Clinical and immunologic predictors of influenza illness among vaccinated older adults.

Vaccine
Zainab ShahidJanet E McElhaney

Abstract

The diagnosis of influenza is often missed in older adults and illness presentation may be modified by prior vaccination. We evaluated the symptoms and immunologic markers predicting laboratory-confirmed influenza (LCI) among vaccinated older adults. In subjects with influenza-like illness (ILI), fever distinguished subjects with laboratory-confirmed influenza (LCI) from those with other ILI (39% vs. 12.5%, p=0.009). In LCI subjects who did not seroconvert to influenza infection, pre-infection levels of the cytolytic mediator, granzyme B, correlated with fever (r=1.000; p=0.01) and the IFN-gamma:IL-10 ratio (r=0.999; p=0.03), and increased following influenza infection in LCI vs. ILI subjects (p=0.03). The cell-mediated immune response to influenza distinguishes A/H3N2 LCI from other ILI in older adults, and suggests a link between cell-mediated immunity and influenza illness severity in vaccinated older adults.

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Citations

Oct 10, 2013·Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research·Tila KhanPaul C Roberts
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Oct 30, 2016·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Kamran HaqJanet E McElhaney
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