelling and neighbourhood present in the HIS and objective indicators for buildings, network infrastructure and green environment developed for the purpose of this project. We assess the mediating role of physical activity, social life, noise and air pollution. In the qualitative part, we conduct walking interviews with Brussels residents to record their subjective well-being in association with their neighbourhood. In the validation part, results from these two approaches are triangulated and evaluated through interviews and focus groups with stakeholders of healthcare and urban planning sectors.

Ethics and dissemination The Privacy Commission of Belgium and ethical committee from University Hospital of Antwerp respectively approved quantitative database merging and qualitative interviewing. We will share project results with a wide audience including the scientific community, policy authorities and civil society through scientific and non-expert communication.

VL - 10 CP - 2 M3 - 10.1136/bmjopen-2019-031963 ER - TY - JOUR T1 - Urban environment and mental health: the NAMED project, protocol for a mixed-method study. JF - BMJ Open Y1 - 2020 A1 - Laura Lauwers A1 - Sonia Trabelsi A1 - Ingrid Pelgrims A1 - Hilde Bastiaens A1 - Eva M De Clercq A1 - Ariane Guilbert A1 - Madeleine Guyot A1 - Michael Leone A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Roy Remmen A1 - Nelly Saenen A1 - Isabelle Thomas A1 - Keune, Hans KW - air pollution KW - Belgium KW - Cities KW - Environment Design KW - Humans KW - Mental health KW - noise KW - Research Design KW - Residence Characteristics KW - social class KW - Social Environment KW - Urban Health KW - Urban Population AB -

INTRODUCTION: Mental health issues appear as a growing problem in modern societies and tend to be more frequent in big cities. Where increased evidence exists for positive links between nature and mental health, associations between urban environment characteristics and mental health are still not well understood. These associations are highly complex and require an interdisciplinary and integrated research approach to cover the broad range of mitigating factors. This article presents the study protocol of a project called Nature Impact on Mental Health Distribution that aims to generate a comprehensive understanding of associations between mental health and the urban residential environment.

METHODS AND ANALYSIS: Following a mixed-method approach, this project combines quantitative and qualitative research. In the quantitative part, we analyse among the Brussels urban population associations between the urban residential environment and mental health, taking respondents' socioeconomic status and physical health into account. Mental health is determined by the mental health indicators in the national Health Interview Survey (HIS). The urban residential environment is described by subjective indicators for the participant's dwelling and neighbourhood present in the HIS and objective indicators for buildings, network infrastructure and green environment developed for the purpose of this project. We assess the mediating role of physical activity, social life, noise and air pollution. In the qualitative part, we conduct walking interviews with Brussels residents to record their subjective well-being in association with their neighbourhood. In the validation part, results from these two approaches are triangulated and evaluated through interviews and focus groups with stakeholders of healthcare and urban planning sectors.

ETHICS AND DISSEMINATION: The Privacy Commission of Belgium and ethical committee from University Hospital of Antwerp respectively approved quantitative database merging and qualitative interviewing. We will share project results with a wide audience including the scientific community, policy authorities and civil society through scientific and non-expert communication.

VL - 10 CP - 2 M3 - 10.1136/bmjopen-2019-031963 ER - TY - JOUR T1 - Use of Whole Genome Sequencing Data for a First in Silico Specificity Evaluation of the RT-qPCR Assays Used for SARS-CoV-2 Detection. JF - Int J Mol Sci Y1 - 2020 A1 - Mathieu Gand A1 - Kevin Vanneste A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Arnaud Capron A1 - Philippe Herman A1 - Nancy Roosens A1 - Sigrid C.J. De Keersmaecker KW - Betacoronavirus KW - Coronavirus Infections KW - Databases, Genetic KW - Genome, Viral KW - Humans KW - Open Reading Frames KW - Pandemics KW - Pneumonia, Viral KW - Polymorphism, Single Nucleotide KW - Real-Time Polymerase Chain Reaction KW - RNA Replicase KW - RNA, Viral KW - Sensitivity and Specificity KW - whole genome sequencing AB -

The current COronaVIrus Disease 2019 (COVID-19) pandemic started in December 2019. COVID-19 cases are confirmed by the detection of SARS-CoV-2 RNA in biological samples by RT-qPCR. However, limited numbers of SARS-CoV-2 genomes were available when the first RT-qPCR methods were developed in January 2020 for initial in silico specificity evaluation and to verify whether the targeted loci are highly conserved. Now that more whole genome data have become available, we used the bioinformatics tool SCREENED and a total of 4755 publicly available SARS-CoV-2 genomes, downloaded at two different time points, to evaluate the specificity of 12 RT-qPCR tests (consisting of a total of 30 primers and probe sets) used for SARS-CoV-2 detection and the impact of the virus' genetic evolution on four of them. The exclusivity of these methods was also assessed using the human reference genome and 2624 closely related other respiratory viral genomes. The specificity of the assays was generally good and stable over time. An exception is the first method developed by the China Center for Disease Control and prevention (CDC), which exhibits three primer mismatches present in 358 SARS-CoV-2 genomes sequenced mainly in Europe from February 2020 onwards. The best results were obtained for the assay of Chan et al. (2020) targeting the gene coding for the spiking protein (S). This demonstrates that our user-friendly strategy can be used for a first in silico specificity evaluation of future RT-qPCR tests, as well as verifying that the former methods are still capable of detecting circulating SARS-CoV-2 variants.

VL - 21 CP - 15 M3 - 10.3390/ijms21155585 ER - TY - Generic T1 - Association between Mental Health and the Perception of Residential Stressors in Belgium Y1 - 2019 A1 - Ingrid Pelgrims A1 - Eva M De Clercq A1 - Pauline Hautekiet A1 - S Trabelsi A1 - M Guyot A1 - Isabelle Thomas A1 - H Keune A1 - et al. JF - 31st annual conference of the International Society for Environmental Epidemiology , on Airs, Waters, Places, Utrecht, The Netherlands, August 2019 ER - TY - JOUR T1 - Bigger and Better? Representativeness of the Influenza A Surveillance Using One Consolidated Clinical Microbiology Laboratory Data Set as Compared to the Belgian Sentinel Network of Laboratories. JF - Front Public Health Y1 - 2019 A1 - Van den Wijngaert, Sigi A1 - Nathalie Bossuyt A1 - Bridget Ferns A1 - Busson, Laurent A1 - Gabriela Serrano A1 - Wautier, Magali A1 - Isabelle Thomas A1 - Matthew Byott A1 - Yves Dupont A1 - Eleni Nastouli A1 - Hallin, Marie A1 - Zisis Kozlakidis A1 - Vandenberg, Olivier AB -

Infectious diseases remain a serious public health concern globally, while the need for reliable and representative surveillance systems remains as acute as ever. The public health surveillance of infectious diseases uses reported positive results from sentinel clinical laboratories or laboratory networks, to survey the presence of specific microbial agents known to constitute a threat to public health in a given population. This monitoring activity is commonly based on a representative fraction of the microbiology laboratories nationally reporting to a single central reference point. However, in recent years a number of clinical microbiology laboratories (CML) have undergone a process of consolidation involving a shift toward laboratory amalgamation and closer real-time informational linkage. This report aims to investigate whether such merging activities might have a potential impact on infectious diseases surveillance. Influenza data was used from Belgian public health surveillance 2014-2017, to evaluate whether national infection trends could be estimated equally as effectively from only just one centralized CML serving the wider Brussels area (LHUB-ULB). The overall comparison reveals that there is a close correlation and representativeness of the LHUB-ULB data to the national and international data for the same time periods, both on epidemiological and molecular grounds. Notably, the effectiveness of the LHUB-ULB surveillance remains partially subject to local regional variations. A subset of the Influenza samples had their whole genome sequenced so that the observed epidemiological trends could be correlated to molecular observations from the same period, as an added-value proposition. These results illustrate that the real-time integration of high-throughput whole genome sequencing platforms available in consolidated CMLs into the public health surveillance system is not only credible but also advantageous to use for future surveillance and prediction purposes. This can be most effective when implemented for automatic detection systems that might include multiple layers of information and timely implementation of control strategies.

VL - 7 M3 - 10.3389/fpubh.2019.00150 ER - TY - Generic T1 - Disentangling the Link between Built/Non-Built Environment and Mental Health in Brussels Y1 - 2019 A1 - Ingrid Pelgrims A1 - H Keune A1 - Isabelle Thomas A1 - H Bastiaens A1 - R Remmen A1 - Tim S Nawrot A1 - S Trabelsi A1 - M Guyot A1 - L Lauwers A1 - Eva M De Clercq JF - The International Societies of Exposure Science (ISES) and Indoor Air Quality and Climate (ISIAQ) joint conference on the built, natural, and social environments: impacts on exposures, health and well-being, Kaunas, Lithuania, August 2019 ER - TY - JOUR T1 - Epidemiology and genotype 3 subtype dynamics of hepatitis E virus in Belgium, 2010 to 2017. JF - Euro Surveill Y1 - 2019 A1 - Vanessa Suin A1 - Sofieke Klamer A1 - Veronik Hutse A1 - Wautier, Magali A1 - Marjorie Meurisse A1 - Mona Abady A1 - Lamoral, Sophie A1 - Vera Verburgh A1 - Isabelle Thomas A1 - Bernard Brochier A1 - Lorenzo Subissi A1 - Steven Van Gucht KW - hepatitis E; HEV; surveillance; epidemiology; genotype; Belgium AB -

BackgroundHepatitis E virus (HEV) is an emerging public health concern in high-income countries and can cause acute and chronic hepatitis. Reported numbers of indigenously acquired HEV infection have increased in the past decade in many European countries. Since 2010, the National Reference Centre (NRC) for Hepatitis Viruses has been testing samples of suspected hepatitis E cases in Belgium.AimIn this surveillance report, we present the epidemiological trends of symptomatic HEV infections in Belgium, from the distribution by age, sex and geography to the molecular characterisation of the viral strains.MethodSerum samples of suspected cases sent to the NRC between 2010 and 2017 were analysed for the presence of HEV-specific IgM and RNA. Virus was sequenced for genotyping and phylogenetic analysis in all samples containing sufficient viral RNA.ResultsThe NRC reported an increase in the number of samples from suspected cases (from 309 to 2,663 per year) and in the number of laboratory-confirmed hepatitis E cases (from 25 to 117 per year). Among 217 sequenced samples, 92.6% were genotype 3 (HEV-3), followed by 6.5% of genotype 1 and 0.9% of genotype 4. HEV-3 subtype viruses were mainly 3f, 3c and 3e. HEV-3f was the most common subtype until 2015, while HEV-3c became the most common subtype in 2016 and 2017.ConclusionThe increasing trend of HEV diagnoses in Belgium may be largely explained by increased awareness and testing.

VL - 24 CP - 10 M3 - 10.2807/1560-7917.ES.2019.24.10.1800141 ER - TY - Generic T1 - Impact of the (Non-) Built Environment on Mental Health in Brussels : The NAMED PROJECT Y1 - 2019 A1 - Ingrid Pelgrims A1 - H Keune A1 - Isabelle Thomas A1 - H Bastiaens A1 - R Remmen A1 - Tim S Nawrot A1 - Eva M De Clercq AB -

Introduction

Mental illnesses are a growing problem in modern societies. While the impact of demographic or socioeconomic factors on these pathologies is acknowledged, the interaction with urbanized environment is little understood. This recently launched research project (NAMED) intends to investigate the impact of the (non-)built environment on mental health in Belgium, one of the most urbanized countries in Europe.

 

Methods

Methods will combine quantitative and qualitative research and focus on the country capital Brussels. First, an epidemiological study will be carried out based on the coupling between data from the national health surveys (2008 and 2013) and specifically developed indicators describing each participant's surroundings in terms of (non-)built environment, quality of air and noise.

Second, civil society, stakeholders and local or scientific experts will be consulted by means of multiple case studies, focus groups and extended peer evaluation.

 

Concerning the quantitative part of the project, the objective of the research is to look at the occurrence of various mental health disorders in relation to the individual’s environment. Both subjective and objective measures of the environment will be used.    First, the place of residence of the HIS (Health interview survey) participants will be characterized through a morphological typology of urban fabrics (mapping). This typology describes the Brussels territory based on GIS data and on the intertwinement of  “network morphology”, “built up morphology” and “ vegetation” elements at the regional scale. Secondly, PM 2.5, BC and NO2 exposure levels provided by IRCELINE will be interpolated for each participants residential address, based on the X,Y coordinates.

 

Finally, the environmental perception of the HIS participants will be analyzed through different dimensions: the nuisance at home (including air pollution, bad smell and noise from different sources) and the nuisance in the neighborhood (including volume and speed of traffic, accumulation of rubbish, vandalism, graffiti or deliberate damage of property, lack of access to parks or other green or recreational public places).

 

 

Results

Expected results are numerous. Quantitative and qualitative approaches will complement each other in order to better understand the impact of urban environment on mental health and the multiple underlying determinants involved at the individual level (age, gender, education, income, cultural, lifestyle, stress, social network factors, etc.) or the environmental level (type, quality, aesthetic, accessibility, safety, labelling, etc.). This research will be more generally informative on the question of the health and environmental inequality.

 

Discussion

By gathering experts in social, geographical, medical and epidemiology sciences, this project intends to get a comprehensive overview of the impact of the (non-)built environment on mental health. Conclusions will be relevant for a wide audience and will have various impacts for society. They will notably permit to inform decision makers and suggest concrete, evidence-based actions significant for public health, urban planning and management of nature.

JF - Etats généraux de l’air de Bruxelles, Brussels, Belgium, April 2019 ER - TY - Generic T1 - Development of a bioinformatics pipeline for the routine analysis of Influenza whole genome sequencing data Y1 - 2018 A1 - Qiang Fu A1 - Raf Winand A1 - Julien Van Braekel A1 - Cyril Barbezange A1 - Veronik Hutse A1 - Isabelle Thomas A1 - Steven Van Gucht A1 - Sigrid C.J. De Keersmaecker A1 - Nancy Roosens A1 - Kevin Vanneste JF - European Conference on Computational Biology 2018 conference (http://eccb18.org/). 8 – 12 September, 2018, Athens, Greece ER - TY - Generic T1 - Evaluation of an isothermal molecular point-of-care method for rapid detection of Respiratory Syncytial Virus and Influneza in routine conditions Y1 - 2018 A1 - O. Kamel A1 - A-I. de Moreau A1 - Isabelle Thomas A1 - B. Ricci A1 - I. Beukinga A1 - L. Blairon JF - ESPID 2018 ER - TY - Generic T1 - Monitoring of influenza: Whole-Genome Sequencing to provide insights in the disease severity Y1 - 2018 A1 - Laura Van Poelvoorde A1 - Sigrid C.J. De Keersmaecker A1 - Kevin Vanneste A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Xavier Saelens A1 - Cyril Barbezange A1 - Nancy Roosens JF - The 6th International Influenza Meeting, 2-4 September 2018 Münster, Germany ER - TY - RPRT T1 - Surveillance des infections à influenza saison 2017-2018 Y1 - 2018 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Nathalie Bossuyt A1 - Natalia Bustos Sierra A1 - V. Van Casteren KW - Grippe KW - INFLUENZA PB - Sciensano CY - Bruxelles ER - TY - RPRT T1 - Surveillance van griepinfecties in seizoen 2017-2018 Y1 - 2018 A1 - Nathalie Bossuyt A1 - Natalia Bustos Sierra A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - V. Van Casteren KW - Flu KW - Griep KW - INFLUENZA PB - Sciensano CY - Brussel ER - TY - RPRT T1 - Virological Surveillance of Influenza in Belgium Season 2017-2018 Y1 - 2018 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Steven Van Gucht A1 - Jeannine Weyckmans A1 - Ilham Fdillate A1 - Reinout Van Eycken A1 - Assia Hamouda A1 - Nathalie Bossuyt A1 - Sophie Quoilin A1 - Viviane Van Casteren A1 - Yolande Pirson VL - ISSN number: D/2018/14.440/40 ER - TY - JOUR T1 - Belgian Wildlife as Potential Zoonotic Reservoir of Hepatitis E Virus. JF - Transbound Emerg Dis Y1 - 2017 A1 - Thiry, D A1 - Mauroy, A A1 - Saegerman, C A1 - Licoppe, A A1 - Fett, T A1 - Isabelle Thomas A1 - Bernard Brochier A1 - Thiry, E A1 - Linden, A AB -

Hepatitis E is an acute human liver disease in healthy individuals but may become chronic in immunocompromised patients. It is caused by the hepatitis E virus (HEV) and can have a zoonotic origin, particularly in high-income countries. In this study, 383 sera from wild boars were selected for serology; for virological analyses, 69 sera and 61 livers from young wild boars were used. A total of 189 and 235 sera of, respectively, red deer and roe deer were collected for serological analysis. For virological analyses, 84 and 68 sera and 29 and 27 livers from, respectively, red and roe deer were sampled. An apparent seroprevalence of 34% (95% CI 29.71-39.46) was found in wild boars, of 1% (95% CI 0-2.4) in red deer and 3% (95% CI 0.8-4.2) in roe deer. To assess the ELISA screening prevalence, Western blot (WB) analyses were carried out, a receiver operating characteristic curve analysis was performed and different scenarios with varying ELISA specificities relative to WB were analysed. Seroprevalence remained high whatever the scenario in the wild boar population. In wild boar, 4 of 69 sera and 4 of 61 livers were detected as positive for HEV RNA. All sequences obtained from sera belonged to genotype HEV-3. HEV RNA, belonging to genotype HEV-3, was detected in one of 29 red deer livers. Wild boar can be considered as a host reservoir of the virus in Belgium. However, in contrast to the epidemiological role played by them in other countries, the low prevalence in deer makes these species an unlikely reservoir. This evidence needs further investigation to determine in which situation deer can serve as reservoir. These results also raise the question of the dynamics of HEV infection between wild fauna, domestic pigs and humans.

VL - 64 CP - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26518619?dopt=Abstract M3 - 10.1111/tbed.12435 ER - TY - RPRT T1 - Seasonal influenza surveillance (Belgique/België/Belgium) : Résumé saison 2016-2017 - Overzicht seizoen 2016-2017 - Overview season 2016-2017 Y1 - 2017 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Steven Van Gucht A1 - Nathalie Bossuyt A1 - Natalia Bustos Sierra A1 - Sophie Quoilin A1 - Viviane Van Casteren A1 - Y. Pirson KW - 2016 KW - 2017 KW - Belgium KW - overview season KW - Seasonal influenza surveillance PB - WIV-ISP CY - Brussels, Belgium ER - TY - Generic T1 - Human influenza surveillance in Belgium Y1 - 2016 A1 - Isabelle Thomas KW - Belgium KW - health KW - Human KW - INFLUENZA KW - Surveillance JF - One health seminar PB - NA CY - NA CP - WIV-ISP U1 - 37205 U2 - 25/05/2016 ER - TY - Generic T1 - Impact of green/blue spaces on specific morbidity and cause-specific mortality in Belgium: the GRESP-HEALTH project Y1 - 2016 A1 - Mariska Bauwelinck A1 - Casas,L. A1 - An Van Nieuwenhuyse A1 - Deboosere,P. A1 - Isabelle Thomas A1 - Nawrot,T. A1 - Bouland,C. A1 - Nemery,B. KW - Belgium KW - European KW - Impact KW - morbidity KW - mortality KW - ON JF - European OneHealth/EcoHealth workshop PB - NA CY - NA CP - Belgian Science Policy U1 - 2632 U2 - 6-7/10/2016 ER - TY - JOUR T1 - Improving influenza virological surveillance in Europe: strain-based reporting of antigenic and genetic characterisation data, 11 European countries, influenza season 2013/14 JF - Euro.Surveill Y1 - 2016 A1 - Broberg,E. A1 - Hungnes,O. A1 - Schweiger,B. A1 - Prosenc,K. A1 - Daniels,R. A1 - Guiomar,R. A1 - Ikonen,N. A1 - Kossyvakis,A. A1 - Pozo,F. A1 - Puzelli,S. A1 - Isabelle Thomas A1 - Waters,A. A1 - Wiman,A. A1 - Meijer,A. KW - a KW - age KW - AGE GROUP KW - AGE GROUPS KW - Age-group KW - ALL KW - Area KW - article KW - Case KW - composition KW - Control KW - Countries KW - data KW - Decision KW - Decision Making KW - disease KW - ecdc KW - ECONOMIC KW - electronic KW - Europe KW - European KW - European countries KW - Genetic KW - Group KW - INFLUENZA KW - IS KW - journal KW - LEVEL KW - levels KW - mechanism KW - p KW - Patient KW - patients KW - pilot KW - pilot study KW - prevention KW - proportion KW - SELECTED KW - study KW - Surveillance KW - Sweden KW - System KW - vaccine KW - VIRUS KW - Viruses AB - Influenza antigenic and genetic characterisation data are crucial for influenza vaccine composition decision making. Previously, aggregate data were reported to the European Centre for Disease Prevention and Control by European Union/European Economic Area (EU/EEA) countries. A system for collecting case-specific influenza antigenic and genetic characterisation data was established for the 2013/14 influenza season. In a pilot study, 11 EU/EEA countries reported through the new mechanism. We demonstrated feasibility of reporting strain-based antigenic and genetic data and ca 10% of influenza virus-positive specimens were selected for further characterisation. Proportions of characterised virus (sub)types were similar to influenza virus circulation levels. The main genetic clades were represented by A/StPetersburg/27/2011(H1N1)pdm09 and A/Texas/50/2012(H3N2). A(H1N1)pdm09 viruses were more prevalent in age groups (by years) < 1 (65%; p = 0.0111), 20-39 (50%; p = 0.0046) and 40-64 (55%; p = 0.00001) while A(H3N2) viruses were most prevalent in those >/= 65 years (62%*; p = 0.0012). Hospitalised patients in the age groups 6-19 years (67%; p = 0.0494) and >/= 65 years (52%; p = 0.0005) were more frequently infected by A/Texas/50/2012 A(H3N2)-like viruses compared with hospitalised cases in other age groups. Strain-based reporting enabled deeper understanding of influenza virus circulation among hospitalised patients and substantially improved the reporting of virus characterisation data. Therefore, strain-based reporting of readily available data is recommended to all reporting countries within the EU/EEA VL - 21 CP - 41 U1 - 37172 M3 - http://dx.doi.org/10.2807/1560-7917.ES.2016.21.41.30370 ER - TY - Generic T1 - Influenza surveillance, vaccinatie en antivirale therapie Y1 - 2016 A1 - Isabelle Thomas KW - EN KW - infecties KW - INFLUENZA KW - Surveillance KW - vaccinatie JF - Virale infecties bij immunocompromitteerde patiënten. PB - NA CY - NA CP - AZ Sint-Jan U1 - 39308 U2 - 22/10/2016 ER - TY - RPRT T1 - Virological surveillance of influenza in Belgium season 2015-2016 Y1 - 2016 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Hombrouck,A. A1 - Steven Van Gucht A1 - Weyckmans,J. A1 - Ullens,L. A1 - Abady,M. A1 - Fdillate,I. A1 - Nathalie Bossuyt A1 - Viviane Van Casteren A1 - Y. Pirson KW - Belgium KW - INFLUENZA KW - Surveillance PB - Johan Peeters/WIV-ISP CY - Bruxelles SN - D/2016/2505/40 U1 - 37183 ER - TY - Generic T1 - Alerte : l'épidémie de grippe atteint son pic. Y1 - 2015 A1 - Isabelle Thomas ED - Le Ligueur KW - de KW - Grippe U1 - 37062 ER - TY - Generic T1 - Epidémie de grippe. Y1 - 2015 A1 - Isabelle Thomas ED - RTBF - Matin vivacité KW - de KW - Grippe U1 - 37064 ER - TY - Generic T1 - Épidémie de grippe: Vaccination. Y1 - 2015 A1 - Isabelle Thomas ED - RTL KW - de KW - Grippe KW - Vaccination U1 - 37065 ER - TY - RPRT T1 - Influenza virological surveillance in Belgium season 2014-2015. Y1 - 2015 A1 - Hombrouck,A. A1 - Nathalie Bossuyt A1 - Viviane Van Casteren A1 - Steven Van Gucht A1 - Isabelle Thomas KW - Belgium KW - INFLUENZA KW - Surveillance PB - WHO CY - . U1 - 39174 ER - TY - Generic T1 - Que faire face à l'épidémie de grippe. Y1 - 2015 A1 - Isabelle Thomas ED - RTBF - Forum du Midi KW - de KW - Face KW - Grippe U1 - 37066 ER - TY - Generic T1 - Vaccine effectiveness estimates in preventing laboratory-confirmed mild and moderate-to-severe influenza in the Belgian population during the last 3 seasons. Y1 - 2015 A1 - Hombrouck,A. A1 - Viviane Van Casteren A1 - Steven Van Gucht A1 - Sophie Quoilin A1 - Françoise Wuillaume A1 - Isabelle Thomas A1 - Nathalie Bossuyt KW - Belgian KW - Belgian population KW - de KW - ET KW - INFLUENZA KW - Laboratory-confirmed KW - Maladies infectieuse KW - Mild KW - POPULATION KW - Seasons KW - Surveillance KW - vaccine JF - Séminaire Diagnostic et surveillance des maladies infectieuses. PB - NA CY - NA CP - WIV-ISP U1 - 38230 U2 - 21/05/2015 ER - TY - RPRT T1 - Virological Surveillance of Influenza in Belgium Season 2014-2015. Y1 - 2015 A1 - Isabelle Thomas A1 - Hombrouck,A. A1 - Steven Van Gucht A1 - Weyckmans,J. A1 - K. El Kadaani A1 - Abady,M. A1 - Fdillate,I. A1 - Nathalie Bossuyt A1 - Viviane Van Casteren A1 - Y. Pirson KW - Belgium KW - INFLUENZA KW - Surveillance PB - WIV-ISP CY - Brussels SN - D/2015/2505/60 U1 - 37049 ER - TY - Generic T1 - Wekelijkse nieuwsberichten en perscommuniqués in verband met de evolutie van de seizoensgriepepidemie in België. Y1 - 2015 A1 - Isabelle Thomas A1 - Hombrouck,A. A1 - Steven Van Gucht KW - België KW - de KW - EN U1 - 37058 ER - TY - JOUR T1 - Estimation of hepatitis E virus (HEV) pig seroprevalence using ELISA and Western blot and comparison between human and pig HEV sequences in Belgium. JF - Vet Microbiol Y1 - 2014 A1 - Thiry, Damien A1 - Mauroy, Axel A1 - Saegerman, Claude A1 - Isabelle Thomas A1 - Wautier, Magali A1 - Miry, Cora A1 - Czaplicki, Guy A1 - Berkvens, Dirk A1 - Praet, Nicolas A1 - van der Poel, Wim A1 - Cariolet, Roland A1 - Bernard Brochier A1 - Thiry, Etienne KW - Animals KW - Belgium KW - Blotting, Western KW - Enzyme-Linked Immunosorbent Assay KW - Genotype KW - Hepatitis E KW - Hepatitis E virus KW - Humans KW - Phylogeny KW - Sensitivity and Specificity KW - Seroepidemiologic Studies KW - Swine KW - Swine Diseases AB -

Zoonotic transmission of hepatitis E virus (HEV) is of special concern, particularly in high income countries were waterborne infections are less frequent than in developing countries. High HEV seroprevalences can be found in European pig populations. The aims of this study were to obtain prevalence data on HEV infection in swine in Belgium and to phylogenetically compare Belgian human HEV sequences with those obtained from swine. An ELISA screening prevalence of 73% (95% CI 68.8-77.5) was determined in Belgian pigs and a part of the results were re-evaluated by Western blot (WB). A receiver operating characteristic curve analysis was performed and scenarios varying the ELISA specificity relative to WB were analysed. The seroprevalences estimated by the different scenarios ranged between 69 and 81% and are in agreement with the high exposure of the European pig population to HEV. Pig HEV sequences were genetically compared to those detected in humans in Belgium and a predominance of genotype 3 subtype f was shown in both swine and humans. The high HEV seroprevalence in swine and the close phylogenetic relationships between pig and human HEV sequences further support the risk for zoonotic transmission of HEV between humans and pigs.

VL - 172 CP - 3-4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/24975642?dopt=Abstract M3 - 10.1016/j.vetmic.2014.06.004 ER - TY - JOUR T1 - Evaluation of 3 rapid influenza diagnostic tests during the 2012-2013 epidemic: influences of subtype and viral load. JF - Diagn Microbiol Infect Dis Y1 - 2014 A1 - Busson, Laurent A1 - Hallin, Marie A1 - Isabelle Thomas A1 - De Foor, Marc A1 - Vandenberg, Olivier KW - ADOLESCENT KW - Adult KW - Aged KW - Aged, 80 and over KW - Belgium KW - Child KW - Child, Preschool KW - Diagnostic Tests, Routine KW - Disease Outbreaks KW - Female KW - Humans KW - Infant KW - Infant, Newborn KW - Influenza A Virus, H1N1 Subtype KW - Influenza A Virus, H3N2 Subtype KW - Influenza, Human KW - Male KW - middle aged KW - Prospective Studies KW - Real-Time Polymerase Chain Reaction KW - Sensitivity and Specificity KW - Viral Load KW - Young adult AB -

This article evaluates the performance of 3 rapid influenza diagnostic tests (RIDTs), in correlation with the influenza subtypes and the viral load. A total of 236 samples were prospectively analyzed with BinaxNOW Influenza A/B, Directigen EZ Flu A and B, and bioNexia Influenza A+B. The results were compared to cell cultures and real-time polymerase chain reaction. Positive samples were further subtyped. Thirty-seven samples were positive for influenza A, and 57, for influenza B. For A(H1N1), the sensitivities were 71.42% for BinaxNOW, 78.57% for Directigen, and 67.85% for bioNexia. Eight samples were positive for A(H3N2), and only the bioNexia test had 1 false-negative result. Lowest sensitivities were observed for influenza B/Yamagata, (56.86% for BinaxNOW and Directigen and 39.21% for bioNexia). The 3 evaluated RIDTs were more efficient at detecting influenza A(H3N2) than for A(H1N1) and B/Yamagata. Highest viral loads in the samples were associated with better rate of detection.

VL - 80 CP - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25241638?dopt=Abstract M3 - 10.1016/j.diagmicrobio.2014.08.015 ER - TY - Generic T1 - NeXSplorer.iph: Development of next generation sequencing data analysis tools in support of a fast response for public health and food chain safety Y1 - 2014 A1 - Sigrid C.J. De Keersmaecker A1 - Sophie Bertrand A1 - Wesley Mattheus A1 - Philippe Herman A1 - Katelijne Dierick A1 - N Botteldoorn A1 - Sarah Denayer A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Deforce,D. A1 - Marchal,K. A1 - Nancy Roosens KW - a KW - analysi KW - analysis KW - application KW - applications KW - bioinformatics KW - data KW - Development KW - food KW - Food Chain KW - GMO KW - health KW - NGS KW - public KW - public health KW - Public-health JF - Applications of Next Generation Sequencing for public health PB - NA CY - NA CP - =WIV-ISP U1 - 38637 U2 - 10/10/2014 ER - TY - JOUR T1 - No evidence of coronavirus infection by reverse transcriptase-PCR in bats in Belgium. JF - J Wildl Dis Y1 - 2014 A1 - Steven Van Gucht A1 - Nazé, Florence A1 - El Kadaani, Karim A1 - Bauwens, Danielle A1 - Aurélie Francart A1 - Bernard Brochier A1 - Françoise Wuillaume A1 - Isabelle Thomas KW - Animals KW - Belgium KW - Chiroptera KW - Coronavirus KW - Coronavirus Infections KW - Feces KW - Reverse Transcriptase Polymerase Chain Reaction AB -

No coronavirus was detected by PCR in lung and intestine samples of 100 bats, mostly common pipistrelles (Pipistrellus pipistrellus), collected dead between 2008 and 2013 for rabies surveillance in Belgium. The negative results contrast with the high prevalence of coronaviruses detected in fecal pellets from live-captured bats in some European countries.

VL - 50 CP - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25098304?dopt=Abstract M3 - 10.7589/2013-10-269 ER - TY - Generic T1 - ORIENT-EXPRESS in times of crisis Y1 - 2014 A1 - Sylvia Broeders A1 - Sigrid C.J. De Keersmaecker A1 - Steven Van Gucht A1 - Isabelle Thomas A1 - Vanessa Suin A1 - Katelijne Dierick A1 - N Botteldoorn A1 - Steven Van Borm A1 - Nancy Roosens KW - application KW - applications KW - arbovirus KW - crisis KW - detection KW - gasto-intestinal parasites KW - GMO KW - health KW - Luminex KW - NGS KW - public KW - public health KW - Public-health KW - qPCR KW - time KW - Times JF - Applications of Next Generation Sequencing for public health PB - NA CY - NA CP - WIV-ISP U1 - 4873 U2 - 10/10/2014 ER - TY - RPRT T1 - Virological Surveillance of Influenza in Belgium Season 2013-2014. National influenza Centre (WHO). Y1 - 2014 A1 - Isabelle Thomas A1 - Hombrouck,A. A1 - Steven Van Gucht A1 - Weyckmans,J. A1 - Bauwens,D. A1 - K. El Kadaani A1 - Abady,M. A1 - Fdillate,I. A1 - Nathalie Bossuyt A1 - Viviane Van Casteren A1 - Y. Pirson KW - Belgium KW - INFLUENZA KW - national KW - Surveillance KW - WHO AB - NA PB - WIV-ISP CY - Brussels SN - D/2014/2505/65 U1 - 39214 ER - TY - JOUR T1 - Duplex molecular assay intended for point-of-care diagnosis of influenza A/B virus infection299 JF - J.Clin.Microbiol. Y1 - 2013 A1 - Wu,L.T. A1 - Isabelle Thomas A1 - Curran,M.D. A1 - Ellis,J.S. A1 - Parmar,S. A1 - Goel,N. A1 - Sharma,P.I. A1 - Allain,J.P. A1 - Lee,H.H. KW - a KW - acid KW - alternative KW - an KW - article KW - Belgium KW - Clinical KW - Common KW - comparing KW - Control KW - detection KW - Development KW - Diagnosis KW - Diagnostics KW - disease KW - electronic KW - Genome KW - health KW - identification KW - im KW - INFECTION KW - INFLUENZA KW - initiation KW - intervention KW - IS KW - journal KW - Laboratories KW - management KW - measure KW - measures KW - medical KW - method KW - Molecular KW - observed KW - ON KW - pathogen KW - performance KW - Point of care KW - present KW - public KW - public health KW - Public-health KW - reducing KW - Respiratory KW - result KW - results KW - Sample KW - SB - IM KW - SENSITIVITY KW - Sensitivity and Specificity KW - specificity KW - Swab KW - System KW - technology KW - Test KW - TESTING KW - tests KW - time KW - treatment KW - United Kingdom KW - United-kingdom KW - Universities KW - university KW - use KW - VIRUS KW - Viruses AB - Early diagnosis and management of influenza virus infection directly correlates with the effectiveness in disease control. Current molecular influenza virus tests were designed for use in diagnostic testing facilities, where sophisticated equipment and highly trained technicians are available. A longer turnaround time for the centralized testing than when testing near the sample source could delay the initiation of medical intervention, thereby reducing the efficacy of antiviral treatment. The new assay, the SAMBA (simple amplification-based assay) Flu duplex test, is a dipstick-based molecular assay developed to provide a simple, accurate, and cost-effective solution for the diagnosis of influenza A/B viruses intended for near-patient testing. The test presents an alternative format of influenza virus molecular testing that utilizes isothermal amplification and visual detection of nucleic acid on a test strip. The entire test procedure (extraction, amplification, and detection) is integrated into an enclosed semiautomated system. Analytically, the SAMBA Flu duplex test detects 95 and 85 copies of viral genomes for influenza A and B viruses, respectively, with no cross-reactivity observed against other common respiratory pathogens. The clinical performance was established by blind testing of 328 nasal/throat and nasopharyngeal swab specimens from the United Kingdom and Belgium and comparing the results with the quantitative reverse transcription-PCR method routinely used in two public health laboratories. The SAMBA Flu duplex test showed a clinical sensitivity and specificity of 100% and 97.9% for influenza virus A and 100% and 100% for influenza virus B. The test provides a new technology that could facilitate simple and timely identification of influenza virus infection, potentially resulting in more efficient control measures VL - 51 CP - 9 U1 - 38474 M3 - http://dx.doi.org/10.1128/JCM.00740-13 ER - TY - Generic T1 - Emergence of the deadly Middle East Respiratory Syndrome coronavirus: are bats to blame? Y1 - 2013 A1 - Steven Van Gucht A1 - Françoise Wuillaume A1 - K. El Kadaani A1 - A. Francart A1 - Bernard Brochier A1 - Naze,F. A1 - Isabelle Thomas KW - bat KW - bats KW - Belgian KW - Congresses KW - Coronavirus KW - disease KW - Middle East KW - Respiratory KW - Societies KW - Society JF - Fifth Belgian Wildlife Disease Society (BWDS) Congress PB - NA CY - NA CP - Belgian Wildlife Disease Society (BWDS) U1 - 38421 U2 - 18/10/2013 ER - TY - JOUR T1 - Hepatitis E virus: an underdiagnosed cause of chronic hepatitis in renal transplant recipients31090 JF - Transpl.Infect.Dis. Y1 - 2012 A1 - Halleux,D. A1 - Kanaan,N. A1 - B. Kabamba Mukadi A1 - Isabelle Thomas A1 - Hassoun,Z. KW - a KW - an KW - article KW - AS KW - Belgium KW - Brussels KW - Case KW - cause KW - chronic KW - de KW - Diagnosis KW - e KW - electronic KW - Hepatitis KW - Hepatitis E KW - Hepatitis E virus KW - im KW - INFECTION KW - IS KW - journal KW - Literature KW - Patient KW - patients KW - reducing KW - RENAL KW - report KW - REVIEW KW - SB - IM KW - Therapy KW - VIRUS AB - Hepatitis E virus (HEV) infection can evolve to chronic hepatitis in immunocompromised patients leading to rapidly progressive cirrhosis. Proper diagnosis is therefore important, as reducing immunosuppressive therapy can allow clearance of the virus. We report a case of chronic HEV infection in a renal transplant recipient that went undiagnosed for many years, discuss the therapeutic options, and review the current available literature VL - 14 CP - 1 U1 - 38219 M3 - http://dx.doi.org/10.1111/j.1399-3062.2011.00677.x ER - TY - JOUR T1 - Prospective evaluation of Coris Influ-A&B Respi-Strip and of BinaxNOW Influenza A&B assay against viral culture and real-time PCR assay for detection of 2009 pandemic influenza A/H1N1v in Belgian patients33848 JF - Acta Clin.Belg. Y1 - 2012 A1 - Reynders,M. A1 - De Foor,M. A1 - Maaroufi,Y. A1 - Isabelle Thomas A1 - Vergison,A. A1 - Debulpaep,S. A1 - Vandenberg,O. A1 - Crokaert,F. KW - 2009 KW - Adult KW - adults KW - age KW - article KW - Belgian KW - Belgium KW - Brussels KW - Bruxelles KW - CHILDREN KW - culture KW - de KW - Design KW - detection KW - Diagnosis KW - differences KW - EVALUATION KW - hospital KW - hospitals KW - illness KW - illnesses KW - im KW - INFLUENZA KW - IS KW - journal KW - Less KW - microbiologie KW - observed KW - paediatric KW - pandemic KW - Patient KW - patients KW - PCR KW - performance KW - Print KW - public KW - real time PCR KW - Real-time PCR KW - Respiratory KW - result KW - results KW - Sample KW - Samples KW - SB - IM KW - SENSITIVITY KW - Sensitivity and Specificity KW - specific KW - specificity KW - Still KW - study KW - study design KW - Swab KW - Test KW - tests KW - Type AB - PURPOSE: Evaluation of the performance of two rapid (15') antigen detection tests (RAT), BinaxNOW Influenza A&B and Coris Influ-A&B Respi-Strip for the detection of A(H1N1)v2009. STUDY DESIGN: Between July 2009 and November 2009, 4105 respiratory specimens from patients with influenza-like illness attending seven public hospitals in Brussels were prospectively examined by two immunochromatographic RAT, followed by viral culture and/or specific real-time RT-PCR. RESULTS: Samples consisted predominantly of nasopharyngeal aspirates (NPA-41%), nasopharyngeal (NPS-37%) and throat swabs (TS-14%). The sensitivity and specificity of Coris RAT and BinaxNOW RAT were 36.6% and 99.7%, and 47% and 98.7% respectively compared to culture; and 33.7% and 99.6%; and 46.5% and 98.8% compared to RT-PCR. Significant differences in sensitivity could be observed when splitting up the samples by sample type and patient's age. NPA gave by far the highest sensitivities: 51.1- 62% for Coris compared to culture and 62.6-78.4% for BinaxNOW. Sensitivities in paediatric NPS varied less between different hospitals (34-41.9%) being still much higher than in adult NPS (11.4-20%). TS resulted in unsatisfactory results: 13% sensitivity in children and 10.5% in adults. CONCLUSIONS: Both RAT showed excellent specificities, but insufficient sensitivities. Consequently, negative results should be confirmed. NPA are clearly superior to NPS orTS, and they stay the sample of choice for viral diagnosis VL - 67 CP - 2 U1 - 38333 ER - TY - JOUR T1 - Recommendations in the event of a suspected transfusion-related acute lung injury (TRALI). JF - Acta Clin Belg Y1 - 2012 A1 - P Van der Linden A1 - M Lambermont A1 - AM. Dierick A1 - R Hübner A1 - Y Benoit A1 - D De Backer A1 - R De Paep A1 - A Ferrant A1 - Latinne, D A1 - L Muylle A1 - D Selleslag A1 - B Szabo A1 - Isabelle Thomas A1 - Vandekerckhove,B. A1 - V Deneys KW - Acute Lung Injury KW - Antibodies, Antineutrophil Cytoplasmic KW - Autoantibodies KW - Belgium KW - Blood Donors KW - Diagnosis, Differential KW - HLA Antigens KW - Humans KW - Oxygen Inhalation Therapy KW - Positive-Pressure Respiration KW - Respiratory Distress Syndrome, Adult KW - Transfusion Reaction AB -

The following recommendations, which aim at improving the clinical diagnosis ofTRALI and the laboratory investigations that can support it, were drawn up by a working group of the Superior Health Council. TRALI is a complication of blood transfusion that is both serious and underreported. Systematic reporting may help to develop preventive actions. Therefore, the Superior Health Council recommends that there should be a more stringent surveillance of patients who receive a blood component transfusion. The clinician should pay very close attention to any change in the patient's respiratory status (cf. dyspnoea and arterial desaturation), which should be notified systematically to the haemovigilance contact person in the hospital.

VL - 67 CP - 3 M3 - 10.2143/ACB.67.3.2062656 ER - TY - JOUR T1 - Viral aetiology of influenza-like illness in Belgium during the influenza A(H1N1)2009 pandemic. JF - Eur J Clin Microbiol Infect Dis Y1 - 2012 A1 - Hombrouck, A A1 - Martine Sabbe A1 - Viviane Van Casteren A1 - Françoise Wuillaume A1 - D Hue A1 - Reynders, M A1 - Gérard, C A1 - Bernard Brochier A1 - Van Eldere, J A1 - Van Ranst, M A1 - Isabelle Thomas KW - ADOLESCENT KW - Adult KW - Age Distribution KW - Aged KW - Aged, 80 and over KW - Belgium KW - Child KW - Child, Preschool KW - Female KW - Humans KW - Infant KW - Infant, Newborn KW - Male KW - middle aged KW - Respiratory Tract Diseases KW - Virus Diseases KW - Viruses KW - Young adult AB -

The purpose of this investigation was to determine the proportion of influenza-like illness (ILI) attributable to specific viruses during the influenza A(H1N1)2009 pandemic and to describe the demographic and clinical characteristics of ILI due to respiratory viruses in Belgium. Nasopharyngeal swabs were collected from ILI patients by general practitioners (GPs) and paediatricians (PediSurv) and analysed for viruses. Of 139 samples collected from children <5 years of age by PediSurv, 86 were positive, including 28 influenza (20%), 27 respiratory syncytial virus (RSV) (19%), 21 rhinovirus (17%), 12 human metapneumovirus (hMPV) (9%) and ten parainfluenza virus (PIV) (7%). Of 810 samples received from GPs, 426 were influenza (53%). Of 312 influenza-negative samples, 41 were rhinovirus (13%), 13 RSV (4%), 11 PIV (4%) and three hMPV (1%). Influenza mostly affected the 6-15 years old age group. Other respiratory viruses were commonly detected in the youngest patients. Similar clinical symptoms were associated with different respiratory viruses. Influenza A(H1N1)2009 was the most detected virus in ILI patients during the 2009-2010 winter, suggesting a good correlation between ILI case definition and influenza diagnosis. However, in children under 5 years of age, other respiratory viruses such as RSV were frequently diagnosed. Furthermore, our findings do not suggest that the early occurrence of the influenza A(H1N1)2009 epidemic impacted the RSV epidemic in Belgium.

VL - 31 CP - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21901635?dopt=Abstract M3 - 10.1007/s10096-011-1398-4 ER - TY - JOUR T1 - Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional study36562 JF - BMC.Fam.Pract. Y1 - 2011 A1 - Michiels,B. A1 - Isabelle Thomas A1 - Van Royen,P. A1 - Coenen,S. KW - a KW - Absence KW - additional KW - an KW - Antwerp KW - Area KW - Area Under Curve KW - article KW - Belgium KW - care KW - Clinical KW - CONTACT KW - CONTACTS KW - Context KW - cross sectional KW - cross sectional studies KW - Cross-sectional KW - cross-sectional studies KW - Diagnosis KW - Diagnosis,Differential KW - electronic KW - epidemic KW - Epidemics KW - EPIDEMIOLOGICAL KW - epidemiology KW - general KW - General practice KW - GENERAL PRACTITIONER KW - general practitioners KW - General-practice KW - Humans KW - illness KW - illnesses KW - im KW - Increase KW - Increases KW - INFECTION KW - infections KW - INFLUENZA KW - Influenza,Human KW - INFORMATION KW - IS KW - isolation & purification KW - IT KW - journal KW - Less KW - Likelihood KW - method KW - methods KW - MODEL KW - Objective KW - ON KW - Orthomyxoviridae KW - Patient KW - patients KW - performance KW - period KW - Point of care KW - Practice KW - practitioner KW - Practitioners KW - Predictive Value of Tests KW - primary care KW - Primary Health Care KW - Ratio KW - Ratios KW - Research KW - Research Support KW - Respiratory KW - result KW - results KW - Reverse Transcriptase Polymerase Chain Reaction KW - Roc Curve KW - Sample KW - Samples KW - SB - IM KW - SENSITIVITY KW - Sensitivity and Specificity KW - sentinel KW - specific KW - specificity KW - statistics & numerical data KW - Still KW - study KW - Swab KW - Symptom KW - Symptoms KW - Temperature KW - Test KW - tests KW - time KW - Times KW - Universities KW - university KW - variables KW - virology KW - VIRUS KW - Winter AB - BACKGROUND: During an influenza epidemic prompt diagnosis of influenza is important. This diagnosis however is still essentially based on the interpretation of symptoms and signs by general practitioners. No single symptom is specific enough to be useful in differentiating influenza from other respiratory infections. Our objective is to formulate prediction rules for the diagnosis of influenza with the best diagnostic performance, combining symptoms, signs and context among patients with influenza-like illness. METHODS: During five consecutive winter periods (2002-2007) 138 sentinel general practitioners sampled (naso- and oropharyngeal swabs) 4597 patients with an influenza-like illness (ILI) and registered their symptoms and signs, general characteristics and contextual information. The samples were analysed by a DirectigenFlu-A&B and RT-PCR tests. 4584 records were useful for further analysis.Starting from the most relevant variables in a Generalized Estimating Equations (GEE) model, we calculated the area under the Receiver Operating Characteristic curve (ROC AUC), sensitivity, specificity and likelihood ratios for positive (LR+) and negative test results (LR-) of single and combined signs, symptoms and context taking into account pre-test and post-test odds. RESULTS: In total 52.6% (2409/4584) of the samples were positive for influenza virus: 64% (2066/3212) during and 25% (343/1372) pre/post an influenza epidemic. During and pre/post an influenza epidemic the LR+ of 'previous flu-like contacts', 'coughing', 'expectoration on the first day of illness' and 'body temperature above 37.8 degrees C' is 3.35 (95%CI 2.67-4.03) and 1.34 (95%CI 0.97-1.72), respectively. During and pre/post an influenza epidemic the LR- of 'coughing' and 'a body temperature above 37.8 degrees C' is 0.34 (95%CI 0.27-0.41) and 0.07 (95%CI 0.05-0.08), respectively. CONCLUSIONS: Ruling out influenza using clinical and contextual information is easier than ruling it in. Outside an influenza epidemic the absence of cough and fever (> 37,8 degrees C) makes influenza 14 times less likely in ILI patients. During an epidemic the presence of 'previous flu-like contacts', cough, 'expectoration on the first day of illness' and fever (>37,8 degrees C) increases the likelihood for influenza threefold. The additional diagnostic value of rapid point of care tests especially for confirming influenza still has to be established VL - 12 U1 - 38299 M3 - http://dx.doi.org/10.1186/1471-2296-12-4 ER - TY - JOUR T1 - Does country influence the health burden of informal care? An international comparison between Belgium and Great Britain36539 JF - Soc.Sci.Med. Y1 - 2011 A1 - Dujardin,C. A1 - Farfan-Portet,M.I. A1 - Mitchell,R. A1 - Popham,F. A1 - Isabelle Thomas A1 - Lorant,V. KW - a KW - Activity KW - Adult KW - an KW - Area KW - Areas KW - article KW - AS KW - association KW - Belgium KW - burden KW - care KW - Caregivers KW - Censuses KW - Comparative Study KW - Comparison KW - Cost of Illness KW - Countries KW - de KW - effect KW - effects KW - electronic KW - European KW - European countries KW - Female KW - Great Britain KW - health KW - Health status KW - Health-status KW - home care KW - Humans KW - im KW - informal care KW - International KW - IS KW - journal KW - Logistic KW - Logistic Models KW - logistic regression KW - Logistic-regression KW - Long-term KW - Male KW - methodology KW - middle aged KW - ON KW - Paper KW - Patient KW - patients KW - POLICIES KW - POLICY KW - regression KW - Research KW - Research Design KW - Research Support KW - residence KW - result KW - results KW - SB - IM KW - Self Report KW - Social Environment KW - status KW - study KW - Type KW - US AB - The aim of this paper is to determine whether the association between the provision of informal care and the health status of caregivers is affected by the country of residence. We focus on two European countries, Belgium and Great Britain, and develop a methodology, which consists of matching a subset of areas from Britain with areas in Belgium that are demographically and socioeconomically similar. These pairs of areas are then used as fixed effects in logistic regressions of poor health. This allows us to take into account the influence of area type on health and to remove the influence of these local contextual characteristics from the estimated country effects. Results suggest that, although caregiving is more prevalent in Britain, the health burden associated with heavy caregiving activities is lower in Britain than in Belgium. This may be explained by the better targeting of long-term home care policies towards more severely dependent patients in Britain than in Belgium VL - 73 CP - 8 U1 - 36539 M3 - http://dx.doi.org/10.1016/j.socscimed.2011.07.016 ER - TY - JOUR T1 - Immunogenicity of an adjuvanted 2009 pandemic influenza A (H1N1) vaccine in haemodialysed patients JF - Nephrol.Dial.Transplant. Y1 - 2011 A1 - Labriola,L. A1 - Hombrouck,A. A1 - Marechal,C. A1 - Steven Van Gucht A1 - Bernard Brochier A1 - Isabelle Thomas A1 - Jadoul,M. A1 - Goubau,P. KW - 0 KW - 2009 KW - Adjuvants,Immunologic KW - administration & dosage KW - Adult KW - Aged KW - Aged,80 and over KW - an KW - antibodies KW - Antibody KW - article KW - AS KW - at KW - Belgium KW - Brussels KW - Case-Control Studies KW - Comparative Study KW - Control KW - de KW - electronic KW - Female KW - Follow-Up Studies KW - GM KW - Hemagglutination Inhibition Tests KW - High risk KW - HIGH-RISK KW - Humans KW - im KW - immunology KW - Increase KW - INFLUENZA KW - Influenza A Virus,H1N1 Subtype KW - Influenza Vaccines KW - Influenza,Human KW - IS KW - journal KW - Kidney Failure,Chronic KW - LEVEL KW - Male KW - males KW - method KW - methods KW - middle aged KW - observed KW - ON KW - p KW - pandemic KW - Pandemics KW - Patient KW - patients KW - prevention & control KW - Prognosis KW - Prospective Studies KW - Renal Dialysis KW - result KW - results KW - SB - IM KW - Still KW - study KW - Survival Rate KW - Therapy KW - Vaccination KW - vaccine KW - vaccines KW - Young adult AB - BACKGROUND: The 2009 pandemic of influenza A (H1N1) prompted an urgent worldwide vaccination campaign, especially of high-risk subjects, such as maintenance haemodialysis (HD) patients. Still the immunogenicity of the pandemic A (H1N1) vaccine in HD patients is unknown. METHODS: We prospectively studied the immunogenicity of a monovalent adjuvanted influenza A/California/2009 (H1N1) vaccine (Pandemrix, GSK Biologicals, Rixensart, Belgium) in HD patients and controls. Antibody level was measured using a seroneutralization assay before (D(0)) and 30 days after (D(30)) a single 3.75 mug vaccine dose. Specimens were tested in quadruplicates. Geometric mean (GM) antibody titers were determined in each subject at D(0) and D(30). Seroconversion was defined as an increase in GM titers by a factor 4 or more. RESULTS: Fifty-three adult HD patients [aged 71 +/- 10, 58.5% males, on HD for a median of 38 (3 - 146) months] and 32 control subjects (aged 47.3 +/- 14, 31.3% males) were analyzed. Baseline GM titers were similar in HD patients and controls [7.9 (6.6 - 9.6) vs 10 (6 - 17); p = 0.69]. Seroconversion was observed in 30 (93.8%) controls and 34 (64.2%) HD patients (p = 0.002). In addition, GM titers at D(30) were significantly higher in controls than in HD patients [373 ( VL - 26 CP - 4 U1 - 36552 M3 - http://dx.doi.org/10.1093/ndt/gfq782 ER - TY - JOUR T1 - Influenza A/H1N1 vaccine in patients treated by kidney transplant or dialysis: a cohort study36521 JF - Clin.J.Am.Soc.Nephrol. Y1 - 2011 A1 - Broeders,N.E. A1 - Hombrouck,A. A1 - Lemy,A. A1 - Wissing,K.M. A1 - Racape,J. A1 - Gastaldello,K. A1 - Massart,A. A1 - Steven Van Gucht A1 - Weichselbaum,L. A1 - De Mul,A. A1 - Bernard Brochier A1 - Isabelle Thomas A1 - Abramowicz,D. KW - 0 KW - 2009 KW - a KW - administration & dosage KW - Adult KW - adverse effects KW - Aged KW - Agent KW - Agents KW - alpha-Tocopherol KW - Analysis of Variance KW - antibodies KW - Antibodies,Neutralizing KW - Antibodies,Viral KW - Antibody KW - Antigens KW - article KW - Belgium KW - blood KW - Brussels KW - Case-Control Studies KW - Chi-Square Distribution KW - Class KW - clinic KW - Cohort Studies KW - Cohort study KW - Combination KW - Confidence Intervals KW - Control KW - data KW - Design KW - disease KW - DRUG KW - Drug Combinations KW - electronic KW - Female KW - GM KW - Histocompatibility Antigens Class I KW - Histocompatibility Antigens Class II KW - hospital KW - Humans KW - i KW - im KW - Immunization KW - immunology KW - Immunosuppressive Agents KW - improve KW - Increase KW - INFLUENZA KW - Influenza A Virus,H1N1 Subtype KW - Influenza Vaccines KW - Influenza,Human KW - interval KW - IS KW - journal KW - Kidney KW - Kidney Failure,Chronic KW - Kidney Transplantation KW - Luminex KW - Male KW - measurement KW - measurements KW - middle aged KW - objectives KW - ODDS RATIO KW - p KW - pandemic KW - PARTICIPANTS KW - Patient KW - patients KW - Polysorbates KW - POPULATION KW - Populations KW - prevalence KW - prevention & control KW - proportion KW - Ratio KW - Ratios KW - recommendation KW - Recommendations KW - regression analysis KW - RENAL KW - Renal Dialysis KW - Research KW - Research Support KW - response KW - result KW - results KW - SB - IM KW - serum KW - Squalene KW - study KW - surgery KW - technology KW - Therapy KW - Time Factors KW - Treatment Outcome KW - Vaccination KW - vaccine KW - vaccines KW - virology AB - BACKGROUND AND OBJECTIVES: In 2009, the pandemic influenza A/H1N1 accounted for worldwide recommendations about vaccination. There are few data concerning the immunogenicity or the security of the adjuvanted-A/H1N1 vaccine in transplanted and hemodialyzed patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Sera from 21 controls, 53 hemodialyzed (HD) patients, and 111 renal transplant recipients (RT) were sampled before (T0) and 1 month after (T1) a single dose of Pandemrix(R) vaccine (GSK Biologicals, AS03-adjuvanted). We measured the neutralizing antibodies against A/H1N1/2009, the geometric mean (GM) titers, the GM titer ratios (T1/T0) with 95% confidence intervals, and the seroconversion rate (responders: >/=4-fold increase in titer). The HLA and MICA immunization was determined by Luminex technology. RESULTS: The GM titer ratio was 38 (19 to 78), 9 (5 to 16), and 5 (3 to 6) for controls, HD patients, and RT patients, respectively (P < 0.001). The proportion of responders was 90%, 57%, and 44%, respectively (P < 0.001). In RT patients, the prevalence of histocompatibility leukocyte antigen (HLA) class I, histocompatibility leukocyte antigen class II, and MHC class I-related chain A immunization, was, respectively, 15%, 14%, and 14% before and 14%, 14%, and 11% after vaccination (P = 1, 1, and 0.39). CONCLUSIONS: The influenza A/H1N1-adjuvanted vaccine is of limited efficacy but is safe in renal disease populations. The humoral response is lower in transplanted versus hemodialyzed patients. Further studies are needed to improve the efficacy of vaccination in those populations VL - 6 CP - 11 U1 - 38093 M3 - http://dx.doi.org/10.2215/CJN.04670511 ER - TY - JOUR T1 - Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe JF - Euro.Surveill Y1 - 2011 A1 - Amato-Gauci,A. A1 - Zucs,P. A1 - Snacken,R. A1 - Ciancio,B. A1 - Lopez,V. A1 - Broberg,E. A1 - Penttinen,P. A1 - Nicoll,A. A1 - European Influenza Surveillance Network EISN A1 - Isabelle Thomas KW - 2009 KW - article KW - Control KW - Diagnosis KW - disease KW - Disease Notification KW - electronic KW - epidemiology KW - Europe KW - European KW - European Union KW - Humans KW - im KW - incidence KW - INFLUENZA KW - Influenza A Virus,H1N1 Subtype KW - Influenza,Human KW - IS KW - isolation & purification KW - journal KW - pandemic KW - Pandemics KW - Population Surveillance KW - prevention KW - REVIEW KW - Risk Factors KW - SB - IM KW - Severity of Illness Index KW - statistics & numerical data KW - Surveillance KW - Sweden KW - trend KW - trends KW - virology AB -

Surveillance trends of the 2009 influenza A(H1N1) pandemic in Europe

VL - 16 CP - 26 U1 - 36511 ER - TY - JOUR T1 - Case finding of Influenza A(H1N1)2009 in a non-exposed population in the early pandemic36885 JF - Archives of Public Health Y1 - 2010 A1 - Sophie Quoilin A1 - Isabelle Thomas A1 - Gerard,C. A1 - Bernard Brochier A1 - Bots,J. A1 - Lokietek,S. A1 - Robesyn,E. A1 - Françoise Wuillaume A1 - Gaetan Muyldermans KW - a KW - Case KW - INFLUENZA KW - pandemic KW - POPULATION AB - Not available VL - 68 U1 - 38328 M3 - http://dx.doi.org/10.1186%2F0778-7367-68-2-53 ER - TY - JOUR T1 - Clinical influenza surveillance of Influenza A(H1N1) 2009 pandemic through the network of Sentinel General Practitioners36890 JF - Archives of Public Health Y1 - 2010 A1 - Viviane Van Casteren A1 - Karl Mertens A1 - Jérôme Antoine A1 - Simeon Wanyama A1 - Isabelle Thomas A1 - Nathalie Bossuyt KW - 2009 KW - Clinical KW - general KW - GENERAL PRACTITIONER KW - general practitioners KW - INFLUENZA KW - Network KW - pandemic KW - practitioner KW - Practitioners KW - sentinel KW - Surveillance AB - Not available VL - 68 U1 - 36890 M3 - http://dx.doi.org/10.1186%2F0778-7367-68-2-62 ER - TY - JOUR T1 - Confirmation diagnosis of Influenza A(H1N1)2009 by Belgian sentinel laboratories during the epidemic phase36883 JF - Archives of Public Health Y1 - 2010 A1 - Gaetan Muyldermans A1 - Ducoffre,G. A1 - Isabelle Thomas A1 - Clement,F. A1 - De Laere,E. A1 - Y. Glupczynski A1 - Hougardy,N. A1 - K. Lagrou A1 - P.E. Léonard A1 - Meex,C. A1 - Denis Piérard A1 - Raymaekers,M. A1 - Reynders,M. A1 - Stalpaert,M. A1 - Verstrepen,W. A1 - Sophie Quoilin KW - Belgian KW - Diagnosis KW - epidemic KW - INFLUENZA KW - Laboratories KW - sentinel AB - Not available VL - 68 U1 - 38306 M3 - http://dx.doi.org/10.1186%2F0778-7367-68-2-76 ER - TY - JOUR T1 - Influenza surveillance in children: First experiences with the Belgian Paediatric Surveillance system "Pedisurv" JF - Archives of Public Health Y1 - 2010 A1 - D Hue A1 - Jérôme Antoine A1 - Yves Dupont A1 - Van Eldere,J. A1 - Marc Van Ranst A1 - Martine Sabbe A1 - Isabelle Thomas KW - Belgian KW - CHILDREN KW - Experience KW - INFLUENZA KW - paediatric KW - Surveillance KW - System AB - Not available VL - 68 CP - 3 U1 - 38343 M3 - http://dx.doi.org/10.1186%2F0778-7367-68-3-94 ER - TY - JOUR T1 - Virological surveillance of the Influenza A (H1N1)2009 pandemic: the role of the Belgian National Influenza Centre JF - Archives of Public Health Y1 - 2010 A1 - Gerard,C. A1 - Bernard Brochier A1 - Sophie Quoilin A1 - Françoise Wuillaume A1 - Viviane Van Casteren A1 - Isabelle Thomas KW - a KW - Belgian KW - INFLUENZA KW - Influenza A Virus,H1N1 Subtype KW - national KW - pandemic KW - Role KW - Surveillance AB -

Not available

VL - 68 CP - 2 U1 - 31233 M3 - http://dx.doi.org/10.1186%2F0778-7367-68-2-68 ER - TY - JOUR T1 - Cluster of hepatitis A cases among travellers returning from Egypt, Belgium, September through November 200836837 JF - Euro.Surveill Y1 - 2009 A1 - Robesyn,E. A1 - Micalessi,M.I. A1 - Sophie Quoilin A1 - Naranjo,M. A1 - Isabelle Thomas KW - 2008 KW - a KW - an KW - article KW - Belgian KW - Belgium KW - Brussels KW - care KW - Case KW - Cluster KW - Common KW - Control KW - Countries KW - disease KW - Disease Outbreaks KW - Egypt KW - electronic KW - epidemiology KW - European KW - Flemish KW - France KW - health KW - Hepatitis KW - Hepatitis A KW - Humans KW - Hypothesis KW - im KW - incidence KW - Infectious KW - investigation KW - IS KW - journal KW - methods KW - need KW - outbreak KW - POLICIES KW - POLICY KW - Population Surveillance KW - public KW - public health KW - Public-health KW - Risk Assessment KW - Risk Factors KW - SB - IM KW - statistics & numerical data KW - Surveillance KW - Travel KW - Vaccination AB - Following a European alert by France, we detected a hepatitis A cluster in Belgian travellers returning from Egypt. Our investigation supports the hypothesis of a common source outbreak, linked to Nile river cruises. The outbreak also suggests the need to consider an intensification of the vaccination policy for travellers to hepatitis A endemic countries VL - 14 CP - 3 U1 - 38334 ER - TY - JOUR T1 - Virologic surveillance of influenza, and of influenza A/H1N1 in particular, in Belgium36843 JF - Bull.Mem.Acad.R.Med.Belg. Y1 - 2009 A1 - Isabelle Thomas A1 - Gerard,C. A1 - Françoise Wuillaume A1 - Viviane Van Casteren A1 - Bernard Brochier KW - abstract KW - Animals KW - article KW - Belgium KW - Bruxelles KW - de KW - epidemiology KW - Grippe KW - History,21st Century KW - Humans KW - im KW - INFLUENZA KW - Influenza A Virus,H1N1 Subtype KW - Influenza A Virus,H3N2 Subtype KW - Influenza,Human KW - IS KW - journal KW - national KW - pathogenicity KW - Print KW - SB - IM KW - Seasons KW - Surveillance KW - Swine KW - Swine Diseases KW - virology AB - abstract VL - 164 CP - 10 U1 - 38397 ER - TY - RPRT T1 - La grippe en Belgique: importance de la surveillance Y1 - 2008 A1 - Isabelle Thomas A1 - Viviane Van Casteren A1 - Gerard,C. A1 - Bernard Brochier KW - Belgique KW - de KW - EN KW - Grippe KW - Surveillance PB - WIV-ISP CY - Brussels SN - D/2009/2505/55 U1 - 38396 ER - TY - JOUR T1 - Management of potential human cases of influenza A/H5N1: lessons from Belgium. JF - Euro Surveill Y1 - 2006 A1 - Sophie Quoilin A1 - Isabelle Thomas A1 - Gérard, C A1 - Maes, S A1 - Haucotte, G A1 - Gerard, M A1 - Van Laethem, Y A1 - Snacken, R A1 - Hanquet, G A1 - Bernard Brochier A1 - Robesyn, E KW - Belgium KW - Communicable Disease Control KW - Diagnosis, Differential KW - Disease Outbreaks KW - Guidelines as Topic KW - Humans KW - Influenza A Virus, H5N1 Subtype KW - Influenza, Human KW - Male KW - Practice Patterns, Physicians' KW - Risk Assessment VL - 11 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/16801712?dopt=Abstract ER - TY - JOUR T1 - Highly pathogenic H5N1 influenza virus in smuggled Thai eagles, Belgium. JF - Emerg Infect Dis Y1 - 2005 A1 - Steven Van Borm A1 - Isabelle Thomas A1 - Hanquet, Germaine A1 - Bénédicte Lambrecht A1 - Boschmans, Marc A1 - Dupont, Gérald A1 - Decaestecker, Mireille A1 - Snacken, René A1 - Thierry van den Berg KW - Acetamides KW - Animals KW - Antiviral Agents KW - Belgium KW - Bird Diseases KW - Crime KW - Influenza A virus KW - Influenza A Virus, H5N1 Subtype KW - Influenza in Birds KW - Oseltamivir KW - Phylogeny KW - Raptors KW - Thailand AB -

We report the isolation and characterization of a highly pathogenic avian influenza A/H5N1 virus from Crested Hawk-Eagles smuggled into Europe by air travel. A screening performed in human and avian contacts indicated no dissemination occurred. Illegal movements of birds are a major threat for the introduction of highly pathogenic avian influenza.

VL - 11 CP - 5 U1 - https://www.ncbi.nlm.nih.gov/pubmed/15890123?dopt=Abstract M3 - 10.3201/eid1105.050211 ER - TY - JOUR T1 - Prevalence of human erythrovirus B19 DNA in healthy Belgian blood donors and correlation with specific antibodies against structural and non-structural viral proteins. JF - Vox Sang Y1 - 2003 A1 - Isabelle Thomas A1 - Di Giambattista, M A1 - Gérard, C A1 - Esther Mathys A1 - Hougardy, V A1 - Latour, B A1 - Branckaert, T A1 - Laub, R KW - Algorithms KW - Antibodies, Viral KW - Belgium KW - Blood Donors KW - DNA, Viral KW - Erythema Infectiosum KW - Humans KW - Parvovirus B19, Human KW - polymerase chain reaction KW - prevalence KW - Serologic Tests KW - Viral Load KW - Viral Proteins AB -

BACKGROUND AND OBJECTIVES: Human parvovirus (erythrovirus) B19 is recognized as a major contaminant of blood and blood products. To reduce the risk of contamination, plasma-pool screening and exclusion of highly viraemic donations are recommended. The objectives of this study were to estimate the prevalence of B19 DNA in our blood-donor population, to determine the appropriate pool size to be tested (taking into account parameters such as prevalence, viral load, test sensitivity, and the efficacy of inactivation procedures), and to correlate viral loads with the serological status of donors as regards antibodies against different viral proteins.

MATERIALS AND METHODS: Pools of different sizes were tested for B19, using a sensitive nested polymerase chain reaction (PCR) as well as an simple, un-nested, less sensitive PCR. Positive pools were resolved to the level of individual donations, and the viral load and serological markers were determined.

RESULTS: Of 16,859 donations, 27 (one of 625) were found to be B19 DNA positive, with viral loads ranging from 10(2) to > 10(7) IU/ml. Twenty-five of the positive donations were tested for VP-specific anti-B19 antibodies, and eight (32%) were negative for both immunoglobulin (Ig)M and IgG. They were probably collected in the preseroconversion window period or from chronic carriers without detectable antibodies. We regarded the seven (28%) IgM-positive donors as being in the early phase of infection. The remaining 10 (40%) IgM-negative, IgG-positive donors were probably carriers of persistent infection (i.e. PCR positive despite the presence of IgG antibodies), as suggested by their low viral loads (< 10(4) IU/ml). Fifteen out of 36 major pools contained one or more contaminated donations. Among these, 12 tested positive by nested PCR and only three by un-nested PCR, this reflecting a viral load of > 10(4) IU/ml.

CONCLUSIONS: By testing all donations as pools of 480 by un-nested PCR, and resolving positive pools to identify the responsible donations, it is possible to ensure that the viral load in fractionation pools (5000 donations) remains < 10(3) IU/ml, compatible with the efficacy of inactivation procedures and complying with Food and Drug Administration (FDA) recommendations.

VL - 84 CP - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/12757504?dopt=Abstract ER - TY - JOUR T1 - The use of nucleic acid amplification techniques to increase the viral safety of blood. JF - Clin Lab Y1 - 2002 A1 - Isabelle Thomas A1 - Esther Mathys A1 - Gerard, Carine KW - Belgium KW - Blood Banks KW - Blood Transfusion KW - DNA, Viral KW - Humans KW - Nucleic Acid Amplification Techniques KW - Virus Diseases AB -

Despite recent significant improvements in the viral safety of blood and blood products there remains a small risk of contamination mainly due to the existence of a window period before the appearance of antibodies. Nucleic acid amplification technologies (NAT) permit a direct detection of the viral genome itself with an extreme sensitivity and specificity, without depending anymore on the delayed appearance of antibodies. These technologies can be applied to detect most blood-borne viruses. However, the usefulness and strategies will largely depend on different features specific to the type of the virus, such as pathogenicity, prevalence of the infection, viral load during preseroconversion, doubling time of the virus and infectious dose. Many studies have already been conducted in different parts of the world, and the results proving the feasibility of the NAT screening are more than encouraging. However, some problems still remain to be solved in theroutine application of these technologies.

VL - 48 CP - 3-4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/11934217?dopt=Abstract ER - TY - JOUR T1 - PCR detects HCV RNA in a plasma pool contaminated by a single preseroconversion donation of genotype 5a. JF - Vox Sang Y1 - 2000 A1 - Isabelle Thomas A1 - Branckaert, T A1 - Esther Mathys A1 - Vranckx, R A1 - Laub, R KW - Belgium KW - Blood Donors KW - Consumer Product Safety KW - Drug Contamination KW - Genotype KW - Hepacivirus KW - Hepatitis C KW - Humans KW - polymerase chain reaction KW - prevalence KW - Reagent Kits, Diagnostic KW - Reference Standards KW - RNA, Viral KW - Sensitivity and Specificity KW - Serologic Tests KW - Viral Load AB -

BACKGROUND AND OBJECTIVES: To determine the prevalence of HCV-RNA-positive plasma pools in Belgium, to validate our PCR method and to increase the safety of the released blood products.

MATERIALS AND METHODS: Plasma pools consisting each of about 5,000 donations from Belgian unpaid volunteer blood donors were analysed by PCR for the presence of HCV RNA. Two different extraction methods were compared and validated.

RESULTS: Two out of 367 plasma pools were found to be HCV RNA positive and were discarded. For one of these two pools, the look-back procedure identified an anti-HCV-negative contaminated donation. The HCV genotype of both the contaminated pool and the donation was 5a, a genotype rare in Europe. The viral load of the preseroconverted donation was 2.9 x 10(7) gEq/ml according to the bDNA method.

CONCLUSION: In the case of plasma derivatives, various important steps are already included to increase safety. Nucleic acid testing of manufacturing plasma pools ensures that viral load in the starting material is as low as possible.

VL - 79 CP - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/11054042?dopt=Abstract M3 - 31214 ER - TY - JOUR T1 - A case-control study after a hantavirus infection outbreak in the south of Belgium: who is at risk? JF - Clin Infect Dis Y1 - 1999 A1 - Van Loock, F A1 - Isabelle Thomas A1 - Clement, J A1 - Ghoos, S A1 - Colson, P KW - ADOLESCENT KW - Adult KW - Aged KW - Aged, 80 and over KW - Animals KW - Antibodies, Viral KW - Belgium KW - Case-Control Studies KW - Disease Outbreaks KW - Female KW - Hantavirus KW - Hantavirus Infections KW - Humans KW - Male KW - middle aged KW - Multivariate Analysis KW - Risk Factors KW - Rodentia AB -

Puumala is the most common hantavirus serotype in Europe and is spread mainly by the red bank vole. Between 1 July 1992 and 31 January 1994, an outbreak of Puumala virus-induced nephropathia epidemica (NE) occurred in the Belgian Ardennes. Serologically confirmed cases (n = 41) were compared with two groups of asymptomatic seronegative controls. Risks identified included sighting of living rodents, exposure to rodent droppings, and trapping rodents during the 4 weeks preceding onset of symptoms. Activities during this 4-week period that presented the greatest risk were woodcutting, reopening of a nonaerated room, and strenuous physical effort. This is the first case-control study on risk factors for NE in Europe. In comparison with the American form of hantavirus pulmonary syndrome, which is spread by deer mice, professional activity appears to be a more important risk factor for acquisition of hantavirus in Europe.

VL - 28 CP - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/10825047?dopt=Abstract M3 - 10.1086/515196 ER - TY - RPRT T1 - Virological Surveillance of Influenza in Belgium: season 2018-2019 Y1 - 0 A1 - Isabelle Thomas A1 - Cyril Barbezange A1 - Steven Van Gucht A1 - Weyckmans,J. A1 - Ilham Fdillate A1 - Reinout Van Eycken A1 - Assia Hamouda A1 - Nathalie Bossuyt A1 - Sophie Quoilin A1 - Dieter Van Cauteren A1 - Sarah Denayer A1 - François Dufrasne ER -