Terho Heikkinen

Publications (91) View all

• Article: Panel 5: microbiology and immunology panel.

  Timothy F Murphy, Tasnee Chonmaitree, Stephen Barenkamp, Jennelle Kyd, Johanna Nokso-Koivisto, Janak A Patel, Terho Heikkinen, Noboru Yamanaka, Pearay Ogra, W Edward Swords, Tania Sih, Melinda M Pettigrew
  [show abstract] [hide abstract]
  ABSTRACT: Objective The objective is to perform a comprehensive review of the literature from January 2007 through June 2011 on the virology, bacteriology, and immunology related to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Three subpanels with co-chairs comprising experts in the virology, bacteriology, and immunology of otitis media were formed. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a second draft was created. The entire panel met at the 10th International Symposium on Recent Advances in Otitis Media in June 2011 and discussed the review and refined the content further. A final draft was created, circulated, and approved by the panel. Conclusion Excellent progress has been made in the past 4 years in advancing an understanding of the microbiology and immunology of otitis media. Advances include laboratory-based basic studies, cell-based assays, work in animal models, and clinical studies. Implications for Practice The advances of the past 4 years formed the basis of a series of short-term and long-term research goals in an effort to guide the field. Accomplishing these goals will provide opportunities for the development of novel interventions, including new ways to better treat and prevent otitis media.
  Otolaryngology Head and Neck Surgery 04/2013; 148(4 Suppl):E64-89. · 1.72 Impact Factor
• Article: Identification of respiratory viruses with a novel point-of-care multianalyte antigen detection test in children with acute respiratory tract infection.

  Lauri Ivaska, Jussi Niemelä, Terho Heikkinen, Tytti Vuorinen, Ville Peltola
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Rapid etiological diagnosis of a respiratory virus infection may have impact on antiviral and antibiotic therapy, patient cohorting, and prediction of the clinical course. Most point-of-care tests for detection of respiratory viruses have limitations in diagnostic performance and clinical usability. A novel, multianalyte point-of-care antigen detection test system (mariPOC(®); ArcDia International Oy Ltd., Turku, Finland) detects eight respiratory viruses (influenza A and B viruses, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus, and parainfluenza type 1, 2, and 3 viruses) from a single nasopharyngeal swab specimen by a fully automated, random-access immunoassay method. OBJECTIVES: To evaluate mariPOC(®) point-of-care test system in comparison with reverse transcription polymerase chain reaction (RT-PCR) in a pediatric emergency department setting. STUDY DESIGN: Prospectively collected samples from 158 children (mean age, 1.8 years) with respiratory symptoms and/or fever were analyzed both by mariPOC(®) and by multiplex RT-PCR. RESULTS: The sensitivities and specificities (95% confidence intervals) of the mariPOC(®) test were for influenza A (n=7), 71% (38-100) and 100%; influenza B (n=22), 86% (72-100) and 98% (95-100); RSV (n=35), 89% (78-99) and 100%; adenovirus (n=12), 25% (1-50) and 97% (95-99); and for human metapneumovirus (n=8), 50% (15-85) and 100%, respectively. Parainfluenzaviruses were detected only in five patients. CONCLUSIONS: This novel point-of-care test system is a rapid, practical, and specific method for simultaneous detection of eight respiratory viruses. Compared with RT-PCR, its sensitivity is moderately high for detection of RSV and influenza viruses, and low for adenovirus.
  Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 03/2013; · 3.12 Impact Factor
• Article: Effectiveness of Intranasal Live Attenuated Influenza Vaccine against All-cause Acute Otitis Media in Children.

  Terho Heikkinen, Stan L Block, Seth L Toback, Xionghua Wu, Christopher S Ambrose
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND:: Acute otitis media (AOM) is a frequent complication of influenza in children, and influenza vaccination helps protect against influenza-associated AOM. A live attenuated influenza vaccine (LAIV) approved for eligible children aged ≥2 years for the prevention of influenza also effectively reduces influenza-associated AOM. However, the annual effectiveness of LAIV against all-cause AOM is unknown. METHODS:: AOM rates in children 6-83 months of age from 6 randomized, placebo-controlled trials and 2 randomized, inactivated influenza vaccine (IIV)-controlled trials were pooled and analyzed. To enable comparison with studies of AOM prevention by pneumococcal conjugate vaccines (PCV), 12-month effectiveness was calculated assuming that LAIV had no effect outside of influenza seasons. RESULTS:: During influenza seasons, LAIV efficacy compared with placebo against all-cause AOM in children 6-71 months of age (N=9497) was 12.4% (95% CI: 2.0%, 21.6%) in year 1. In year 2, the efficacy in children aged 18-83 months (N=4142) was 6.2% (95% CI: -12.4%, 21.7%). Compared with IIV, the efficacy of LAIV in children 6-71 months (N=9901) against febrile all-cause AOM was 9.7% (95% CI: -2.1%, 20.1%). The estimated 12-month effectiveness of LAIV compared with placebo against all-cause AOM was 7.5% (95% CI: -2.4%, 16.2%). CONCLUSIONS:: LAIV reduced the incidence of all-cause AOM compared with placebo in children. The estimated 12-month effectiveness of LAIV was comparable with PCV7. The effects of the vaccines will overlap somewhat; however, because PCVs only prevent a fraction of all pneumococcal AOM and influenza-associated AOM can be caused by other pathogens, LAIV could further reduce the incidence of AOM in children.
  The Pediatric Infectious Disease Journal 12/2012; · 3.58 Impact Factor
• Article: Burden of paediatric influenza in Western Europe: a systematic review.

  Evgeniya N Antonova, Catherine E Rycroft, Christopher S Ambrose, Terho Heikkinen, Nicola Principi
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Influenza illness in children causes significant clinical and economic burden. Although some European countries have adopted influenza immunisation policies for healthy children, the debate about paediatric influenza vaccination in most countries of the European Union is ongoing. Our aim was to summarise influenza burden (in terms of health outcomes and economic burden) in children in Western Europe via a systematic literature review. METHODS: We conducted a systematic literature search of PubMed, EMBASE, and the Cochrane Library (1970-April 2011) and extracted data on influenza burden in children (defined as aged <= 18 years) from 50 publications (13 reporting laboratory-confirmed influenza; 37 reporting influenza-like illness). RESULTS: Children with laboratory-confirmed influenza experienced hospitalisations (0.3%-20%), medical visits (1.7-2.8 visits per case), antibiotic prescriptions (7%-55%), and antipyretic or other medications for symptomatic relief (76%-99%); young children and those with severe illness had the highest rates of health care use. Influenza in children also led to absenteeism from day care, school, or work for the children, their siblings, and their parents. Average (mean or median) length of absence from school or day care associated with confirmed influenza ranged from 2.8 to 12.0 days for the children, from 1.3 to 6.0 days for their siblings, and from 1.3 to 6.3 days for their parents. Influenza negatively affected health-related quality of life in children with asthma, including symptoms and activities; this negative effect was smaller in vaccinated children than in non-vaccinated children. CONCLUSIONS: Influenza burden in children is substantial and has a significant direct impact on the ill children and an indirect impact on their siblings and parents. The identified evidence regarding the burden of influenza may help inform both influenza antiviral use in children and paediatric immunisation policies in European countries.
  BMC Public Health 11/2012; 12(1):968. · 2.00 Impact Factor
• Article: Safety of MF59-adjuvanted A/H1N1 influenza vaccine in pregnancy: a comparative cohort study.

  Terho Heikkinen, James Young, Erik van Beek, Henk Franke, Thomas Verstraeten, John G Weil, Giovanni Della Cioppa
  [show abstract] [hide abstract]
  ABSTRACT: The 2009-2010 A/H1N1 pandemic provided a unique setting to study the safety of MF59-adjuvanted vaccination in pregnancy. This was an observational cohort study of the safety of an MF59-adjuvanted A/H1N1 vaccine (Focetria) conducted among 4508 pregnant women (2295 vaccinated vs 2213 unvaccinated), with 3 month follow-up of neonates. No maternal deaths or abortions occurred among the vaccinated women. No differences between the vaccinated and unvaccinated cohorts were observed for gestational diabetes, preeclampsia, stillbirth, low birthweight, neonatal deaths, or congenital malformations. The risk of premature birth was significantly decreased among the vaccinated women (adjusted proportional hazard, 0.69; 95% confidence interval, 0.51-0.92). No differences were observed in rates of congenital malformations after vaccination in the first (2.1%), second (2.7%), or third (2.1%) trimesters. There was no evidence of a safety risk for MF59-adjuvanted A/H1N1 vaccination in pregnant women; protection was observed against premature birth.
  American journal of obstetrics and gynecology 09/2012; 207(3):177.e1-8. · 3.28 Impact Factor