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As influenza is an acute self-limited infection there are no mechanisms that allow for influenza persistence, and there are no influenza-associated pathways that inhibit apoptosis.
When attempting to assess the likelihood of influenza persistence in a focal region (e.g., Vietnam), we must sample outside the focal region to determine whether local viruses have been reintroduced from elsewhere.
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Using a mouse model of infection, we show that corticosteroid treatment promotes H. influenzae persistence.
Taken together, these data indicate that treatment with beclomethasone enhanced H. influenzae persistence in the airway and systemically in this model of infection.
Using a mouse model of acute infection, we show that the presence of glucocorticosteroids promotes H. influenzae persistence without influencing the host inflammatory response.
We show that the presence of beclomethasone promotes H. influenzae persistence without influencing the host inflammatory response in a mouse model of acute infection.
Mometasone (50 μM) also appeared to promote H. influenzae persistence, although its influence was considerably less than the other two steroids tested.
The effects of beclomethasone on H. influenzae persistence were also examined in C57BL/6 mice that did not receive the cyclophosphamide treatment.
The same trend was observed where beclomethasone treatment enhanced H. influenzae persistence in the airway, although in this case, no dissemination to the spleen was seen (Supplementary Fig S2).
However, influenza virus persistence, possibly caused by inability of the child's immune system to clear the infection, and prolonged treatment with oseltamivir, led to the appearance of the H275Y mutation.
Given Vietnam's high population density and strong travel connections to eastern Asia, Southeast Asia, and Australia/New Zealand, Vietnam is as likely as any other country in eastern or Southeast Asia to support continuous, year-round circulation of a single influenza lineage (persistence) and potentially act as a global source of influenza viruses.
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