Acute respiratory infections, influenza-like illness and JIA: impact on disease activity and response to the influenza vaccine

Methods Surveillance for Flu and other respiratory virus: respiratory syncytial virus (RSV), metapneumovirus (MPV), parainfluenza virus (PIV), bocavirus (Bov), adenovirus (Adv), rhinovirus (RV) and coronavirus (Cov) was conducted in JIA patients attending a tertiary Pediatric Rheumatology Clinic from March to August 2007 (61 JIA patients included) and from March to August 2008 (63 JIA patients). Patients presenting signs of ARI and/ or IL had airway secretion collected in a 72hs period, by combined nasal and pharyngeal swab, and viruses detection was performed using real time PCR (qPCR). 44 JIA patients aged 2 to 18 years received trivalent split Flu vaccine A/Solomon Islands/3/2006, H1N1; A/Brisbane/ 10/200, H3N2; B/Florida/2006 (Sanofi Pasteur SA/ Butantan Institute) in 2008. Thirty-one of the patients (70%) were on MTX or leflunomide and 5 (11%) were on anti-TNF drugs at the time of vaccination. Clinical and laboratory evaluation, including ACRPed30 were performed during the surveillance period, before and after vaccination. Flu titers were determined by hemagglutination inhibition (HI) assay before and 30-40 days after vaccination. Immune response was defined by seroconversion (a 4-fold or greater rise in HI antibodies) and seroprotection (HI titers at least 1:40).