H caution because of the retrospective study design, selection bias and small sample size. Despite our study limitations, we observed some important trends in severe infection with 2009 H1N1 virus infection. This study indicated age groups at higher risk of hospitalization during the immediate post-pandemic period were changing, compared with those during the 2009?010 pandemic. During the winter season of 2010?011, children under 5 years had the highest risk of hospitalization and death associated withHospitalized Cases of 2009 H1N1 after PandemicH1N1 infection. Additionally, a decline of risk of hospitalization among people aged 5?4 years and a shift to older age for fatal patients was detected. The relative risk of hospitalization and death among people older than 64 years increased. Consistent with seasonal influenza and the 2009?010 pandemic period, purchase PD-168393 chronic medical conditions are important risk factors for severe disease during the winter season of 2010?011. This study demonstrated the benefit of maintenance of severe patients surveillance to determine changes in the epidemiology of 2009 H1N1 infection after the pandemic period, and contributing to recommendations to target groups for influenza prevention and control interventions.Figure S2 Age distribution of hospitalized caseswith and without chronic medical conditions, the 2010?011 winter season. Bar labels denote percent of hospitalized cases with chronic medical conditions in each age group. (TIF)AcknowledgmentsWe thank the participating hospitals, local health departments and Centers for Disease Control and Prevention in China for assistance in coordinating data collection, and the Ministry of Health, China for supporting this study.Supporting InformationGeographical distribution of all hospitalized cases reported to China CDC, China, from November 2010 to May 2011. (TIF)Figure SAuthor ContributionsConceived and designed the experiments: CX YS. P7C3 web Performed the experiments: CX MC TC JS JY LW FY. Analyzed the data: CX P-YC ADI. Contributed reagents/materials/analysis tools: CX MC TC JS LW FY. Wrote the paper: CX ADI YS M-AW.
Misfolding of cellular prion protein (PrPC) into the scrapie prion protein (PrPSc) isoform is a key event in the pathogenesis of prion disorders [1,2]. PrPSc is the main component of the TSE infectious agent [3?] and is able to propagate itself by seeding and templating a conformational change in PrPC, a glycosylphosphatidylinositol (GPI)-anchored glycoprotein [2,4,9,10]. Unlike PrPC, PrPSc tends to be aggregated [11?5], partially resistant to proteases [3,14], rich in beta sheet [16?0], and lacking in native alpha helices [16,18,19]. In the brain PrPSc can accumulate in deposits ranging from large fibrillar amyloid plaques [21?4] to smaller diffuse nonamyloid oligomers [25,26]. Diffuse forms are predominant in many human and animal TSEs. However, PrPSc amyloid is a prominent feature of some genetic human prion diseases such as Gerstmann-Straussler-Scheinker syndrome (GSS) [27] and prion ?protein cerebral 1317923 amyloid angiopathy (PrP-CAA) [28]. In numerous TSE types, both amyloid and non-amyloid deposits can be found in the same tissue. However, in scrapie-infected transgenic mice expressing prion protein lacking the glycosylphosphatidylinositol anchor (GPI), PrPSc appears to be exclusively contained in amyloid plaques [29,30]. Both large amyloid fibrils and nonamyloid aggregates of PrPSc are associated with high levels of infectivity [13,29], but smaller non-fibril.H caution because of the retrospective study design, selection bias and small sample size. Despite our study limitations, we observed some important trends in severe infection with 2009 H1N1 virus infection. This study indicated age groups at higher risk of hospitalization during the immediate post-pandemic period were changing, compared with those during the 2009?010 pandemic. During the winter season of 2010?011, children under 5 years had the highest risk of hospitalization and death associated withHospitalized Cases of 2009 H1N1 after PandemicH1N1 infection. Additionally, a decline of risk of hospitalization among people aged 5?4 years and a shift to older age for fatal patients was detected. The relative risk of hospitalization and death among people older than 64 years increased. Consistent with seasonal influenza and the 2009?010 pandemic period, chronic medical conditions are important risk factors for severe disease during the winter season of 2010?011. This study demonstrated the benefit of maintenance of severe patients surveillance to determine changes in the epidemiology of 2009 H1N1 infection after the pandemic period, and contributing to recommendations to target groups for influenza prevention and control interventions.Figure S2 Age distribution of hospitalized caseswith and without chronic medical conditions, the 2010?011 winter season. Bar labels denote percent of hospitalized cases with chronic medical conditions in each age group. (TIF)AcknowledgmentsWe thank the participating hospitals, local health departments and Centers for Disease Control and Prevention in China for assistance in coordinating data collection, and the Ministry of Health, China for supporting this study.Supporting InformationGeographical distribution of all hospitalized cases reported to China CDC, China, from November 2010 to May 2011. (TIF)Figure SAuthor ContributionsConceived and designed the experiments: CX YS. Performed the experiments: CX MC TC JS JY LW FY. Analyzed the data: CX P-YC ADI. Contributed reagents/materials/analysis tools: CX MC TC JS LW FY. Wrote the paper: CX ADI YS M-AW.
Misfolding of cellular prion protein (PrPC) into the scrapie prion protein (PrPSc) isoform is a key event in the pathogenesis of prion disorders [1,2]. PrPSc is the main component of the TSE infectious agent [3?] and is able to propagate itself by seeding and templating a conformational change in PrPC, a glycosylphosphatidylinositol (GPI)-anchored glycoprotein [2,4,9,10]. Unlike PrPC, PrPSc tends to be aggregated [11?5], partially resistant to proteases [3,14], rich in beta sheet [16?0], and lacking in native alpha helices [16,18,19]. In the brain PrPSc can accumulate in deposits ranging from large fibrillar amyloid plaques [21?4] to smaller diffuse nonamyloid oligomers [25,26]. Diffuse forms are predominant in many human and animal TSEs. However, PrPSc amyloid is a prominent feature of some genetic human prion diseases such as Gerstmann-Straussler-Scheinker syndrome (GSS) [27] and prion ?protein cerebral 1317923 amyloid angiopathy (PrP-CAA) [28]. In numerous TSE types, both amyloid and non-amyloid deposits can be found in the same tissue. However, in scrapie-infected transgenic mice expressing prion protein lacking the glycosylphosphatidylinositol anchor (GPI), PrPSc appears to be exclusively contained in amyloid plaques [29,30]. Both large amyloid fibrils and nonamyloid aggregates of PrPSc are associated with high levels of infectivity [13,29], but smaller non-fibril.
