Author
Keiji Fukuda
Other affiliations: United States Department of Agriculture, University of Hong Kong, National Institutes of Health ...read more
Bio: Keiji Fukuda is an academic researcher from Li Ka Shing Faculty of Medicine, University of Hong Kong. The author has contributed to research in topics: Influenza A virus subtype H5N1 & Influenza A virus. The author has an hindex of 46, co-authored 95 publications receiving 27831 citations. Previous affiliations of Keiji Fukuda include United States Department of Agriculture & University of Hong Kong.
Papers published on a yearly basis
Papers
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TL;DR: Infants and young children without chronic or serious medical conditions are at increased risk for hospitalization during influenza seasons, and routine influenza vaccination should be considered in these children.
Abstract: Background Young children may be at increased risk for serious complications from influenzavirus infection. However, in population-based studies it has been difficult to separate the effects of influenzavirus from those of respiratory syncytial virus. Respiratory syncytial virus often circulates with influenzaviruses and is the most frequent cause of hospitalization for lower respiratory tract infections in infants and young children. We studied the rates of hospitalization for acute respiratory disease among infants and children during periods when the circulation of influenzaviruses predominated over the circulation of respiratory syncytial virus. Methods For each season from October to May during the period from 1992 to 1997, we used local viral surveillance data to define periods in Washington State and northern California when the circulation of influenzaviruses predominated over that of respiratory syncytial virus. We calculated the rates of hospitalization for acute respiratory disease, excess rate...
1,001 citations
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TL;DR: A more sensitive microneutralization assay is developed to detect antibodies to avian influenza in humans and is being used for the seroepidemiologic investigations of the avian H5N1 influenza outbreak.
Abstract: From May to December 1997, 18 cases of mild to severe respiratory illness caused by avian influenza A (H5N1) viruses were identified in Hong Kong. The emergence of an avian virus in the human population prompted an epidemiological investigation to determine the extent of human-to-human transmission of the virus and risk factors associated with infection. The hemagglutination inhibition (HI) assay, the standard method for serologic detection of influenza virus infection in humans, has been shown to be less sensitive for the detection of antibodies induced by avian influenza viruses. Therefore, we developed a more sensitive microneutralization assay to detect antibodies to avian influenza in humans. Direct comparison of an HI assay and the microneutralization assay demonstrated that the latter was substantially more sensitive in detecting human antibodies to H5N1 virus in infected individuals. An H5-specific indirect enzyme-linked immunosorbent assay (ELISA) was also established to test children’s sera. The sensitivity and specificity of the microneutralization assay were compared with those of an H5-specific indirect ELISA. When combined with a confirmatory H5-specific Western blot test, the specificities of both assays were improved. Maximum sensitivity (80%) and specificity (96%) for the detection of anti-H5 antibody in adults aged 18 to 59 years were achieved by using the microneutralization assay combined with Western blotting. Maximum sensitivity (100%) and specificity (100%) in detecting anti-H5 antibody in sera obtained from children less than 15 years of age were achieved by using ELISA combined with Western blotting. This new test algorithm is being used for the seroepidemiologic investigations of the avian H5N1 influenza outbreak.
827 citations
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TL;DR: The large proportion of influenza-related deaths during each pandemic and the following decade among persons <65 years old should be considered in planning for pandemics.
Abstract: Almost all deaths related to current influenza epidemics occur among the elderly. However, mortality was greatest among the young during the 1918-1919 pandemic. This study compared the age distribution of influenza-related deaths in the United States during this century's three influenza A pandemics with that of the following epidemics. Half of influenza-related deaths during the 1968-1969 influenza A (H3N2) pandemic and large proportions of influenza-related deaths during the 1957-1958 influenza A (H2N2) and the 1918-1919 influenza A (H1N1) pandemics occurred among persons <65 years old. However, this group accounted for decrementally smaller proportions of deaths during the first decade following each pandemic. A model suggested that this mortality pattern may be explained by selective acquisition of protection against fatal illness among younger persons. The large proportion of influenza-related deaths during each pandemic and the following decade among persons <65 years old should be considered in planning for pandemics.
684 citations
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TL;DR: Influenza vaccination of healthy working adults younger than 65 years can reduce the rates of ILI, lost workdays, and physician visits during years when the vaccine and circulating viruses are similar, but vaccination may not provide overall economic benefits in most years.
Abstract: ContextAlthough the cost-effectiveness and cost-benefit of influenza vaccination
are well established for persons aged 65 years or older, the benefits for
healthy adults younger than 65 years are less clear.ObjectiveTo evaluate the effectiveness and cost-benefit of influenza vaccine
in preventing influenzalike illness (ILI) and reducing societal costs of ILI
among healthy working adults.DesignDouble-blind, randomized, placebo-controlled trial conducted during
2 influenza seasons.Setting and ParticipantsHealthy adults aged 18 to 64 years and employed full-time by a US manufacturing
company (for 1997-1998 season, n = 1184; for 1998-1999 season, n = 1191).InterventionsFor each season, participants were randomly assigned to receive either
trivalent inactivated influenza vaccine (n = 595 in 1997-1998 and n = 587
in 1998-1999) or sterile saline injection (placebo; n = 589 in 1997-1998 and
n = 604 in 1998-1999). Participants in 1997-1998 were rerandomized if they
participated in 1998-1999.Main Outcome MeasuresInfluenzalike illnesses and associated physician visits and work absenteeism
reported in biweekly questionnaires by all participants, and serologically
confirmed influenza illness among 23% of participants in each year (n = 275
in 1997-1998; n = 278 in 1998-1999); societal cost of ILI per vaccinated vs
unvaccinated person.ResultsFor 1997-1998 and 1998-1999, respectively, 95% (1130/1184) and 99% (1178/1191)
of participants had complete follow-up, and 23% in each year had serologic
testing. In 1997-1998, when the vaccine virus differed from the predominant
circulating viruses, vaccine efficacy against serologically confirmed influenza
illness was 50% (P = .33). In this season, vaccination
did not reduce ILI, physician visits, or lost workdays; the net societal cost
was $65.59 per person compared with no vaccination. In 1998-1999, the vaccine
and predominant circulating viruses were well matched. Vaccine efficacy was
86% (P = .001), and vaccination reduced ILI, physician
visits, and lost workdays by 34%, 42%, and 32%, respectively. However, vaccination
resulted in a net societal cost of $11.17 per person compared with no vaccination.ConclusionInfluenza vaccination of healthy working adults younger than 65 years
can reduce the rates of ILI, lost workdays, and physician visits during years
when the vaccine and circulating viruses are similar, but vaccination may
not provide overall economic benefits in most years.
670 citations
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TL;DR: Among currently active members of 4 Air Force populations, a chronic multisymptom condition was significantly associated with deployment to the GW and veterans who met the case definition had significantly diminished functioning and well-being.
Abstract: Context.—Gulf War (GW) veterans report nonspecific symptoms significantly more
often than their nondeployed peers. However, no specific disorder has been
identified, and the etiologic basis and clinical significance of their symptoms
remain unclear.Objectives.—To organize symptoms reported by US Air Force GW veterans into a case
definition, to characterize clinical features, and to evaluate risk factors.Design.—Cross-sectional population survey of individual characteristics and
symptoms and clinical evaluation (including a structured interview, the Medical
Outcomes Study Short Form 36, psychiatric screening, physical examination,
clinical laboratory tests, and serologic assays for antibodies against viruses,
rickettsia, parasites, and bacteria) conducted in 1995.Participants and Setting.—The cross-sectional questionnaire survey included 3723 currently active
volunteers, irrespective of health status or GW participation, from 4 air
force populations.The cross-sectional clinical evaluation included 158 GW
veterans from one unit, irrespective of health status.Main Outcome Measures.—Symptom-based case definition; case prevalence rate for GW veterans
and nondeployed personnel; clinical and laboratory findings among veterans
who met the case definition.Results.—We defined a case as having 1 or more chronic symptoms from at least
2 of 3 categories (fatigue, mood-cognition, and musculoskeletal). The prevalence
of mild-to-moderate and severe cases was 39% and 6%, respectively, among 1155
GW veterans compared with 14% and 0.7% among 2520 nondeployed personnel. Illness
was not associated with time or place of deployment or with duties during
the war. Fifty-nine clinically evaluated GW veterans (37%) were noncases,
86 (54%) mild-to-moderate cases, and 13 (8%) severe cases. Although no physical
examination, laboratory, or serologic findings identified cases, veterans
who met the case definition had significantly diminished functioning and well-being.Conclusions.—Among currently active members of 4 Air Force populations, a chronic
multisymptom condition was significantly associated with deployment to the
GW. The condition was not associated with specific GW exposures and also affected
nondeployed personnel.
668 citations
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01 Jan 2014
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.
9,618 citations
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TL;DR: Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad.
Abstract: Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.
5,932 citations
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McMaster University1, Northwestern University2, University of Texas Health Science Center at San Antonio3, Johns Hopkins University4, University of Mississippi5, University of Utah6, LDS Hospital7, Centers for Disease Control and Prevention8, United States Department of Veterans Affairs9, Baylor College of Medicine10, Winthrop-University Hospital11, Stony Brook University12, University of Barcelona13
TL;DR: This work presents a meta-analyses of the immune system’s response to chronic obstructive pulmonary disease and shows clear patterns of decline in the immune systems of elderly patients with compromised immune systems.
Abstract: Lionel A. Mandell, Richard G. Wunderink, Antonio Anzueto, John G. Bartlett, G. Douglas Campbell, Nathan C. Dean, Scott F. Dowell, Thomas M. File, Jr. Daniel M. Musher, Michael S. Niederman, Antonio Torres, and Cynthia G. Whitney McMaster University Medical School, Hamilton, Ontario, Canada; Northwestern University Feinberg School of Medicine, Chicago, Illinois; University of Texas Health Science Center and South Texas Veterans Health Care System, San Antonio, and Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas; Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi School of Medicine, Jackson; Division of Pulmonary and Critical Care Medicine, LDS Hospital, and University of Utah, Salt Lake City, Utah; Centers for Disease Control and Prevention, Atlanta, Georgia; Northeastern Ohio Universities College of Medicine, Rootstown, and Summa Health System, Akron, Ohio; State University of New York at Stony Brook, Stony Brook, and Department of Medicine, Winthrop University Hospital, Mineola, New York; and Cap de Servei de Pneumologia i Allergia Respiratoria, Institut Clinic del Torax, Hospital Clinic de Barcelona, Facultat de Medicina, Universitat de Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer, CIBER CB06/06/0028, Barcelona, Spain.
5,558 citations
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TL;DR: This report updates the 2000 recommendations by the Advisory Committee on Immunization Practices on the use of influenza vaccine and antiviral agents with new or updated information regarding the cost-effectiveness of influenza vaccination and the 2001-2002 trivalent vaccine virus strains.
Abstract: This report updates the 2002 recommendations by the Advisory Committee on Immunization Practices (ACIP) on the use of influenza vaccine and antiviral agents (CDC. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51 [No. RR-3]:1-31). The 2003 recommendations include new or updated information regarding 1) the timing of influenza vaccination by age and risk group; 2) influenza vaccine for children aged 6-23 months; 3) the 2003-2004 trivalent inactivated vaccine virus strains: A/Moscow/10/99 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Hong Kong/330/2001-like antigens (for the A/Moscow/10/99 [H3N2]-like antigen, manufacturers will use the antigenically equivalent A/Panama/2007/99 [H3N2] virus, and for the B/Hong Kong/330/2001-like antigen, manufacturers will use either B/Hong Kong/330/2001 or the antigenically equivalent B/Hong Kong/1434/2002); 4) availability of certain influenza vaccine doses with reduced thimerosal content, including single 0.25 mL-dose syringes; and 5) manufacturers of influenza vaccine for the U.S. market. Although the optimal time to vaccinate against influenza is October and November, vaccination in December and later continues to be strongly recommended A link to this report and other information regarding influenza can be accessed at http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm.
5,334 citations
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TL;DR: The new STD treatment guidelines for gonorrhea, chlamydia, bacterial vaginosis, trichomonas, vulvovaginal candidiasis, pelvic inflammatory disease, genital warts, herpes simplex virus infection, syphilis, and scabies are reviewed.
Abstract: The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.
4,563 citations