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Ramos-Rincón JM, Pinargote-Celorio H, González-de-la-Aleja P, Sánchez-Payá J, Reus S, Rodríguez-Díaz JC, Merino E. Impact of influenza related hospitalization in Spain: characteristics and risk factor of mortality during five influenza seasons (2016 to 2021). Front Public Health 2024; 12:1360372. [PMID: 38628848 PMCID: PMC11018950 DOI: 10.3389/fpubh.2024.1360372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/12/2024] [Indexed: 04/19/2024] Open
Abstract
Background Estimating the global influenza burden in terms of hospitalization and death is important for optimizing prevention policies. Identifying risk factors for mortality allows for the design of strategies tailored to groups at the highest risk. This study aims to (a) describe the clinical characteristics of hospitalizations with a diagnosis of influenza over five flu seasons (2016-2017 to 2020-2021), (b) assess the associated morbidity (hospitalization rates and ICU admissions rate), mortality and cost of influenza hospitalizations in different age groups and (c) analyze the risk factors for mortality. Methods This retrospective study included all hospital admissions with a diagnosis of influenza in Spain for five influenza seasons. Data were extracted from the Spanish National Surveillance System for Hospital Data from 1 July 2016 to 30 June 2021. We identified cases coded as having influenza as a primary or secondary diagnosis (International Classification of Diseases, 10th revision, J09-J11). The hospitalization rate was calculated relative to the general population. Independent predictors of mortality were identified using multivariable logistic regression. Results Over the five seasons, there were 127,160 hospitalizations with a diagnosis of influenza. The mean influenza hospitalization rate varied from 5/100,000 in 2020-2021 (COVID-19 pandemic) to 92.9/100,000 in 2017-2018. The proportion of influenza hospitalizations with ICU admission was 7.4% and was highest in people aged 40-59 years (13.9%). The case fatality rate was 5.8% overall and 9.4% in those aged 80 years or older. Median length of stay was 5 days (and 6 days in the oldest age group). In the multivariable analysis, independent risk factors for mortality were male sex (odds ratio [OR] 1.14, 95% confidence interval [95% CI] 1.08-1.20), age (<5 years: OR 1; 5-19 years: OR 2.02, 95%CI 1.17-3.49; 20-39 years: OR 4.11, 95% CI 2.67-6.32; 40-59 years: OR 8.15, 95% CI 5.60-11.87; 60-79 years: OR 15.10, 95% CI 10.44-21.84; ≥80 years: OR 33.41, 95% CI 23.10-48.34), neurological disorder (OR 1.97, 95% CI 1.83-2.11), heart failure (OR 1.85, 95% CI 1.74-1.96), chronic kidney disease (OR 1.33, 95% CI 1.25-1.41), chronic liver disease (OR 2.95, 95% CI 2.68-3.27), cancer (OR 1.85, 95% CI 1.48-2.24), coinfection with SARS-CoV2 (OR 3.17, 95% CI 2.34-4.28), influenza pneumonia (OR 1.76, 95% CI 1.66-1.86) and admission to intensive care (OR 7.81, 95% CI 7.31-8.36). Conclusion Influenza entails a major public health burden. People aged over 60-and especially those over 80-show the longest hospital stays. Age is also the most significant risk factor for mortality, along with certain associated comorbidities.
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Affiliation(s)
- José-Manuel Ramos-Rincón
- Internal Medicine Department, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Héctor Pinargote-Celorio
- Unit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pilar González-de-la-Aleja
- Unit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Preventive Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Sergio Reus
- Unit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Juan-Carlos Rodríguez-Díaz
- Microbiology Service, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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2
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Jacob J, Biering-Sørensen T, Holger Ehlers L, Edwards CH, Mohn KGI, Nilsson A, Hjelmgren J, Ma W, Sharma Y, Ciglia E, Mould-Quevedo J. Cost-Effectiveness of Vaccination of Older Adults with an MF59 ®-Adjuvanted Quadrivalent Influenza Vaccine Compared to Standard-Dose and High-Dose Vaccines in Denmark, Norway, and Sweden. Vaccines (Basel) 2023; 11:753. [PMID: 37112667 PMCID: PMC10145635 DOI: 10.3390/vaccines11040753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Individuals aged 65 years and above are at increased risk of complications and death from influenza compared with any other age group. Enhanced vaccines, as the MF59®-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (HD-QIV), provide increased protection for older adults in comparison to the traditional standard-dose quadrivalent influenza vaccines (SD-QIV). This study aimed to assess the cost-effectiveness of aQIV compared to SD-QIV and HD-QIV in Denmark, Norway, and Sweden for adults aged ≥65 years. A static decision tree model was used to evaluate costs and outcomes of different vaccination strategies from healthcare payer and societal perspectives. This model projects that compared to SD-QIV, vaccination with aQIV could prevent a combined total of 18,772 symptomatic influenza infections, 925 hospitalizations, and 161 deaths in one influenza season across the three countries. From a healthcare payer perspective, the incremental costs per quality adjusted life year (QALY) gained with aQIV versus SD-QIV were EUR 10,170/QALY in Denmark, EUR 12,515/QALY in Norway, and EUR 9894/QALY in Sweden. The aQIV was cost saving compared with HD-QIV. This study found that introducing aQIV to the entire population aged ≥65 years may contribute to reducing the disease and economic burden associated with influenza in these countries.
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Affiliation(s)
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, 2730 Herlev, Denmark
- Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | | | - Christina H Edwards
- Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Kristin Greve-Isdahl Mohn
- Influenza Centre, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway
- Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Anna Nilsson
- Infectious Disease Unit, Malmö, Skåne University Hospital, 214 28 Malmö, Sweden
| | - Jonas Hjelmgren
- The Swedish Institute for Health Economics, 223 61 Lund, Sweden
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3
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Social and demographic patterns of influenza vaccination coverage in Norway, influenza seasons 2014/15 to 2020/21. Vaccine 2023; 41:1239-1246. [PMID: 36639272 DOI: 10.1016/j.vaccine.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
AIMS To examine influenza vaccination coverage among risk groups (RG) and health care workers (HCW), and study social and demographic patterns of vaccination coverage over time. METHODS Vaccination coverage was estimated by self-report in a nationally representative telephone survey among 14919 individuals aged 18-79 years over seven influenza seasons from 2014/15 to 2020/21. We explored whether belonging to an influenza RG (being >=65 years of age and/or having >=1 medical risk factor), being a HCW or educational attainment was associated with vaccination status using logistic regression. RESULTS Vaccination coverage increased from 27 % to 66 % among individuals 65-79 years, from 13 % to 33 % among individuals 18-64 years with >=1 risk factor, and from 9 % to 51 % among HCWs during the study period. Being older, having a risk factor or being a HCW were significantly associated with higher coverage in all multivariable logistic regression analyses. Higher education was also consistently associated with higher coverage, but the difference did not reach significance in all influenza seasons. Educational attainment was not significantly associated with coverage while coverage was at its lowest (2014/15-2017/18), but as coverage increased, so did the differences. Individuals with intermediate or lower education were less likely to report vaccination than those with higher education in season 2018/19, OR = 0.61 (95 % CI 0.46-0.80) and OR = 0.58 (95 % CI 0.41-0.83), respectively, and in season 2019/20, OR = 0.69 (95 % CI 0.55-0.88) and OR = 0.71 (95 % CI 0.53-0.95), respectively. When the vaccine was funded in the COVID-19 pandemic winter of 2020/21, educational differences diminished again and were no longer significant. CONCLUSIONS We observed widening educational differences in influenza vaccination coverage as coverage increased from 2014/15 to 2019/20. When influenza vaccination was funded in 2020/21, differences in coverage by educational attainment diminished. These findings indicate that economic barriers influence influenza vaccination decisions among risk groups in Norway.
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4
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Klüwer B, Rydland K, Greve-Isdahl M, Bragstad K, Berg AS. Flere barn bør få influensavaksine. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2022; 142:22-0678. [DOI: 10.4045/tidsskr.22.0678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Dale JN, Morken T, Eliassen KE, Blinkenberg J, Rørtveit G, Hunskaar S, Rebnord IK, Baste V. Preparedness and management during the first phase of the COVID-19 outbreak - a survey among emergency primary care services in Norway. BMC Health Serv Res 2022; 22:896. [PMID: 35820916 PMCID: PMC9275270 DOI: 10.1186/s12913-022-08284-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The emergency primary care (EPC) services in Norway have been at the frontline of the COVID-19 pandemic. Knowledge about the EPC services' management of the COVID-19 outbreak can be used to prepare for future outbreaks and improve patient management. The objectives of this study were to identify pandemic preparedness and management strategies in EPC centres in Norway during the COVID-19 outbreak. METHODS Questions regarding patient management of the COVID-19 outbreak were included in data collection for the National Out-Of-Hours Services Registry. The data collection was web-based, and an invitation was sent by email to the managers of all EPC services in Norway in June 2020. The EPC services were asked questions about pre-pandemic preparedness, access to personal protective equipment (PPE), organizational measures taken, and how staffing was organized during the onset of the pandemic. RESULTS There were 169 municipal and inter-municipal EPC services in Norway in 2020, and all responded to the questionnaire. Among the EPC services, 66.7% (n = 112) had a pandemic plan, but only 4.2% had performed training for pandemic preparedness. Further, fewer than half of the EPC centres (47.5%) had access to supplies of PPE, and 92.8% answered that they needed extra supplies of PPE. 75.3% of the EPC services established one or more respiratory clinics. Staffing with other personnel than usual was done in 44.6% (n = 74) of the EPC services. All EPC services except one implemented new strategies for assessing patients, while about half of the wards implemented new strategies for responding to emergency calls. None of the largest EPC services experienced that their pandemic plan was adequate, while 13.3% of the medium-sized EPC services and 48.9% of the small EPC services reported having an adequate pandemic plan. CONCLUSIONS Even though the EPC services lacked well-tested plans and had insufficient supplies of PPE at the outbreak of the COVID-19 pandemic, most services adapted to the pandemic by altering the ways they worked and by hiring health care professionals from other disciplines. These observations may help decision makers plan for future pandemics.
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Affiliation(s)
- Jonas Nordvik Dale
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Tone Morken
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Knut Eirik Eliassen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jesper Blinkenberg
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Guri Rørtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Steinar Hunskaar
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ingrid Keilegavlen Rebnord
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
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6
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Kanecki K, Lewtak K, Goryński P, Tyszko P, Bogdan M, Rząd M, Nitsch-Osuch A. Hospitalization of Children Aged <5 Years Due to Influenza: Study Based on the National Hospitalization Registry. CHILDREN (BASEL, SWITZERLAND) 2022; 9:930. [PMID: 35883914 PMCID: PMC9321516 DOI: 10.3390/children9070930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022]
Abstract
Background: Influenza constitutes a significant health care burden that can be related to an increased morbidity and mortality. The aim of the study is to show up-to-date information on influenza hospitalization cases in Poland in children aged <5 years. Methods: The data used in the study were hospitalization records from 2015−2019, which had been gathered in a Nationwide General Hospital Morbidity Study and made available by the National Institute of Public Health. Results: 8565 records of patients with influenza were subject to analysis. The mean and median age of the patients were 2.2 and 2.1 years, respectively. Influenza hospitalization incidence was estimated at 90 per 100,000 person-years (PY) in children aged <5 years. The number of hospitalization cases was significantly higher in patients living in urban regions than in those living in rural regions (97 vs. 77 per 100,000 PY; p < 0.001). The age of patients living in urban regions was significantly lower than the age of patients living in rural regions (2.2 vs. 2.3 years; p < 0.001). A statistically significant increase in hospitalization was observed. Conclusions: The reported increasing trend in hospitalizations indicates the need to take focused measures. Presented data may be useful in comparative analyses in a European context.
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Affiliation(s)
- Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
| | - Paweł Goryński
- National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland;
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
- Institute of Rural Health in Lublin, 2 Jaczewskiego Street, 20-090 Lublin, Poland
| | - Magdalena Bogdan
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
| | - Michał Rząd
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.K.); (P.T.); (M.B.); (M.R.); (A.N.-O.)
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7
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Wæhre T, Tunheim G, Bodin JE, Laake I, Kvale D, Kran AMB, Brekke H, Løken R, Oftung F, Mjaaland S, Dyrhol-Riise AM. Clinical characteristics and outcomes in hospitalized adult influenza patients: an observational study from Norway 2014-2018. Infect Dis (Lond) 2022; 54:367-377. [PMID: 34983302 DOI: 10.1080/23744235.2021.2022196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Seasonal influenza causes substantial numbers of hospitalizations annually. We have characterized the clinical picture and treatment practice in hospitalized adult influenza patients and assessed whether clinical risk scores on admission or influenza type were associated with severe outcomes. METHODS Clinical characteristics and risk scores on admission (CRB65, CRB, SIRS and quick Sequential Organ Failure Assessment [qSOFA]), treatment and severe outcomes (defined as: stay in intensive care unit (ICU), receiving oxygen supplementation or staying ≥5 days in hospital), were recorded in patients hospitalized with influenza at Oslo University Hospital, Norway, between 2014 and 2018. RESULTS Among the 156 included patients, 52.6% had influenza A(H3N2), 32.6% influenza B and 12.8% influenza A(H1N1). Median age was 70 years and 59.6% of patients were ≥65 years. Nine (5.8%) of the patients were treated in ICU, 43.0% received oxygen and 47.4% stayed ≥5 days in hospital. Overall, 34.6% of the patients had a high CRB score on admission which was associated with stay in ICU and oxygen supplementation. Multivariate analyses identified age, and pneumonia (46.8%), but not influenza type, to be associated with severe outcomes. Antiviral treatment was given to 37.2% of the patients, while 77.6% received antibiotics. Only 25.5% of patients with influenza B received antiviral therapy. CONCLUSIONS The influenza patients were mostly elderly, and few patients were treated in ICU. A high CRB score was associated with severe outcomes with possible implications for patient monitoring. Less than 40% of the patients received antiviral therapy, whereas the majority were treated with antibiotics, indicating potential for optimising treatment strategies.
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Affiliation(s)
- Torgun Wæhre
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway
| | - Gro Tunheim
- K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Johanna Eva Bodin
- K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Ida Laake
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Dag Kvale
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Hanne Brekke
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Ragnhild Løken
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Fredrik Oftung
- K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Siri Mjaaland
- K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Margarita Dyrhol-Riise
- Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Centre for Influenza Vaccine Research, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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8
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Bøås H, Bekkevold T, Havdal LB, Kran AMB, Rojahn AE, Størdal K, Debes S, Døllner H, Nordbø SA, Barstad B, Haarr E, Vázquez Fernández L, Nakstad B, Leegaard TM, Hungnes O, Flem E. The burden of hospital-attended influenza in Norwegian children. Front Pediatr 2022; 10:963274. [PMID: 36160779 PMCID: PMC9491848 DOI: 10.3389/fped.2022.963274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Norwegian health authorities do not recommend universal pediatric vaccination against seasonal influenza. We aimed to estimate the incidence of influenza by age and underlying medical conditions in hospitalized Norwegian children aged <18 years. METHODS Active surveillance for influenza in children <18 years was implemented in five hospitals during 2015-18. Children with respiratory symptoms and/or fever were prospectively enrolled and tested for influenza. Surveillance data were linked to health registry data to estimate the national burden of influenza in hospitals. RESULTS In 309 (10%) out of 3,010 hospital contacts, the child tested positive for influenza, corresponding to an average incidence of 0.96 hospital-attended influenza cases per 1,000 children <18 years of age. Children <1 year of age (3.8 per 1,000 children) and children with underlying medical conditions (17 per 1,000 children with bronchopulmonary dysplasia) had the highest average incidence. Among <1 year old children, 3% tested positive for influenza, compared to 25% for children aged 6-17. Few children were vaccinated against influenza. CONCLUSIONS Children <1 year of age and children with underlying medical conditions had a higher incidence of influenza requiring hospital treatment compared to the general population. Effective interventions against seasonal influenza for children in Norway should be considered.
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Affiliation(s)
- Håkon Bøås
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lise Beier Havdal
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Nordbyhagen, Norway
| | - Anne-Marte Bakken Kran
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | | | - Ketil Størdal
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Department of Pediatrics, Østfold Hospital, Grålum, Norway.,Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sara Debes
- Department of Medical Microbiology, Østfold Hospital, Grålum, Norway
| | - Henrik Døllner
- Department of Pediatrics, St. Olavs University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Svein Arne Nordbø
- Department of Medical Microbiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn Barstad
- Department of Paediatric and Adolescent Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Elisebet Haarr
- Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway
| | | | - Britt Nakstad
- Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Nordbyhagen, Norway.,Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Truls Michael Leegaard
- Department of Microbiology and Infection Control, Akershus University Hospital, Nordbyhagen, Norway.,Division of Medicine and Laboratory Sciences, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav Hungnes
- Norwegian Institute of Public Health, Oslo, Norway
| | - Elmira Flem
- Norwegian Institute of Public Health, Oslo, Norway
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9
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Amdam H, Madsen A, Zhou F, Bansal A, Trieu MC, Cox RJ. Functional and Binding H1N1pdm09-Specific Antibody Responses in Occasionally and Repeatedly Vaccinated Healthcare Workers: A Five-Year Study (2009-2014). Front Immunol 2021; 12:748281. [PMID: 34938285 PMCID: PMC8685392 DOI: 10.3389/fimmu.2021.748281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background In 2009, a novel influenza A/H1N1pdm09 emerged and caused a pandemic. This strain continued to circulate and was therefore included in the seasonal vaccines up to the 2016/2017-season. This provided a unique opportunity to study the long-term antibody responses to H1N1pdm09 in healthcare workers (HCW) with a different vaccination history. Methods HCW at Haukeland University Hospital, Bergen, Norway were immunized with the AS03-adjuvanted H1N1pdm09 vaccine in 2009 (N=55) and divided into groups according to their vaccination history; one vaccination (N=10), two vaccinations (N=15), three vaccinations (N=5), four vaccinations (N=15) and five vaccinations (N=10). HCW are recommended for influenza vaccination to protect both themselves and their patients, but it is voluntary in Norway. Blood samples were collected pre- and at 21 days, 3, 6, and 12 months after each vaccination, or annually from 2010 HCW without vaccination. ELISA, haemagglutination inhibition (HI) and microneutralization (MN) assays were used to determine the antibody response. Results Pandemic vaccination induced a significant increase in the H1N1-specific antibodies measured by ELISA, HI and MN. Seasonal vaccination boosted the antibody response, both in HCW with only the current vaccination and those with prior and current vaccination during 2010/11-2013/14. We observed a trend of increased antibody responses in HCW with only the current vaccination in 2013/14. A two- and three-year gap before vaccination in 2013/14 provided a more potent antibody response compared to annually vaccinated HCW. Conclusions Our long term follow up study elucidates the antibody response in HCW with different vaccination histories. Our findings contribute to our understanding of the impact of repeated vaccination upon antibody responses.
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Affiliation(s)
- Håkon Amdam
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anders Madsen
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Fan Zhou
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Amit Bansal
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Mai-Chi Trieu
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Microbiology, Haukeland University Hospital, Bergen, Norway
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10
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Klüwer B, Rydland KM, Laake I, Todd M, Juvet LK, Mamelund SE. Influenza risk groups in Norway by education and employment status. Scand J Public Health 2021; 50:756-764. [PMID: 34930055 PMCID: PMC9361423 DOI: 10.1177/14034948211060635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aims: This study aimed to estimate the size of the risk group for severe influenza
and to describe the social patterning of the influenza risk group in Norway,
defined as everyone ⩾65 years of age and individuals of any age with certain
chronic conditions (medical risk group). Methods: Study data came from a nationally representative survey among 10,923
individuals aged 16–79 years. The medical risk group was defined as
individuals reporting one or more relevant chronic conditions. The
associations between educational attainment, employment status, age and risk
of belonging to the medical risk group were studied with logistic
regression. Results: Nearly a fifth (19.0%) of respondents reported at least one chronic
condition, while 29.4% belonged to the influenza risk group due to either
age or chronic conditions. Being older, having a low educational level
(comparing compulsory education to higher education, odds ratio (OR)=1.4,
95% confidence interval (CI) 1.2–1.8 among women, and OR=1.3, 95% CI 1.1–1.7
among men) and a weaker connection to working life (comparing disability
pension to working full-time, OR=6.8, 95% CI 5.3–8.7 among women, and
OR=6.5, 95% CI 4.9–8.5 among men) was associated with a higher risk of
belonging to the medical risk group for severe influenza. Conclusions: This study indicates that the prevalence of medical risk factors for
severe influenza is disproportionally distributed across the
socio-economic spectrum in Norway. These results should influence both
public funding decisions regarding influenza vaccination and
communication strategies towards the public and health
professionals.
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Affiliation(s)
- Birgitte Klüwer
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Kjersti Margrethe Rydland
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Ida Laake
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Megan Todd
- Division of Chronic Disease and Injury Prevention, Philadelphia Department of Public Health, USA
| | - Lene Kristine Juvet
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics and Society, Oslo Metropolitan University, Norway
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11
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Debes S, Haug JB, de Blasio BF, Jonassen CM, Dudman SG. Etiology of viral respiratory tract infections in hospitalized adults, and evidence of the high frequency of prehospitalization antibiotic treatment in Norway. Health Sci Rep 2021; 4:e403. [PMID: 34646942 PMCID: PMC8499681 DOI: 10.1002/hsr2.403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND AIMS Respiratory tract infections (RTIs) cause considerable morbidity and mortality in all age groups, but the epidemiology and role of several of the viral RTIs in the adult and elderly patients are still unclear, as is the extent of prehospitalization antibacterial drug use in this population. METHODS We conducted a three-year (2015-2018) observational study of viral RTIs in hospitalized patients in a 500-bed hospital in Southeastern Norway, including all patients ≥18 years with RTI symptoms where one of the following viral agents was detected in a respiratory specimen (Seegene Allplex): Influenza A/B, RSV A/B, human metapneumovirus (hMPV), adenovirus and parainfluenza virus 1-4. Viral findings, demographical data, and information on prehospital antibiotic prescriptions were recorded. RESULTS In 1182 patients 1222 viral infection events occurred. The mean patient age was 69.6 years, and 53% were females. Influenza virus A/B (63%), RSV A/B (15%) and hMPV (13%) were the most common agents detected. The proportional burden of influenza A H1 was found to be relatively high (65%) in the age groups <69 years, compared to older patients (P = .001, chi-square).As many as 20% of the patients had been treated with antibiotics prior to admission, with the lowest rate for influenza A H3 group at 17% (P = .036, chi-square), and highest for the RSV group at 28% (P = .004, chi-square).Oseltamivir was prescribed prior to hospitalization in only 3 cases (0.2%). CONCLUSIONS We found a high rate of prehospital antibiotic prescription in adults hospitalized with viral RTIs, warranting better stewardship programs to tackle the increasing antibiotic resistance problem.
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Affiliation(s)
- Sara Debes
- Østfold Hospital Trust, Center for Laboratory MedicineSarpsborgNorway
- Faculty of MedicineInstitute of Clinical Medicine, University of OsloOsloNorway
| | - Jon Birger Haug
- Department of Infection ControlØstfold Hospital TrustSarpsborgNorway
| | - Birgitte Freiesleben de Blasio
- Department of Methods Development and Analytics, Division of Infection Control and Environmental HealthNorwegian Institute of Public HealthOsloNorway
- Department of BiostatisticsCentre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of OsloOsloNorway
| | - Christine Monceyron Jonassen
- Østfold Hospital Trust, Center for Laboratory MedicineSarpsborgNorway
- Department of Chemistry, Biotechnology and Food ScienceNorwegian University of Life SciencesÅsNorway
| | - Susanne Gjeruldsen Dudman
- Faculty of MedicineInstitute of Clinical Medicine, University of OsloOsloNorway
- Department of MicrobiologyOslo University HospitalOsloNorway
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12
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Behavior of hospitalized severe influenza cases according to the outcome variable in Catalonia, Spain, during the 2017-2018 season. Sci Rep 2021; 11:13587. [PMID: 34193898 PMCID: PMC8245597 DOI: 10.1038/s41598-021-92895-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/14/2021] [Indexed: 12/04/2022] Open
Abstract
Influenza is an important cause of severe illness and death among patients with underlying medical conditions and in the elderly. The aim of this study was to investigate factors associated with ICU admission and death in patients hospitalized with severe laboratory-confirmed influenza during the 2017–2018 season in Catalonia. An observational epidemiological case-to-case study was carried out. Reported cases of severe laboratory-confirmed influenza requiring hospitalization in 2017–2018 influenza season were included. Mixed-effects regression analysis was used to estimate the factors associated with ICU admission and death. A total of 1306 cases of hospitalized severe influenza cases were included, of whom 175 (13.4%) died and 217 (16.6%) were ICU admitted. Age 65–74 years and ≥ 75 years and having ≥ 2 comorbidities were positively associated with death (aOR 3.19; 95%CI 1.19–8.50, aOR 6.95, 95%CI 2.76–1.80 and aOR 1.99; 95%CI 1.12–3.52, respectively). Neuraminidase inhibitor treatment and pneumonia were negatively associated with death. The 65–74 years and ≥ 75 years age groups were negatively associated with ICU admission (aOR 0.41; 95%CI 0.23–0.74 and aOR 0.30; 95%CI 0.17–0.53, respectively). A factor positively associated with ICU admission was neuraminidase inhibitor treatment. Our results support the need to investigate the worst outcomes of hospitalized severe cases, distinguishing between death and ICU admission.
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13
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Sansone M, Andersson M, Gustavsson L, Andersson LM, Nordén R, Westin J. Extensive Hospital In-Ward Clustering Revealed By Molecular Characterization of Influenza A Virus Infection. Clin Infect Dis 2021; 71:e377-e383. [PMID: 32011654 DOI: 10.1093/cid/ciaa108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/31/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nosocomial transmission of influenza A virus (InfA) infection is not fully recognized. The aim of this study was to describe the characteristics of hospitalized patients with InfA infections during an entire season and to investigate in-ward transmission at a large, acute-care hospital. METHODS During the 2016-17 season, all hospitalized patients ≥18 years old with laboratory-verified (real-time polymerase chain reaction) InfA were identified. Cases were characterized according to age; sex; comorbidity; antiviral therapy; viral load, expressed as cycle threshold values; length of hospital stay; 30-day mortality; and whether the InfA infection met criteria for a health care-associated influenza A infection (HCAI). Respiratory samples positive for InfA that were collected at the same wards within 7 days were chosen for whole-genome sequencing (WGS) and a phylogenetic analysis was performed to detect clustering. For reference, concurrent InfA strains from patients with community-acquired infection were included. RESULTS We identified a total of 435 InfA cases, of which 114 (26%) met the HCAI criteria. The overall 30-day mortality rate was higher among patients with HCAI (9.6% vs 4.6% among non-HCAI patients), although the difference was not statistically significant in a multivariable analysis, where age was the only independent risk factor for death (P < .05). We identified 8 closely related clusters (involving ≥3 cases) and another 10 pairs of strains, supporting in-ward transmission. CONCLUSIONS We found that the in-ward transmission of InfA occurs frequently and that HCAI may have severe outcomes. WGS may be used for outbreak investigations, as well as for evaluations of the effects of preventive measures.
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Affiliation(s)
- Martina Sansone
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Andersson
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gustavsson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars-Magnus Andersson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rickard Nordén
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Westin
- Department of Clinical Microbiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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14
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Parimalanathan V, Joy M, Van Dam PJ, Fan X, de Lusignan S. Association between Influenza Vaccine Administration and Primary Care Consultations for Respiratory Infections: Sentinel Network Study of Five Seasons (2014/2015-2018/2019) in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020523. [PMID: 33435229 PMCID: PMC7827078 DOI: 10.3390/ijerph18020523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/25/2022]
Abstract
Influenza, a vaccine preventable disease, is a serious global public health concern which results in a considerable burden on the healthcare system. However, vaccine hesitancy is increasingly becoming a global problem. One prevalent misconception is that influenza vaccinations can cause the flu. We carried out this study to determine whether people undertaking influenza vaccination presented less with acute respiratory tract infection (ARTI) and influenza-like-illness (ILI) following vaccination. We utilised the Oxford Royal College of General Practitioners Research and Surveillance Centre sentinel database to examine English patients who received vaccination between 2014/2015 and 2018/2019. Of the 3,841,700 influenza vaccinations identified, vaccination details and primary care respiratory consultation counts were extracted to calculate the relative incidence (RI) per exposure risk period using the self-controlled case series methodology. Results showed a significant increase in the RI of respiratory consultation rates within fourteen days of vaccination across all five years. Less than 6.2% of vaccinations led to consultations for ARTI or ILI in primary care (crude consultation rate 6196 per 100,000). These findings, particularly if confirmed in further research, may reduce the risk of cross-infection between waiting patients and increase uptake of influenza vaccine.
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Affiliation(s)
- Vaishnavi Parimalanathan
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (V.P.); (P.J.V.D.)
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
- Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
| | - Pieter Jan Van Dam
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia; (V.P.); (P.J.V.D.)
| | - Xuejuan Fan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK; (M.J.); (X.F.)
- Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, UK
- Correspondence: ; Tel.: +44-1865-617-283
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15
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Hauge SH, Bakken IJ, de Blasio BF, Håberg SE. Risk conditions in children hospitalized with influenza in Norway, 2017-2019. BMC Infect Dis 2020; 20:769. [PMID: 33076855 PMCID: PMC7569759 DOI: 10.1186/s12879-020-05486-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/07/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Norwegian children are more frequently hospitalized with influenza than adults. Little is known about the characteristics of these children. Our aim was to investigate the presence of pre-existing risk conditions and to determine the duration of influenza hospitalizations in children during two influenza seasons. METHODS The Norwegian Patient Registry holds data on all hospitalized patients in Norway. We included all patients younger than 18 years hospitalized with a diagnosis of influenza during the influenza seasons 2017-18 and 2018-19. Pre-existing risk conditions for influenza were identified by ICD-10 diagnoses in the Norwegian Patient Registry. In addition, information on asthma diagnoses were also retrieved from the Norwegian Registry for Primary Health Care. To estimate the prevalence of risk conditions in the child population, we obtained diagnoses on all Norwegian children in a two-year period prior to each influenza season. We calculated age-specific rates for hospitalization and risk for being hospitalized with influenza in children with risk conditions. RESULTS In total, 1013 children were hospitalized with influenza during the two influenza seasons. Children younger than 6 months had the highest rate of hospitalization, accounting for 13.5% of all admissions (137 children). Hospitalization rates decreased with increasing age. Among children hospitalized with influenza, 25% had one or more pre-existing risk conditions for severe influenza, compared to 5% in the general population under 18 years. Having one or more risk conditions significantly increased the risk of hospitalization, (Odds Ratio (OR) 6.1, 95% confidence interval (CI) 5.0-7.4 in the 2017-18 season, and OR 6.8, 95% CI 5.4-8.4 in the 2018-19 season). Immunocompromised children and children with epilepsy had the highest risk of hospitalization with influenza, followed by children with heart disease and lung disease. The average length of stay in hospital were 4.6 days, and this did not differ with age. CONCLUSION Children with pre-existing risk conditions for influenza had a higher risk of hospitalization for influenza. However, most children (75%) admitted to hospital with influenza in Norway during 2017-2019 did not have pre-existing risk conditions. Influenza vaccination should be promoted in particular for children with risk conditions and pregnant women to protect new-borns.
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Affiliation(s)
- Siri Helene Hauge
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Inger Johanne Bakken
- Department of Health Registries, Norwegian Directorate of Health, Trondheim, Norway
| | - Birgitte Freiesleben de Blasio
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siri Eldevik Håberg
- Norwegian Institute of Public Health, Centre for Fertility and Health, Oslo, Norway
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16
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Araujo KLRD, Aquino ÉCD, Silva LLSD, Ternes YMF. Factors associated with Severe Acute Respiratory Syndrome in a Brazilian central region. CIENCIA & SAUDE COLETIVA 2020; 25:4121-4130. [PMID: 33027348 DOI: 10.1590/1413-812320202510.2.26802020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/10/2020] [Indexed: 11/22/2022] Open
Abstract
Severe Acute Respiratory Infection (SARI) is a notifiable syndrome that must be investigated. This study aimed to analyze the epidemiological profile and factors associated with SARI-related hospitalization and deaths reported in Goiás. Retrospective cohort study, with data from the investigation files of the Notifiable Diseases Information System's Influenza Web. Multivariate analysis methods were employed to verify the association between exposure variables with the outcomes of ICU admission and death. A total of 4,832 SARI cases were reported in Goiás from 2013 to 2018. The primary etiological diagnosis was Influenza A (22.3%) with the predominant subtype A (H1N1pdm09), followed by the Respiratory Syncytial Virus. A total of 34.6% of the patients required ICU admission, and 19% died. A longer time to start treatment with antivirals was associated with a higher likelihood to have an ICU admission, while a previous non-vaccination against Influenza, longer time to start treatment, and older age were associated with a higher likelihood to suffer death. The study showed a high frequency of respiratory diseases caused by the Influenza virus in Goiás and that the severity of the syndrome, characterized by ICU admission and deaths, is associated with the start of antiviral treatment vaccine status, and patient's age.
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Affiliation(s)
- Kamilla Lelis Rodrigues de Araujo
- Programa de Pós-Graduação em Assistência e Avaliação em Saúde, Universidade Federal de Goiás (UFG). Av. Rúda Quadra 41A, Lote 10, Vila Brasília. 74905-760 Aparecida de Goiânia GO Brasil.
| | - Érika Carvalho de Aquino
- Instituto de Patologia Tropical e Saúde Pública, Departamento de Saúde Coletiva, UFG. Goiânia GO Brasil
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17
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Flick H, Arns BM, Bolitschek J, Bucher B, Cima K, Gingrich E, Handzhiev S, Hochmair M, Horak F, Idzko M, Jaksch P, Kovacs G, Kropfmüller R, Lamprecht B, Löffler-Ragg J, Meilinger M, Olschewski H, Pfleger A, Puchner B, Puelacher C, Prior C, Rodriguez P, Salzer H, Schenk P, Schindler O, Stelzmüller I, Strenger V, Täubl H, Urban M, Wagner M, Wimberger F, Zacharasiewicz A, Zwick RH, Eber E. Management of patients with SARS-CoV-2 infections and of patients with chronic lung diseases during the COVID-19 pandemic (as of 9 May 2020) : Statement of the Austrian Society of Pneumology (ASP). Wien Klin Wochenschr 2020; 132:365-386. [PMID: 32533443 PMCID: PMC7291190 DOI: 10.1007/s00508-020-01691-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is currently a challenge worldwide. In Austria, a crisis within the healthcare system has so far been prevented. The treatment of patients with community-acquired pneumonia (CAP), including SARS-CoV‑2 infections, should continue to be based on evidence-based CAP guidelines during the pandemic; however, COVID-19 specific adjustments are useful. The treatment of patients with chronic lung diseases has to be adapted during the pandemic but must still be guaranteed.
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Affiliation(s)
- Holger Flick
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | | | - Brigitte Bucher
- Department of Pulmonology, Tirol Kliniken, Hospital Hochzirl-Natters, Natters, Austria
| | - Katharina Cima
- Department of Pulmonology, Tirol Kliniken, Hospital Hochzirl-Natters, Natters, Austria
| | | | - Sabin Handzhiev
- Department of Pulmonology, University Hospital Krems, Krems, Austria
| | - Maximilian Hochmair
- Respiratory Oncology Unit, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Department of Internal and Respiratory Medicine, Krankenhaus Nord-Klinik Floridsdorf, Vienna, Austria
| | | | - Marco Idzko
- Division of Pulmonology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Peter Jaksch
- Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Gabor Kovacs
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Roland Kropfmüller
- Department of Pulmonology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Bernd Lamprecht
- Department of Pulmonology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II (Infectious Diseases, Pneumology, Rheumatology), Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Meilinger
- Department of Internal and Respiratory Medicine, Krankenhaus Nord-Klinik Floridsdorf, Vienna, Austria
| | - Horst Olschewski
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Andreas Pfleger
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria
| | | | | | | | - Patricia Rodriguez
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria
| | - Helmut Salzer
- Department of Pulmonology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Peter Schenk
- Department of Pulmonology, Landesklinikum Hochegg, Grimmenstein, Austria
| | - Otmar Schindler
- Department of Internal, Respiratory and Critical Care Medicine, State Hospital II, Location Enzenbach, Gratwein-Straßengel, Austria
| | | | - Volker Strenger
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria
| | - Helmut Täubl
- Department of Pulmonology, Tirol Kliniken, Hospital Hochzirl-Natters, Natters, Austria
| | - Matthias Urban
- Department of Internal and Respiratory Medicine, Krankenhaus Nord-Klinik Floridsdorf, Vienna, Austria
| | - Marlies Wagner
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria
| | | | - Angela Zacharasiewicz
- Department of Paediatrics, Teaching Hospital of the Medical University of Vienna, Wilhelminen Hospital, Vienna, Austria
| | | | - Ernst Eber
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036, Graz, Austria.
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18
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Flick H, Arns BM, Bolitschek J, Bucher B, Cima K, Gingrich E, Handzhiev S, Hochmair M, Horak F, Idzko M, Jaksch P, Kovacs G, Kropfmüller R, Lamprecht B, Löffler-Ragg J, Meilinger M, Olschewski H, Pfleger A, Puchner B, Puelacher C, Prior C, Rodriguez P, Salzer H, Schenk P, Schindler O, Stelzmüller I, Strenger V, Täubl H, Urban M, Wagner M, Wimberger F, Zacharasiewicz A, Zwick RH, Eber E. [Statement of the Austrian Society of Pneumology (ASP)]. WIENER KLINISCHES MAGAZIN : BEILAGE ZUR WIENER KLINISCHEN WOCHENSCHRIFT 2020; 23:92-115. [PMID: 32427192 PMCID: PMC7232599 DOI: 10.1007/s00740-020-00350-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic is currently a challenge worldwide. In Austria, a crisis within the health care system has so far been avoided. The treatment of patients with community-acquired pneumonia (CAP), including SARS-CoV‑2 infections, should continue to be based on evidence-based CAP guidelines during the pandemic. However, COVID-19-specific adjustments are useful. The treatment of patients with chronic lung diseases must be adapted during the pandemic, but must still be guaranteed.
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Affiliation(s)
- H. Flick
- Klinische Abteilung für Pulmonologie, Univ. Klinik für Innere Medizin, Medizinische Universität Graz/LKH Graz Ost, Graz, Österreich
| | - B. M. Arns
- 1. Medizinische Abteilung, Hanusch Krankenhaus, Wien, Österreich
| | | | - B. Bucher
- Abteilung für Pneumologie, Tirol Kliniken, Landeskrankenhaus Hochzirl-Natters, Natters, Österreich
| | - K. Cima
- Abteilung für Pneumologie, Tirol Kliniken, Landeskrankenhaus Hochzirl-Natters, Natters, Österreich
| | - E. Gingrich
- Lungenfachärztliche Ordination, Wien, Österreich
| | - S. Handzhiev
- Klinische Abteilung für Pneumologie, Universitätsklinikum Krems, Krems, Österreich
| | - M. Hochmair
- Karl Landsteiner Institut für Lungenforschung und pneumologische Onkologie, Krankenhaus Nord – Klinik Floridsdorf, Wien, Österreich
| | - F. Horak
- Allergiezentrum Wien West, Wien, Österreich
| | - M. Idzko
- Klinische Abteilung für Pulmologie, Univ. Klinik für Innere Medizin II, Medizinische Universität Wien/AKH Wien, Wien, Österreich
| | - P. Jaksch
- Klinische Abteilung für Thoraxchirurgie, Univ. Klinik für Chirurgie, Medizinische Universität Wien/AKH Wien, Wien, Österreich
| | - G. Kovacs
- Klinische Abteilung für Pulmonologie, Univ. Klinik für Innere Medizin, Medizinische Universität Graz/LKH Graz Ost, Graz, Österreich
- Ludwig Boltzmann Institut für Lungengefäßforschung Graz, Graz, Österreich
| | - R. Kropfmüller
- Klinik für Lungenheilkunde/Pneumologie, Medizinische Fakultät, Johannes Kepler Universität, Linz, Österreich
| | - B. Lamprecht
- Klinik für Lungenheilkunde/Pneumologie, Medizinische Fakultät, Johannes Kepler Universität, Linz, Österreich
| | - J. Löffler-Ragg
- Pneumologische Ambulanz, Univ. Klinik für Innere Medizin II, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - M. Meilinger
- Abteilung für Innere Medizin und Pneumologie, Krankenhaus Nord – Klinik Floridsdorf, Wien, Österreich
| | - H. Olschewski
- Klinische Abteilung für Pulmonologie, Univ. Klinik für Innere Medizin, Medizinische Universität Graz/LKH Graz Ost, Graz, Österreich
- Ludwig Boltzmann Institut für Lungengefäßforschung Graz, Graz, Österreich
| | - A. Pfleger
- Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036 Graz, Österreich
| | - B. Puchner
- Department für Pneumologie, Reha Zentrum Münster, Münster, Österreich
| | - C. Puelacher
- Interdisziplinäres Schlaflabor, Telfs, Österreich
| | - C. Prior
- Lungenfachärztliche Ordination, Innsbruck, Österreich
| | - P. Rodriguez
- Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036 Graz, Österreich
| | - H. Salzer
- Klinik für Lungenheilkunde/Pneumologie, Medizinische Fakultät, Johannes Kepler Universität, Linz, Österreich
| | - P. Schenk
- Abteilung Pulmologie, Landesklinikum Hochegg, Grimmenstein, Österreich
| | - O. Schindler
- Abteilung für Innere Medizin und Pneumologie, LKH Graz II, Standort Enzenbach, Gratwein, Österreich
| | | | - V. Strenger
- Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036 Graz, Österreich
| | - H. Täubl
- Abteilung für Pneumologie, Tirol Kliniken, Landeskrankenhaus Hochzirl-Natters, Natters, Österreich
| | - M. Urban
- Abteilung für Innere Medizin und Pneumologie, Krankenhaus Nord – Klinik Floridsdorf, Wien, Österreich
| | - M. Wagner
- Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036 Graz, Österreich
| | - F. Wimberger
- Ordensklinikum Elisabethinen Linz, Linz, Österreich
| | - A. Zacharasiewicz
- Abteilung für Kinder- und Jugendheilkunde, Wilhelminenspital der Stadt Wien, Lehrkrankenhaus der Medizinischen Universität Wien, Wien, Österreich
| | - R. H. Zwick
- Ambulante Pneumologische Rehabilitation, Therme Wien Med, Wien, Österreich
| | - E. Eber
- Klinische Abteilung für pädiatrische Pulmonologie und Allergologie, Univ. Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Auenbruggerplatz 34/2, 8036 Graz, Österreich
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19
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Pivette M, Nicolay N, de Lauzun V, Hubert B. Characteristics of hospitalizations with an influenza diagnosis, France, 2012-2013 to 2016-2017 influenza seasons. Influenza Other Respir Viruses 2020; 14:340-348. [PMID: 32022436 PMCID: PMC7182605 DOI: 10.1111/irv.12719] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 12/25/2022] Open
Abstract
Background Estimating the global burden of influenza hospitalizations is required to allocate resources and assess interventions that aim to prevent severe influenza. In France, the current routine influenza surveillance system does not fully measure the burden of severe influenza cases. The objective was to describe the characteristics and severity of influenza hospitalizations by age‐group and by season between 2012 and 2017. Methods All hospitalizations with a diagnosis of influenza in metropolitan France between July 2012 and June 2017 were extracted from the French national hospital discharge database (PMSI). For each season, the total number of influenza hospitalizations, admissions to intensive care units (ICU), proportion of deaths, lengths of stay, and distribution in diagnosis‐related groups were described by age‐group. Results Over the five seasons, 91 255 hospitalizations with a diagnosis of influenza were identified. The average influenza hospitalization rate varied from 13/100 000 in 2013‐2014 to 46/100 000 in 2016‐2017. A high rate was observed in elderlies during the 2014‐2015 and 2016‐2017 seasons, dominated by A(H3N2) virus. The youngest were impacted in 2015‐2016, dominated by B/Victoria virus. The proportion of influenza hospitalizations with ICU admission was 10%, and was higher in age‐group 40‐79 years. The proportion of deaths and length of stay increased with age. Conclusions The description of influenza hospitalizations recorded in the PMSI give key information on the burden of severe influenza in France. Analyses of these data annually is valuable in order to document the severity of influenza hospitalizations by age‐group and according to the circulating influenza viruses.
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Affiliation(s)
- Mathilde Pivette
- Santé publique France, Direction des régions, Saint-Maurice, France
| | - Nathalie Nicolay
- Santé publique France, Direction des régions, Saint-Maurice, France
| | | | - Bruno Hubert
- Santé publique France, Direction des régions, Saint-Maurice, France
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20
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Gunnes N, Gjessing HK, Bakken IJ, Ghaderi S, Gran JM, Hungnes O, Magnus P, Samuelsen SO, Skrondal A, Stoltenberg C, Trogstad L, Wilcox AJ, Håberg SE. Seasonal and pandemic influenza during pregnancy and risk of fetal death: A Norwegian registry-based cohort study. Eur J Epidemiol 2020; 35:371-379. [PMID: 31950373 PMCID: PMC7192880 DOI: 10.1007/s10654-020-00600-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/02/2020] [Indexed: 11/03/2022]
Abstract
Previous studies of fetal death with maternal influenza have been inconsistent. We explored the effect of maternal influenza-like illness (ILI) in pregnancy on the risk of fetal death, distinguishing between diagnoses during regular influenza seasons and the 2009/2010 pandemic and between trimesters of ILI. We used birth records from the Medical Birth Registry of Norway to identify fetal deaths after the first trimester in singleton pregnancies (2006-2013). The Norwegian Directorate of Health provided dates of clinical influenza diagnoses by primary-health-care providers, whereas dates of laboratory-confirmed influenza A (H1N1) diagnoses were provided by the Norwegian Surveillance System for Communicable Diseases. We obtained dates and types of influenza vaccinations from the Norwegian Immunisation Registry. Cox proportional-hazards regression models were fitted to estimate hazard ratios (HRs) of fetal death, with associated 95% confidence intervals (CIs), comparing women with and without an ILI diagnosis in pregnancy. There were 2510 fetal deaths among 417,406 eligible pregnancies. ILI during regular seasons was not associated with increased risk of fetal death: adjusted HR = 0.90 (95% CI 0.64-1.27). In contrast, ILI during the pandemic was associated with substantially increased risk of fetal death, with an adjusted HR of 1.75 (95% CI 1.21-2.54). The risk was highest following first-trimester ILI (adjusted HR = 2.28 [95% CI 1.45-3.59]). ILI during the pandemic-but not during regular seasons-was associated with increased risk of fetal death in the second and third trimester. The estimated effect was strongest with ILI in first trimester.
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Affiliation(s)
- Nina Gunnes
- Norwegian Institute of Public Health, Oslo, Norway. .,Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway.
| | - Håkon Kristian Gjessing
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Inger Johanne Bakken
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sara Ghaderi
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jon Michael Gran
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Olav Hungnes
- Norwegian Institute of Public Health, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sven Ove Samuelsen
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Mathematics, University of Oslo, Oslo, Norway
| | - Anders Skrondal
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.,University of California, Berkeley, CA, USA.,Centre for Educational Measurement, University of Oslo, Oslo, Norway
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Allen J Wilcox
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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21
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Ghaderi S, Berg-Hansen P, Bakken IJ, Magnus P, Trogstad L, Håberg SE. Hospitalization following influenza infection and pandemic vaccination in multiple sclerosis patients: a nationwide population-based registry study from Norway. Eur J Epidemiol 2019; 35:355-362. [PMID: 31873811 PMCID: PMC7222066 DOI: 10.1007/s10654-019-00595-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/05/2019] [Indexed: 01/27/2023]
Abstract
Patients with multiple sclerosis (MS) are at increased risk of infections and related worsening of neurological function. Influenza infection has been associated with increased risk of various neurological complications. We conducted a population-based registry study to investigate the risk of acute hospitalization of MS patients in relation to influenza infection or pandemic vaccination in Norway. The entire Norwegian population in the years 2008-2014 was defined as our study population (N = 5,219,296). Information on MS diagnosis, influenza infection and vaccination were provided by Norwegian national registries. The self-controlled case series method was used to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CI) in defined risk periods. 6755 MS patients were identified during the study period. Average age at first registration of an MS diagnosis was 51.8 years among men and 49.9 years among females (66.9%). The IRR for emergency hospitalization among MS patients the first week after an influenza diagnosis was 3.4 (95% CI 2.4-4.8). The IRR was 5.6 (95% CI 2.7-11.3) after pandemic influenza, and 4.8 (95% CI 3.1-7.4) after seasonal influenza. Pandemic vaccination did not influence risk of hospitalization [IRR within the first week: 0.7 (95% CI 0.5-1.0)]. Among MS patients, influenza infection was associated with increased risk for acute hospitalization while no increased risk was observed after pandemic vaccination. Influenza vaccination could prevent worsening of MS-related symptoms as well as risk of hospitalization.
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Affiliation(s)
- Sara Ghaderi
- Department of Global Health and Primary Care, University of Bergen, Post Box 7804, 5020, Bergen, Norway.
| | - Pål Berg-Hansen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Health, Oslo, Norway
| | - Lill Trogstad
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Health, Oslo, Norway
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Health, Oslo, Norway
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22
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an der Heiden M, Buchholz U, Buda S. Estimation of influenza- and respiratory syncytial virus-attributable medically attended acute respiratory infections in Germany, 2010/11-2017/18. Influenza Other Respir Viruses 2019; 13:517-521. [PMID: 31339223 PMCID: PMC6692544 DOI: 10.1111/irv.12666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The burden of influenza in primary care is difficult to assess, since most patients with symptoms of a respiratory infection are not tested. The case definition of "medically attended acute respiratory infection" (MAARI) in the German physician sentinel is sensitive; however, it requires modelling techniques to derive estimates of disease attributable to influenza and respiratory syncytial virus (RSV). OBJECTIVES The objective of this paper was to review and extend our previously published model in order to estimate the burden of RSV and the differential burden of the two influenza B lineages (Victoria, Yamagata) as well as both influenza A subtypes on primary care visits. METHODS Data on MAARI and virological results of respiratory samples (virological sentinel) were available from 2010/11 until 2017/18. We updated the previously published generalized additive regression model to include RSV. RESULTS We found that the proportion of MAARI due to RSV is substantial only in the 0-1- and 2-4-year-old age groups (0-1 years old: median 7.5%, range 4.0%-14.8%; 2-4 years old: median 6.5%, range 4.0%-10.3%); in the 0-1 years old age group, RSV leads in almost all seasons to a higher burden than any influenza type or subtype, but this is reversed in the age group 2-4 years old. CONCLUSIONS We succeeded in rearranging our previously published model on MAARI to incorporate RSV as well as the two influenza B lineages (Victoria, Yamagata) in the time period 2010 to 2018.
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Affiliation(s)
| | - Udo Buchholz
- Department for Infectious Disease EpidemiologyRobert Koch‐InstituteBerlinGermany
| | - Silke Buda
- Department for Infectious Disease EpidemiologyRobert Koch‐InstituteBerlinGermany
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23
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Hauge SH, Bakken IJ, de Blasio BF, Håberg SE. Burden of medically attended influenza in Norway 2008-2017. Influenza Other Respir Viruses 2019; 13:240-247. [PMID: 30637942 PMCID: PMC6468058 DOI: 10.1111/irv.12627] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/06/2018] [Accepted: 12/08/2018] [Indexed: 12/21/2022] Open
Abstract
Background The burden of influenza in Norway remains uncertain, and data on seasonal variations and differences by age groups are needed. Objective To describe number of patients diagnosed with influenza in Norway each season and the number treated in primary or specialist health care by age. Further, to compare the burden of seasonal influenza with the 2009‐2010 pandemic outbreak. Methods We used Norwegian national health registries and identified all patients diagnosed with influenza from 2008 to 2017. We calculated seasonal rates, compared hospitalized patients with patients in primary care and compared seasonal influenza with the 2009‐2010 pandemic outbreak. Results Each season, on average 1.7% of the population were diagnosed with influenza in primary care, the average rate of hospitalization was 48 per 100 000 population while the average number of hospitalized patients each season was nearly 2500. The number of hospitalized influenza patients ranged from 579 in 2008‐2009 to 4973 in 2016‐2017. Rates in primary care were highest among young adults while hospitalization rates were highest in patients 80 years and older and in children below 5 years. The majority of in‐hospital deaths were in patients 70 years and older. Fewer patients were hospitalized during the 2009‐2010 pandemic than in seasonal outbreaks, but during the pandemic, more people in the younger age groups were hospitalized and fatal cases were younger. Conclusion Influenza causes a substantial burden in primary care and hospitals. In non‐pandemic seasons, people above 80 years have the highest risk of influenza hospitalization and death.
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Affiliation(s)
- Siri Helene Hauge
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Johanne Bakken
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Birgitte F de Blasio
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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