tick-borne encephalitis

蜱传脑炎
  • 文章类型: Journal Article
    蜱传脑炎病毒(TBEV)感染导致亚洲和欧洲人类严重的中枢神经系统疾病。在中国,蜱传脑炎的病例主要由远东TBEV亚型引起,与其他广泛研究的亚型相比,它表现出不同的病程。然而,在中国,关于感染TBEV的患者的核酸和血清学诊断特征的知识有限,这是本研究的重点。
    本研究建立了一种TaqManqPCR方法,以最佳特异性检测血清中的TBEVRNA,灵敏度,和精度。用TaqManqPCR和ELISA法检测TBEVIgM,对东北地区63例被蜱叮咬的住院患者的血清样本进行了诊断特征调查。
    25例患者病毒RNA阳性;19例患者IgM阳性,9例病毒RNA和IgM阳性。通过比较分析,TBEVRNA拷贝与病毒潜伏期呈负相关。IgM水平与患者临床症状评分呈正相关。临床症状的严重程度和蜱叮咬后的长度可用于预测IgM的发生。此外,IgM水平和病毒RNA拷贝在双阳性患者中不相关。
    核酸和血清学检测方法都显示出检测TBEV感染的不同窗口,有一些重叠,并与特定的相关因素有关。这项研究为中国TBEV诱发的蜱传脑炎的诊断和病程提供了新的见解。
    UNASSIGNED: Tick-borne encephalitis virus (TBEV) infections result in severe central nervous system diseases in humans across Asia and Europe. In China, cases of tick-borne encephalitis are primarily caused by the Far East subtype of TBEV, which exhibits a distinct disease course compared to other extensively studied subtypes. However, there is limited knowledge regarding the nucleic acid and serological diagnostic characteristics of patients infected with the TBEV in China, which is the focus of investigation in the present study.
    UNASSIGNED: This study established a TaqMan qPCR approach to detect TBEV RNA in the serum with optimal specificity, sensitivity, and precision. Using TaqMan qPCR and ELISA assay for TBEV IgM detection, serum samples from 63 hospitalized patients bitten by ticks in Northeast China were investigated for diagnostic characteristics.
    UNASSIGNED: Twenty-five patients were positive for viral RNA; nineteen patients were positive for IgM, and nine were positive for both viral RNA and IgM. Through comparative analysis, TBEV RNA copies were negatively correlated with the virus incubation period. IgM levels were positively correlated with the clinical symptom scores of patients. The severity of clinical symptoms and the length after the tick bite could be used to predict the IgM occurrence. Furthermore, IgM levels and viral RNA copies were not correlated in double-positive patients.
    UNASSIGNED: Both nucleic acid and serological detection methods exhibited distinct windows for detecting TBEV infection, with some overlap, and were associated with specific correlated factors. This study provided novel insights into the diagnosis and course of TBEV-induced tick-borne encephalitis in China.
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  • 文章类型: Journal Article
    肾综合征出血热(HFRS)和蜱传脑炎(TBE)是俄罗斯最常见的病毒性疾病。HFRS由六种不同类型的汉坦病毒引起:汉坦病毒,阿穆尔,首尔,Puumala,Kurkino,还有索契,通过Muridae和Cricetidae家族的小型哺乳动物传播给人类。TBE由属于五种不同系统发育亚型的病毒引起。这里介绍了HFRS和TBE病原体的生态学相似性。感染汉坦病毒的小型哺乳动物可以将病毒传播给未感染的动物,蜱也可以将汉坦病毒传播给其他蜱和哺乳动物。汉坦病毒从蜱传播到人类只有在间接数据的基础上才有可能。在过去的23年里,在俄罗斯登记了164,582例HFRS(每105人4.9例)和71,579例TBE(每105人2.5例)。HFRS的死亡率为0.4%(668例),TBE的死亡率为1.6%(1136例)。14岁以下儿童有4030例(2.5%)和9414例TBE(13%)。HFRS和TBE病例在俄罗斯85个地区中的42个登记;仅在18个HFRS中,在13只TBE中,12人没有报告病例。本文对HFRS和TBE联合疫苗的应用前景进行了展望。
    Hemorrhagic fever with renal syndrome (HFRS) and tick-borne encephalitis (TBE) are the most common viral diseases in Russia. HFRS is caused by six different types of hantaviruses: Hantaan, Amur, Seoul, Puumala, Kurkino, and Sochi, which are transmitted to humans through small mammals of the Muridae and Cricetidae families. TBE is caused by viruses belonging to five different phylogenetic subtypes. The similarities in the ecology of HFRS and TBE pathogens is presented here. Hantavirus-infected small mammals can transmit the virus to uninfected animals, and ticks can also transmit hantavirus to other ticks and mammals. Hantavirus transmission from ticks to humans is possible only hypothetically based on indirect data. Over the past 23 years, 164,582 cases of HFRS (4.9 per 105 people) and 71,579 cases of TBE (2.5 per 105 people) were registered in Russia. The mortality rate was 0.4% (668 cases) in HFRS and 1.6% deaths (1136 cases) in TBE. There were 4030 HFRS (2.5%) and 9414 TBE (13%) cases in children under 14 years old. HFRS and TBE cases were registered in 42 out of 85 Russian regions; in 18-only HFRS, in 13-only TBE, and 12 had no reported cases. The prospects of applying a combined vaccine for HFRS and TBE prevention are shown in this paper.
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  • 文章类型: Journal Article
    这项横断面调查研究旨在评估波兰儿童监护人对蜱传脑炎(TBE)及其疫苗的态度和知识,以及将这些态度与其他传染病及其疫苗的态度进行比较。数据是通过匿名问卷收集的,纸质和在线,来自波兰各地的3030名受访者,大多数来自TBE流行地区。调查包括人口特征问题,一般的疫苗接种信念,以及对TBE及其疫苗的具体认识。统计分析显示,TBE疫苗接种意愿与一般疫苗接种态度等因素之间存在显著关联。信息来源,疫苗安全评级,以及对疾病严重程度的看法。结果表明,大城市和儿童较少的监护人更有可能接种疫苗。此外,支持一般疫苗接种的父母更愿意接种TBE疫苗.该研究的结论是,提高公众对TBE疫苗安全性和重要性的认识,尤其是在流行地区,对于提高疫苗接种率至关重要。有针对性的公共卫生干预措施解决误解和提供准确的信息是增加TBE疫苗摄入量和保护儿童免受这种严重疾病的重要策略。
    This cross-sectional survey study aimed to assess the attitudes and knowledge of children\'s guardians in Poland towards tick-borne encephalitis (TBE) and its vaccine, as well as to compare these attitudes to those regarding other infectious diseases and their vaccines. Data were collected through anonymous questionnaires, both paper-based and online, from 3030 respondents across Poland, with the majority being from TBE-endemic areas. The survey included questions on demographic characteristics, general vaccination beliefs, and specific perceptions of TBE and its vaccine. Statistical analysis revealed significant associations between willingness to vaccinate against TBE and factors such as general vaccination attitudes, information sources, vaccine safety ratings, and perceptions of disease severity. Results indicated that guardians from larger cities and those with fewer children were more likely to vaccinate. Additionally, parents who supported general vaccinations were significantly more willing to vaccinate against TBE. The study concludes that enhancing public awareness about the safety and importance of the TBE vaccine, especially in endemic regions, is crucial for improving vaccination rates. Targeted public health interventions addressing misconceptions and providing accurate information are essential strategies to increase TBE vaccine uptake and protect children from this serious disease.
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  • 文章类型: Journal Article
    尽管有蜱传脑炎(TBE)疫苗,TBE的发病率正在增加。为了了解感染的历史模式,我们对2023年12月之前的研究进行了全球荟萃分析,这些研究报告了按国家分层的普通或高危人群中针对TBEV(TBE病毒)的人类抗体患病率,收集年,血清学方法,和疫苗接种状况。通过随机效应模型在组内比较汇总数据。总的来说,检索到2403篇文章;包括自1959年以来发表的130篇文章。数据来自33个国家的96名一般人群(117,620名参与者)和71名高危人群(53,986名参与者)。德国有最多的人口群体(21),波兰的参与者最多(44,688人)。使用了七种血清学方法;最常见的是常规IgG/IgMELISA(44%)。四项研究(1.7%)使用NS1-ELISA血清学。在1956-1991年和1992-2022年之间,来自“高风险”地区(p=0.458)的所有人群的抗TBEV血清阳性率保持在〜2.75%,但在普通人群(1.7%至1%;p=0.001)和高风险人群(5.1%至1.3%;p<0.001)中有所下降,可能是由于不同时期研究方法的差异。本总结探讨了血清学方法如何用于评估TBE疫苗接种覆盖率和TBEV的潜在暴露或测量TBE负担,并强调了在进行TBE血清阳性率研究以比较人群时需要标准化方法。
    Despite the availability of tick-borne encephalitis (TBE) vaccines, the incidence of TBE is increasing. To understand the historical patterns of infection, we conducted a global meta-analysis of studies before December 2023 reporting human antibody prevalence against TBEV (TBE virus) among general or high-risk population groups stratified by country, collection year, serological method, and vaccination status. Pooled data were compared within groups over time by random-effects modeling. In total, 2403 articles were retrieved; 130 articles published since 1959 were included. Data were extracted from 96 general populations (117,620 participants) and 71 high-risk populations (53,986 participants) across 33 countries. Germany had the most population groups (21), and Poland had the most participants (44,688). Seven serological methods were used; conventional IgG/IgM ELISAs were the most common (44%). Four studies (1.7%) used NS1-ELISA serology. Between 1956-1991 and 1992-2022, anti-TBEV seroprevalence remained at ~2.75% across all population groups from \"high-risk\" areas (p = 0.458) but decreased within general populations (1.7% to 1%; p = 0.001) and high-risk populations (5.1% to 1.3%; p < 0.001), possibly due to differences in the study methodologies between periods. This global summary explores how serological methods can be used to assess TBE vaccination coverage and potential exposure to TBEV or measure TBE burden and highlights the need for standardized methodology when conducting TBE seroprevalence studies to compare across populations.
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  • 文章类型: Journal Article
    越来越多的研究表明,病毒性脑膜炎和脑膜脑炎,即使是那些患有轻度脑膜炎的人,会导致残留的后遗症。
    我们旨在调查病毒性脑膜炎和脑膜脑炎/脑炎患者的长期结局,以及长期后遗症对患者社会和职业日常生活的影响。
    总共50名患者(12%的脑炎,58%的脑膜脑炎和30%的脑膜炎)和21名对照者参加了研究。最常见的原因是蜱传脑炎(TBE)病毒。2年后最重要的持续体征和症状是主观认知障碍(36%),疲劳和/或白天过度嗜睡(31%),夜间睡眠受到干扰(31%)和头痛(13%),以及在认知努力后感觉更快疲惫(53%)。与急性期的疾病严重程度无关,近三分之一的患者报告说,由于长期后遗症,社会和/或职业生活受到轻度损害,与健康对照相比,健康状况评估中的得分仍然显着降低。
    无论急性疾病的严重程度如何,尽管在2年内不断改善,67%的患者仍有持续的体征和症状,但这些仅与约30%的患者的日常社交或职业生活有关。
    UNASSIGNED: An increasing number of studies demonstrate that viral meningitis and meningoencephalitis, even those with a mild course of meningitis, can result in residual sequelae.
    UNASSIGNED: We aimed to investigate the long-term outcome in both viral meningitis and meningoencephalitis/encephalitis patients and impact of long-term sequelae on patients\' social and professional daily lives in a prospective observational study with a follow-up period of 20 months.
    UNASSIGNED: A total of 50 patients (12% encephalitis, 58% meningoencephalitis and 30% meningitis) and 21 control persons participated in the study. The most common cause was the tick-borne encephalitis (TBE) virus. The most important persistent signs and symptoms after 2 years were subjective cognitive impairment (36%), fatigue and/or excessive daytime sleepiness (31%), disturbed nighttime sleep (31%) and headaches (13%), as well as feeling more rapidly exhausted after cognitive effort (53%). Independent of disease severity in the acute phase, almost one third of patients still reported mildly impaired social and/or professional life due to the long-term sequelae, with scores in the health status assessment still significantly lower compared to healthy controls.
    UNASSIGNED: Regardless of the severity of the acute illness and despite constant improvement within 2 years, 67% of patients still had persistent signs and symptoms, but these were only relevant to everyday social or professional life in about 30% of these patients.
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  • 文章类型: Journal Article
    这项观察性研究的目的是评估专用国家监测系统(ISS数据)与互联网上的搜索相比,意大利大多数报告的虫媒病毒病的潜在流行病学趋势。评估Google和Wikipedia中的用户搜索与真实案例之间是否存在相关性/关联。该研究考虑了从2012年6月到2023年12月的时间间隔。我们使用了以下意大利语搜索词:\"VirusToscana\",“西尼罗病毒”(西尼罗河病毒英文),\"Encefalitetrasmesadazecche\"(TickBorne脑炎英文),和“登革热”。我们将GoogleTrends和Wikipedia的数据重叠起来进行线性回归和相关性分析。适当时使用Pearson相关系数(r)或Spearman等级相关系数(rho)进行统计分析。ISS数据与维基百科或GT之间的所有相关性均具有统计学意义。登革热GT和ISS(rho=0.71)以及TBEGT和ISS(rho=0.71)的相关性很强,而其余相关性的r和rho值在0.32和0.67之间,显示出中等的时间相关性。观察到的相关性和回归模型为未来的研究提供了基础,鼓励对数字信息寻求行为和疾病患病率之间的动态进行更细致的探索。
    The purpose of this observational study was to evaluate the potential epidemiological trend of arboviral diseases most reported in Italy by the dedicated national surveillance system (ISS data) compared to searches on the internet, assessing whether a correlation/association between users\' searches in Google and Wikipedia and real cases exists. The study considers a time interval from June 2012 to December 2023. We used the following Italian search terms: \"Virus Toscana\", \"Virus del Nilo occidentale\" (West Nile Virus in English), \"Encefalite trasmessa da zecche\" (Tick Borne encephalitis in English), and \"Dengue\". We overlapped Google Trends and Wikipedia data to perform a linear regression and correlation analysis. Statistical analyses were performed using Pearson\'s correlation coefficient (r) or Spearman\'s rank correlation coefficient (rho) as appropriate. All the correlations between the ISS data and Wikipedia or GT exhibited statistical significance. The correlations were strong for Dengue GT and ISS (rho = 0.71) and TBE GT and ISS (rho = 0.71), while the remaining correlations had values of r and rho between 0.32 and 0.67, showing a moderate temporal correlation. The observed correlations and regression models provide a foundation for future research, encouraging a more nuanced exploration of the dynamics between digital information-seeking behavior and disease prevalence.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:描述挪威蜱传脑炎(TBE)住院患者队列的临床特征和与疾病严重程度相关的因素。
    方法:这项观察性多中心研究纳入了2018年至2022年挪威东南部流行地区的TBE住院患者。临床症状和实验室检查的结果,脑电图,记录CT和MRI扫描。比较轻度患者的患者特征,中度,和严重的TBE,并确定了与疾病严重程度相关的因素。
    结果:几乎所有符合条件的患者都被纳入最终队列(153/189名参与者,81%)。中位年龄为56岁,63%是男性,7%的人接种了TBE疫苗;没有参与者完全接种疫苗。TBE在31%的患者中表现为轻度(脑膜)疾病,在54%和14%的患者中表现为中度或重度(脑炎)疾病,分别。我们发现46%的患者有单相病程,64%有低钠血症,7%出现中枢神经系统(CNS)症状,而脑脊液(CSF)中无细胞增多症。感觉异常,以前没有描述的症状,在10%的患者中报告。大多数客观发现与中枢神经系统有关。先前存在的合并症,CRP和CSF蛋白水平是更严重疾病的预测因子。
    结论:挪威大型队列的这一新颖介绍支持TBE作为挪威东南部地区的一种严重疾病。大多数住院患者出现脑炎,很少出现脑膜炎。合并症,CRP和CSF蛋白水平与更严重的疾病有关。
    背景:Prosjekt#2,296,959-挪威蜱传脑炎研究-NOTES。急性期特征和长期结果。-克里斯汀.
    OBJECTIVE: To describe the clinical characteristics and factors associated with disease severity in a Norwegian cohort of hospitalized patients with tick-borne encephalitis (TBE).
    METHODS: This observational multicenter study included hospitalized patients with TBE in the endemic area in the southeastern region of Norway from 2018 to 2022. Clinical signs and findings from laboratory tests, EEG, CT and MRI scans were recorded. Patient characteristics were compared among those with mild, moderate, and severe TBE, and factors associated with disease severity were identified.
    RESULTS: Nearly all eligible patients were included in the final cohort (153/189 participants, 81%). The median age was 56 years, 63% were men, and 7% were vaccinated against TBE; no participants were fully vaccinated. TBE presented as mild (meningeal) disease in 31% of patients and as moderate or severe (encephalitic) disease in 54% and 14% of patients, respectively. We found that 46% of the patients had a monophasic course, 64% had hyponatremia, and 7% presented with central nervous system (CNS) symptoms without pleocytosis in cerebrospinal fluid (CSF). Dysesthesia, a symptom previously not described, was reported in 10% of the patients. Most objective findings were related to the CNS. Preexisting comorbidities, CRP and CSF protein levels were predictors of more severe disease.
    CONCLUSIONS: This novel presentation of a large Norwegian cohort supports TBE as a serious disease in the southeastern region of Norway. The majority of hospitalized patients presented with encephalitis, and fewer presented with meningitis. Comorbidities, CRP and CSF protein levels were associated with more severe disease.
    BACKGROUND: Prosjekt #2,296,959 - The Norwegian Tick-borne Encephalitis Study - NOTES. Acute phase characteristics and long-term outcomes. - Cristin.
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  • 文章类型: Journal Article
    BackgroundTick传脑炎(TBE)是一种严重的,疫苗可预防的中枢神经系统病毒感染。儿童和青少年的症状通常比成人轻,虽然严重的疾病确实发生。更好地了解疾病负担和疫苗介导的保护持续时间对于疫苗接种建议很重要。为了估计TBE疫苗接种覆盖率,瑞士0-17岁人群的疾病严重程度和疫苗有效性(VE)。方法使用瑞士国家疫苗接种覆盖率调查(SNVCS)估计2005年至2022年之间的疫苗接种覆盖率。一个全国性的,评估疫苗摄取的重复横断面研究。使用瑞士疾病监测系统的数据确定2005年至2022年TBE的发生率和严重程度,并使用病例对照分析计算VE。将TBE案例与SNVCS控件进行匹配。结果在研究期间,疫苗接种覆盖率大幅增加,从4.8%(95%置信区间(CI):4.1-5.5%)到50.1%(95%CI:48.3-52.0%)。无论年龄如何,TBE病例的报告临床症状相似。与未接种疫苗相比,未完全(1-2剂量)和完全(≥3剂量)接种疫苗的病例中神经系统受累的可能性较小。对于不完全的疫苗接种,VE为66.2%(95%CI:42.3-80.2),而完整疫苗接种的VE为90.8%(95%CI:87.7-96.4).疫苗有效性仍然很高,83.9%(95%CI:69.0-91.7)自上次疫苗接种以来长达10年。结论即使小于5岁的儿童也会经历严重的TBE。不完整和完整的疫苗接种可防止疾病的神经系统表现。完整的疫苗接种为TBE提供长达10年的持久保护。
    BackgroundTick-borne encephalitis (TBE) is a severe, vaccine-preventable viral infection of the central nervous system. Symptoms are generally milder in children and adolescents than in adults, though severe disease does occur. A better understanding of the disease burden and duration of vaccine-mediated protection is important for vaccination recommendations.AimTo estimate TBE vaccination coverage, disease severity and vaccine effectiveness (VE) among individuals aged 0-17 years in Switzerland.MethodsVaccination coverage between 2005 and 2022 was estimated using the Swiss National Vaccination Coverage Survey (SNVCS), a nationwide, repeated cross-sectional study assessing vaccine uptake. Incidence and severity of TBE between 2005 and 2022 were determined using data from the Swiss disease surveillance system and VE was calculated using a case-control analysis, matching TBE cases with SNVCS controls.ResultsOver the study period, vaccination coverage increased substantially, from 4.8% (95% confidence interval (CI): 4.1-5.5%) to 50.1% (95% CI: 48.3-52.0%). Reported clinical symptoms in TBE cases were similar irrespective of age. Neurological involvement was less likely in incompletely (1-2 doses) and completely (≥ 3 doses) vaccinated cases compared with unvaccinated ones. For incomplete vaccination, VE was 66.2% (95% CI: 42.3-80.2), whereas VE for complete vaccination was 90.8% (95% CI: 87.7-96.4). Vaccine effectiveness remained high, 83.9% (95% CI: 69.0-91.7) up to 10 years since last vaccination.ConclusionsEven children younger than 5 years can experience severe TBE. Incomplete and complete vaccination protect against neurological manifestations of the disease. Complete vaccination offers durable protection up to 10 years against TBE.
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  • 文章类型: Case Reports
    目的:用TBE病毒(TBEV)IgG阳性血浆治疗1例X连锁无丙种球蛋白血症(XLA)合并重症蜱传脑炎(TBE)患者。患者的临床反应,体液和细胞免疫反应的特点是感染前和感染后.
    方法:对血清进行ELISA和中和测定,对血清和脑脊液进行TBEVPCR测定。对患者的外周血和五个健康接种的对照进行T细胞测定。
    结果:患者因头痛和发热入院。他未接种TBE疫苗,但接受皮下IgG替代疗法(IGRT)。TBEVIgG抗体呈低水平阳性(由于scIGRT),但TBEVIgM和TBEV中和试验均为阴性.住院期间,他的临床状况恶化(格拉斯哥昏迷评分3/15),并在ICU接受了皮质类固醇和外部脑室引流治疗。然后用含有TBEVIgG的血浆治疗他,没有明显的副作用。他的症状在几天内得到改善,并且TBEV中和测试转变为阳性。在感染后3个月和18个月观察到强烈的CD8+T细胞反应,在没有B细胞的情况下。这通过对TBEV具有特异性的四聚体证实。
    结论:对未出现明显不良反应的XLA患者给予TBEVIgG阳性血浆可能有助于临床转归。类似的方法可以为研究体液免疫缺陷患者的治疗选择提供有希望的基础。重要的是,尽管缺乏B细胞,但感染后仍观察到强大的CD8+T细胞应答,这表明这些患者可以清除急性病毒感染,并可从未来的疫苗接种计划中获益.
    OBJECTIVE: A patient with X-linked agammaglobulinemia (XLA) and severe tick-borne encephalitis (TBE) was treated with TBE virus (TBEV) IgG positive plasma. The patient\'s clinical response, humoral and cellular immune responses were characterized pre- and post-infection.
    METHODS: ELISA and neutralisation assays were performed on sera and TBEV PCR assay on sera and cerebrospinal fluid. T cell assays were conducted on peripheral blood the patient and five healthy vaccinated controls.
    RESULTS: The patient was admitted to the hospital with headache and fever. He was not vaccinated against TBE but receiving subcutaneous IgG-replacement therapy (IGRT). TBEV IgG antibodies were low-level positive (due to scIGRT), but the TBEV IgM and TBEV neutralisation tests were negative. During hospitalisation his clinical condition deteriorated (Glasgow coma scale 3/15) and he was treated in the ICU with corticosteroids and external ventricular drainage. He was then treated with plasma containing TBEV IgG without apparent side effects. His symptoms improved within a few days and the TBEV neutralisation test converted to positive. Robust CD8+ T cell responses were observed at three and 18-months post-infection, in the absence of B cells. This was confirmed by tetramers specific for TBEV.
    CONCLUSIONS: TBEV IgG-positive plasma given to an XLA patient with TBE without evident adverse reactions may have contributed to a positive clinical outcome. Similar approaches could offer a promising foundation for researching therapeutic options for patients with humoral immunodeficiencies. Importantly, a robust CD8+ T cell response was observed after infection despite the lack of B cells and indicates that these patients can clear acute viral infections and could benefit from future vaccination programs.
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