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Gharpure R, Chard AN, Cabrera Escobar M, Zhou W, Valleau MM, Yau TS, Bresee JS, Azziz-Baumgartner E, Pallas SW, Lafond KE. Costs and cost-effectiveness of influenza illness and vaccination in low- and middle-income countries: A systematic review from 2012 to 2022. PLoS Med 2024; 21:e1004333. [PMID: 38181066 PMCID: PMC10802964 DOI: 10.1371/journal.pmed.1004333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/22/2024] [Accepted: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Historically, lack of data on cost-effectiveness of influenza vaccination has been identified as a barrier to vaccine use in low- and middle-income countries. We conducted a systematic review of economic evaluations describing (1) costs of influenza illness; (2) costs of influenza vaccination programs; and (3) vaccination cost-effectiveness from low- and middle-income countries to assess if gaps persist that could hinder global implementation of influenza vaccination programs. METHODS AND FINDINGS We performed a systematic search in Medline, Embase, Cochrane Library, CINAHL, and Scopus in January 2022 and October 2023 using a combination of the following key words: "influenza" AND "cost" OR "economic." The search included studies with publication years 2012 through 2022. Studies were eligible if they (1) presented original, peer-reviewed findings on cost of illness, cost of vaccination program, or cost-effectiveness of vaccination for seasonal influenza; and (2) included data for at least 1 low- or middle-income country. We abstracted general study characteristics and data specific to each of the 3 study types. Of 54 included studies, 26 presented data on cost-effectiveness, 24 on cost-of-illness, and 5 on program costs. Represented countries were classified as upper-middle income (UMIC; n = 12), lower-middle income (LMIC; n = 7), and low-income (LIC; n = 3). The most evaluated target groups were children (n = 26 studies), older adults (n = 17), and persons with chronic medical conditions (n = 12); fewer studies evaluated pregnant persons (n = 9), healthcare workers (n = 5), and persons in congregate living settings (n = 1). Costs-of-illness were generally higher in UMICs than in LMICs/LICs; however, the highest national economic burden, as a percent of gross domestic product and national health expenditure, was reported from an LIC. Among studies that evaluated the cost-effectiveness of influenza vaccine introduction, most (88%) interpreted at least 1 scenario per target group as either cost-effective or cost-saving, based on thresholds designated in the study. Key limitations of this work included (1) heterogeneity across included studies; (2) restrictiveness of the inclusion criteria used; and (3) potential for missed influenza burden from use of sentinel surveillance systems. CONCLUSIONS The 54 studies identified in this review suggest an increased momentum to generate economic evidence about influenza illness and vaccination from low- and middle-income countries during 2012 to 2022. However, given that we observed substantial heterogeneity, continued evaluation of the economic burden of influenza illness and costs/cost-effectiveness of influenza vaccination, particularly in LICs and among underrepresented target groups (e.g., healthcare workers and pregnant persons), is needed. Use of standardized methodology could facilitate pooling across settings and knowledge sharing to strengthen global influenza vaccination programs.
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Affiliation(s)
- Radhika Gharpure
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna N. Chard
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Weigong Zhou
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Molly M. Valleau
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tat S. Yau
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Joseph S. Bresee
- Task Force for Global Health, Atlanta, Georgia, United States of America
| | | | - Sarah W. Pallas
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kathryn E. Lafond
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Blanchet Zumofen MH, Frimpter J, Hansen SA. Impact of Influenza and Influenza-Like Illness on Work Productivity Outcomes: A Systematic Literature Review. PHARMACOECONOMICS 2023; 41:253-273. [PMID: 36515814 PMCID: PMC9748403 DOI: 10.1007/s40273-022-01224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Influenza is a persistent public health problem with a significant burden on patients, employers, and society. A systematic review by Keech and Beardsworth (2008) characterized the burden of influenza/influenza-like illness (ILI) on absenteeism. We conducted a systematic literature review evaluating the impact of influenza/ILI on work productivity among adults as an update to the work of Keech and Beardsworth. METHODS This systematic review identified studies evaluating the impact of influenza/ILI on absenteeism, presenteeism, or related work productivity measures for employees and employed caregivers based on laboratory confirmation, physician diagnosis, and/or self-reported illness. Eligible studies were in English, French, or German published from 7 March 2007 through 15 February 2022, in PubMed, Embase, or BIOSIS. Two reviewers completed screening and full-text review, with conflicts resolved by a third advisor. Summary data were extracted by two analysts; all records were quality checked by one analyst. Work productivity outcomes were summarized qualitatively, and risk of bias was not evaluated. RESULTS A total of 14,387 records were retrieved; 12,245 titles/abstracts were screened and 145 full-text publications were reviewed, of which 63 were included in the qualitative assessment. Studies of self-reported ILI were most frequent (49%), followed by laboratory-confirmed cases (37%) and physician diagnoses (11%). Overall, approximately 20-75% of employees missed work due to illness across study settings and populations. Mean time out of work among ill employees varied widely across study designs and populations, ranging from < 1 to > 10 days, and was often reported to be approximately 2-3 days. Considerable heterogeneity was observed across study designs, populations, and outcomes. Most employees (≈ 60-80%) reported working while experiencing influenza/ILI symptoms. Reporting of costs was sparse and heterogeneous; one study reported annual costs of influenza-related absences equating to $42,851 per 100,000 employee health plan members. Results were partitioned based on the following categories. Among otherwise healthy adults, 1-74% of workers missed ≥1 workday due to influenza/ILI, for a mean [standard deviation (SD)] of 0.5 (1.44) to 5.3 (4.50) days, and 42-89% reported working while ill, for a mean (SD) of 0.3 (0.63) to 4.4 (3.73) days. Among working caregivers, 50-75% missed work to care for children/household members with influenza/ILI, for 1-2 days on average. Similarly, the mean absenteeism among healthcare workers ranged from 0.5 to 3.2 days. Across studies evaluating vaccination status, generally smaller proportions of vaccinated employees missed time from work due to influenza/ILI. CONCLUSIONS This systematic review summarized the productivity burden of influenza/ILI on the worldwide working-age population. Despite notable heterogeneity in study designs, influenza/ILI case definitions, and productivity outcome measures, this review highlighted the substantial productivity burden that influenza/ILI may have on employees, employers, and society, consistent with the findings of Keech and Beardsworth (2008).
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Hadian SA, Rezayatmand R. Economic impact of acute respiratory disease pandemics: A scoping review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:88. [PMID: 36685026 PMCID: PMC9854936 DOI: 10.4103/jrms.jrms_870_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/26/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022]
Abstract
Background The economic impact of acute respiratory disease pandemics has yet to be specifically systematically reviewed. The aim of this scoping review is to identify and classify the economic impacts and its values and ranges. Materials and Methods We conducted a literature search across three key databases using an extensive list of keywords. Then, we included studies which explored direct and indirect costs as well as broader economic impact associated with different nine acute respiratory diseases, i.e., pandemic and seasonal influenza, avian influenza, equine influenza, swine influenza, severe acute respiratory syndrome, coronavirus disease 2019, Middle East respiratory syndrome, H1N1, and H7N9. Results We included 62 studies in English language between 1987 and 2020, mostly from the countries of East Asia and Pacific pertinent. We classified the economic impact into 5 main categories and 18 subcategories. The main categories were macroeconomic impacts, impacts on health cost, industry, businesses and trade, and education. Conclusion Respiratory disease pandemics have widely impacted different sectors of economy such as the direct cost on macroeconomic, providing and receiving health services, disease management, industries, business and trade, education, and indirect costs due to productivity losses. However, lots of the reviewed studies were unable to quantify the actual economic cost of these impacts. This made it challenging to conduct any kind of quantitative comparison of the results. A key priority for future research is to develop standard methods to quantify the broader economic costs of respiratory disease pandemics. Understanding the total economic impact of respiratory disease pandemics is a key step to inform national and international priority setting for disease prevention and pandemic control interventions.
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Affiliation(s)
- Shirin Alsadat Hadian
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Rezayatmand
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Reza Rezayatmand, Hezar Jerib St., Isfahan University of Medical Sciences, Health Management and Economics Research Center, Postal Code: 81746-73461, Isfahan, Iran. E-mail:
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Villani L, D'Ambrosio F, Ricciardi R, Waure C, Calabrò GE. Seasonal influenza in children: Costs for the health system and society in Europe. Influenza Other Respir Viruses 2022; 16:820-831. [PMID: 35429133 PMCID: PMC9343336 DOI: 10.1111/irv.12991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/29/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
| | - Chiara Waure
- Department of Medicine and Surgery University of Perugia Perugia Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
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Lai X, Rong H, Ma X, Hou Z, Li S, Jing R, Zhang H, Lyu Y, Wang J, Feng H, Peng Z, Feng L, Fang H. The Economic Burden of Influenza-Like Illness among Children, Chronic Disease Patients, and the Elderly in China: A National Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126277. [PMID: 34200619 PMCID: PMC8296061 DOI: 10.3390/ijerph18126277] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 12/03/2022]
Abstract
Background: The disease burden of seasonal influenza is substantial in China, while there is still a lack of nationwide economic burden estimates. This study aims to examine influenza-like illness (ILI) prevalence, healthcare-seeking behaviors, economic impact of ILI, and its influencing factors among three priority groups during the 2018–19 influenza season. Methods: From August to October 2019, 6668 children’s caregivers, 1735 chronic disease patients, and 3849 elderly people were recruited from 10 provinces in China to participate in an on-site survey. The economic burden of ILI consisted of direct (medical or non-medical) and indirect burdens, and a two-part model was adopted to predict the influencing factors of total economic burden. Results: There were 45.73% children, 16.77% chronic disease patients, and 12.70% elderly people reporting ILI, and most participants chose outpatient service or over-the-counter (OTC) medication after ILI. The average economic burden was CNY 1647 (USD 237.2) for children, CNY 951 (USD 136.9) for chronic disease patients, and CNY 1796 (USD 258.6) for the elderly. Two-part regression showed that age, gender, whether the only child in the family, region, and household income were important predictors of ILI economic burden among children, while age, region, place of residence, basic health insurance, and household income were significant predictors of ILI economic burden among chronic disease patients and the elderly. Conclusions: A large economic burden of ILI was highlighted, especially among the elderly with less income and larger medical burdens, as well as children, with higher prevalence and higher self-payment ratio. It is important to adopt targeted interventions for high-risk groups, and this study can help national-level decision-making on the introduction of influenza vaccination as a public health project.
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Affiliation(s)
- Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
- Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai 200032, China;
| | - Shunping Li
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China
| | - Rize Jing
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Yun Lyu
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Huangyufei Feng
- School of Public Health, Peking University, Beijing 100083, China; (X.L.); (R.J.); (H.Z.); (Y.L.); (J.W.); (H.F.)
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
| | - Zhibin Peng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Correspondence: (L.F.); (H.F.); Tel.: +86-10-6525-6093 (L.F.); +86-10-8280-5702 (H.F.)
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; (H.R.); (X.M.)
- Peking University Health Science Center—Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University, Beijing 100083, China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing 100083, China
- Correspondence: (L.F.); (H.F.); Tel.: +86-10-6525-6093 (L.F.); +86-10-8280-5702 (H.F.)
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Wong PL, Sii HL, P'ng CK, Ee SS, Yong Oong X, Ng KT, Hanafi NS, Tee KK, Tan MP. The effects of age on clinical characteristics, hospitalization and mortality of patients with influenza-related illness at a tertiary care centre in Malaysia. Influenza Other Respir Viruses 2020; 14:286-293. [PMID: 32022411 PMCID: PMC7182601 DOI: 10.1111/irv.12691] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background Age is an established risk factor for poor outcomes in individuals with influenza‐related illness, and data on its influence on clinical presentations and outcomes in the South‐East Asian settings are scarce. The aim of this study was to determine the above among adults with influenza‐related upper respiratory tract infection at a teaching hospital in Malaysia. Methods A retrospective case‐note analysis was conducted on a cohort of 3935 patients attending primary care at the University Malaya Medical Centre, Malaysia from February 2012 till May 2014 with URTI symptoms. Demographics, clinical characteristics, medical and vaccination history were obtained from electronic medical records, and mortality data from the National Registration Department. Comparisons were made between those aged <25, ≥25 to <65 and ≥65 years. Results 470 (11.9%) had PCR‐confirmed influenza virus infection. Six (1.3%) received prior influenza vaccination. Those aged ≥65 years were more likely to have ≥2 comorbidities (P < .001) and were less likely to present with fever (P = .004). One‐third of those aged ≥65 years experienced hospitalization, intensive care admission or death within a year compared to 10% in the ≥25 to <65 years. Age ≥65 years was an independent predictor of hospitalization and death (OR = 9.97; 95% CI = 3.11‐31.93) compared to those aged <25 years. Conclusion Older patients in our cohort were more likely to have comorbidities and present with atypical features, with older age being an independent predictor of poor health outcomes. Our findings will now inform future health policies on older persons and economic modelling of adult vaccination programmes.
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Affiliation(s)
- Pui Li Wong
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hoe Leong Sii
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chun Keat P'ng
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soon Sean Ee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Xiang Yong Oong
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kim Tien Ng
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Keng Tee
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia
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Influenza-associated Hospitalization in Children Younger Than 5 Years of Age in Suzhou, China, 2011-2016. Pediatr Infect Dis J 2019; 38:445-452. [PMID: 30153228 PMCID: PMC6501799 DOI: 10.1097/inf.0000000000002178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studying the burden and risk factors associated with severe illness from influenza infection in young children in eastern China will contribute to future cost-effectiveness analyses of local influenza vaccine programs. METHODS We conducted prospective, severe acute respiratory infection (SARI) surveillance at Suzhou University-Affiliated Children's Hospital to estimate influenza-associated hospitalizations in Suzhou University-Affiliated Children's Hospital by month in children younger than 5 years of age from October 2011 to September 2016. SARI was defined as fever (measured axillary temperature ≥ 38°C) and cough or sore throat or inflamed/red pharynx in the 7 days preceding hospitalization. We combined SARI surveillance data with healthcare utilization survey data to estimate and characterize the burden of influenza-associated SARI hospitalizations in Suzhou within this age group in the 5-year period. RESULTS Of the 36,313 SARI cases identified, 2,297 from respiratory wards were systematically sampled; of these, 259 (11%) were influenza positive. Estimated annual influenza-associated SARI hospitalization rates per 1,000 children younger than 5 years of age ranged from 4 (95% confidence interval [CI], 2-5) in the 2012-2013 season to 16 (95% CI, 14-19) in the 2011-2012 season. The predominant viruses were A/H3N2 (59%) in 2011-12, both A/H1N1pdm09 (42%) and B (46%) in 2012-13, A/H3N2 (71%) in 2013-14, A/H3N2 (55%) in 2014-15 and both A/H1N1pdm09 (50%) and B (50%) in 2015-16. The age-specific influenza-associated SARI hospitalization rates for the 5-year period were 11 (95% CI, 8-15) per 1,000 children 0-5 months of age; 8 (95% CI, 7-10) per 1,000 children 6-23 months of age and 5 (95% CI, 4-5) per 1,000 children 24-59 months of age, respectively. CONCLUSIONS From 2011 to 2016, influenza-associated SARI hospitalization rates in children aged younger than 5 years of age in Suzhou, China, were high, particularly among children 0-5 months of age. Higher hospitalization rates were observed in years where the predominant circulating virus was influenza A/H3N2. Immunization for children > 6 months, and maternal and caregiver immunization for those < 6 months, could reduce influenza-associated hospitalizations in young children in Suzhou.
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Rudge JW, Inthalaphone N, Pavlicek R, Paboriboune P, Flaissier B, Monidarin C, Steenkeste N, Davong V, Vongsouvath M, Bonath KA, Messaoudi M, Saadatian-Elahi M, Newton P, Endtz H, Dance D, Paranhos Baccala G, Sanchez Picot V. "Epidemiology and aetiology of influenza-like illness among households in metropolitan Vientiane, Lao PDR": A prospective, community-based cohort study. PLoS One 2019; 14:e0214207. [PMID: 30951544 PMCID: PMC6450629 DOI: 10.1371/journal.pone.0214207] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/08/2019] [Indexed: 11/18/2022] Open
Abstract
Respiratory diseases are a major contributor to morbidity and mortality in many tropical countries, including Lao PDR. However, little has been published regarding viral or bacterial pathogens that can contribute to influenza-like illness (ILI) in a community setting. We report on the results of a community-based surveillance that prospectively monitored the incidence of ILI and its causative pathogens in Vientiane capital in Lao PDR. A cohort of 995 households, including 4885 study participants, were followed-up between May 2015 and May 2016. Nasopharyngeal swabs, throat swabs, and sputum specimens were collected from ILI cases identified through active case-finding. Real-Time PCR was used to test nasopharyngeal swabs for 21 respiratory pathogens, while throat and sputum samples were subjected to bacterial culture. Generalized linear mixed models were used to assess potential risk factors for associations with ILI. In total, 548 episodes of ILI were reported among 476 (9.7%) of the study participants and 330 (33.2%) of the study households. The adjusted estimated incidence of ILI within the study area was 10.7 (95%CI: 9.4-11.9) episodes per 100 person-years. ILI was significantly associated with age group (p<0.001), sex (p<0.001), and number of bedrooms (p = 0.04) in multivariate analysis. In 548 nasopharyngeal swabs, the most commonly detected potential pathogens were Streptococcus pneumoniae (17.0%), Staphylococcus aureus (11.3%), influenza A (11.1%; mostly subtype H3N2), rhinovirus (7.5%), and influenza B (8.0%). Streptococci were isolated from 42 (8.6%) of 536 throat swabs, most (27) of which were Lancefield Group G. Co-infections were observed in 132 (24.1%) of the 548 ILI episodes. Our study generated valuable data on respiratory disease burden and patterns of etiologies associated with community-acquired acute respiratory illness Laos. Establishment of a surveillance strategy in Laos to monitor trends in the epidemiology and burden of acute respiratory infections is required to minimize their impact on human health.
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Affiliation(s)
- James W. Rudge
- Communicable Diseases Policy Research Group, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom; Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nui Inthalaphone
- Center of Infectiology Christophe Mérieux of Laos, Vientiane, Laos
| | | | | | | | | | | | - Viengmon Davong
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
| | | | - K. A. Bonath
- University of Health Sciences, Phnom Penh, Cambodia
| | | | | | - Paul Newton
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
| | | | - David Dance
- Mahidol Oxford Tropical Medicine Research Unit, Vientiane, Laos
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Overview of influenza vaccination policy in Beijing, China: Current status and future prospects. J Public Health Policy 2017; 38:366-379. [DOI: 10.1057/s41271-017-0079-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zhang T, Zhang J, Hua J, Wang D, Chen L, Ding Y, Zeng S, Wu J, Jiang Y, Geng Q, Zhou S, Song Y, Iuliano AD, Greene CM, McFarland J, Zhao G. Influenza-associated outpatient visits among children less than 5 years of age in eastern China, 2011-2014. BMC Infect Dis 2016; 16:267. [PMID: 27287453 PMCID: PMC4901396 DOI: 10.1186/s12879-016-1614-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 06/03/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The disease burden of influenza in China has not been well described, especially among young children. The aim of this study was to estimate the incidence of outpatient visits associated with influenza in young children in Suzhou, a city of more than 11 million residents in Jiangsu Province in eastern China. METHODS Influenza-like illness (ILI) was defined as the presence of fever (axillary temperature ≥38 °C) and cough or sore throat. We collected throat swabs for children less than 5 years of age with ILI who visited Suzhou University Affiliated Children's Hospital (SCH) outpatient clinic or emergency room between April 2011 and March 2014. Suzhou CDC, a national influenza surveillance network laboratory, tested for influenza viruses by real-time reverse transcription-polymerase chain reaction assay (rRT-PCR). Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza by rRT-PCR. To calculate the incidence of influenza-associated outpatient visits, we conducted community-based healthcare utilization surveys to determine the proportion of hospital catchment area residents who sought care at SCH. RESULTS The estimated incidence of influenza-associated ILI outpatient visits among children aged <5 years in the catchment area of Suzhou was, per 100 population, 17.4 (95 % CI 11.0-25.3) during April 2011-March 2012, 14.6 (95 % CI 5.2-26.2) during April 2012-March 2013 and 21.4 (95 % CI: 10.9-33.5) during April 2013-March 2014. The age-specific outpatient visit rates of influenza-associated ILI were 4.9, 21.1 and 21.2 per 100 children aged 0- <6 months, 6- <24 months and 24- <60 months, respectively. CONCLUSION Influenza virus infection causes a substantial burden of outpatient visits among young children in Suzhou, China. Targeted influenza prevention and control strategies for young children in Suzhou are needed to reduce influenza-associated outpatient visits in this age group.
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Affiliation(s)
- Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jun Hua
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Dan Wang
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Liling Chen
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Yunfang Ding
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Shanshan Zeng
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Jing Wu
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Yanwei Jiang
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Qian Geng
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Suizan Zhou
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, P.O. Box 289, No.138 Yi Xue Yuan Road, Shanghai, 200032, China.
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China.
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11
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Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis. PLoS One 2016; 11:e0153664. [PMID: 27082431 PMCID: PMC4833415 DOI: 10.1371/journal.pone.0153664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/02/2016] [Indexed: 11/19/2022] Open
Abstract
Background Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor—a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China. Objective To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI. Methods We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER). Results In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy compared to the post RIDT treatment with oseltamivir. Conclusion In the Chinese setting of current health system, our modelling based simulation analysis suggests that empiric treatment with oseltamivir to be a cost-saving and very cost-effective strategy in managing children with ILI.
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12
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Wang Y, Zhang T, Chen L, Greene C, Ding Y, Cheng Y, Yang C, Zeng S, Hua J, Zhou S, Song Y, Luan L, Zhang J, Zhao G. Seasonal influenza vaccine effectiveness against medically attended influenza illness among children aged 6-59 months, October 2011-September 2012: A matched test-negative case-control study in Suzhou, China. Vaccine 2016; 34:2460-2465. [PMID: 27016650 DOI: 10.1016/j.vaccine.2016.03.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 03/14/2016] [Accepted: 03/16/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Seasonal influenza infections among young children in China lead to substantial numbers of hospitalizations and financial burden. This study assessed the seasonal influenza vaccine effectiveness (VE) against laboratory confirmed medically attended influenza illness among children in Suzhou, China, from October 2011-September 2012. METHODS We conducted a test-negative case-control study among children aged 6-59 months who sought care at Soochow University Affiliated Children's Hospital (SCH) from October 2011-September 2012. A case was defined as a child with influenza-like illness (ILI) or severe acute respiratory infection (SARI) with an influenza-positive nasopharyngeal swab by rRT-PCR. Controls were selected from children presenting with ILI or SARI without laboratory confirmed influenza. We conducted 1:1 matching by age and admission date. Vaccination status was verified from the citywide immunization system database. VE was calculated with conditional logistic regression: (1-OR)×100%. RESULT During the study period, 2634 children aged 6-59 months presented to SCH with ILI (1975) or SARI (659) and were tested for influenza. The vaccination records were available for 69% (1829; ILI: 1354, SARI: 475). Among those, 23% (427) tested positive for influenza, and were included as cases. Among influenza positive cases, the vaccination rates were 3.2% for SARI and 4.5% for ILI. Among controls, the vaccination rates were 13% for SARI, and 11% for ILI. The overall VE against lab-confirmed medically attended influenza virus infection was 67% (95% CI: 41-82). The VE for SARI was 75% (95% CI: 11-93) and for ILI was 64% (95% CI: 31-82). CONCLUSIONS The seasonal influenza vaccine was effective against medically attended lab-confirmed influenza infection in children aged 6-59 months in Suzhou, China in the 2011-12 influenza season. Increasing seasonal influenza vaccination among young children in Suzhou may decrease medically attended influenza-associated ILI and SARI cases in this population.
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Affiliation(s)
- Yin Wang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Liling Chen
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Carolyn Greene
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yunfang Ding
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Yuejia Cheng
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Chao Yang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Shanshan Zeng
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jun Hua
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Suizan Zhou
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lin Luan
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China.
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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13
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Wang D, Chen L, Ding Y, Zhang J, Hua J, Geng Q, Ya X, Zeng S, Wu J, Jiang Y, Zhang T, Zhao G. Viral etiology of medically attended influenza-like illnesses in children less than five years old in Suzhou, China, 2011-2014. J Med Virol 2016; 88:1334-40. [PMID: 26792409 PMCID: PMC7166643 DOI: 10.1002/jmv.24480] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 01/20/2023]
Abstract
Limited information is available on the non‐influenza etiology and epidemiology of influenza‐like illness (ILI) in China. From April 2011 to March 2014, we collected oropharyngeal swabs from children less than 5 years of age with symptoms of ILI who presented to the outpatient departments of Suzhou University Affiliated Children's Hospital (SCH). We used reverse transcription polymerase chain reaction (rt‐PCR) or PCR to detect 11 respiratory viruses. Among 3,662 enrolled ILI patients, 1,292 (35.3%) tested positive for at least one virus. Influenza virus (16.9%) was detected most frequently (influenza A 7.4%, influenza B 9.5%), followed by respiratory syncytial virus (RSV) (5.6%), parainfluenza virus (PIV) types 1–4 (4.8%), human bocavirus (HBoV) (3.8%), human metapneumovirus (HMPV) (3.5%), and adenovirus (ADV) (3.0%). Co‐infections were identified in 108 (2.9%) patients. Influenza virus predominantly circulated in January–March and June–July. The 2013–2014 winter peaks of RSV and influenza overlapped. Compared with other virus positive cases, influenza positive cases were more likely to present with febrile seizure, and RSV positive cases were more likely to present with cough and wheezing, and were most frequently diagnosed with pneumonia. These data provide a better understanding of the viral etiology of ILI among children less than 5 years of age in Suzhou, China. Influenza is not only the most frequently identified pathogen but it is also the only vaccine preventable illness among the 11 pathogens tested. Such findings suggest the potential value of exploring value of influenza vaccination among this influenza vaccination target group. J. Med. Virol. 88:1334–1340, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Dan Wang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Liling Chen
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Yunfang Ding
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jun Hua
- Suzhou University Affiliated Children's Hospital, Suzhou, China
| | - Qian Geng
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xuerong Ya
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Shanshan Zeng
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jing Wu
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yanwei Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Tao Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Genming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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14
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Yang J, Jit M, Leung KS, Zheng YM, Feng LZ, Wang LP, Lau EHY, Wu JT, Yu HJ. The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey. Infect Dis Poverty 2015; 4:44. [PMID: 26445412 PMCID: PMC4595124 DOI: 10.1186/s40249-015-0077-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The seasonal influenza vaccine coverage rate in China is only 1.9 %. There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level, even though this kind of information is important for informing national-level immunization policy decision-making. METHODS A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective. Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013. Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients. RESULTS The study enrolled 529 outpatients (median age: eight years; interquartile range [IQR]: five to 20 years) and 254 inpatients (median age: four years; IQR: two to seven years). Among the outpatients, 22.1 % (117/529) had underlying diseases and among the inpatients, 52.8 % (134/254) had underlying diseases. The average total costs related to influenza-associated outpatient visits and inpatient visits were US$ 155 (standard deviation, SD US$ 122) and US$ 1,511 (SD US$ 1,465), respectively. Direct medical costs accounted for 45 and 69 % of the total costs related to influenza-associated outpatient and inpatient visits, respectively. For influenza outpatients, the mean cost per episode in children aged below five years (US$ 196) was higher than that in other age groups (US$ 129-153). For influenza inpatients, the mean cost per episode in adults aged over 60 years (US$ 2,735) was much higher than that in those aged below 60 years (US$ 1,417-1,621). Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions (outpatients: US$ 186 vs. US$ 146; inpatients: US$ 1,800 vs. US$ 1,189). In the baseline analysis, inpatients reported costs were 18 % higher than those found in the accounts review (n = 38). CONCLUSION The economic burden of influenza-associated outpatient and inpatient visits in China is substantial, particularly for young children, the elderly, and patients with underlying medical conditions. More widespread influenza vaccination would likely alleviate the economic burden of patients. The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.
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Affiliation(s)
- Juan Yang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Mark Jit
- Modelling and Economics Unit of Public Health in England, London, UK. .,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | - Kathy S Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F North Wing, Patrick Manson Building, 7 Sassoon Road, Pok Fu Lam, Hong Kong Special Administrative Region, China.
| | - Ya-Ming Zheng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Lu-Zhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Li-Ping Wang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F North Wing, Patrick Manson Building, 7 Sassoon Road, Pok Fu Lam, Hong Kong Special Administrative Region, China.
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 2/F North Wing, Patrick Manson Building, 7 Sassoon Road, Pok Fu Lam, Hong Kong Special Administrative Region, China.
| | - Hong-Jie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
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15
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Feng L, Yang P, Zhang T, Yang J, Fu C, Qin Y, Zhang Y, Ma C, Liu Z, Wang Q, Zhao G, Yu H. Technical guidelines for the application of seasonal influenza vaccine in China (2014-2015). Hum Vaccin Immunother 2015; 11:2077-101. [PMID: 26042462 PMCID: PMC4635867 DOI: 10.1080/21645515.2015.1027470] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Abstract
Influenza, caused by the influenza virus, is a respiratory infectious disease that can severely affect human health. Influenza viruses undergo frequent antigenic changes, thus could spread quickly. Influenza causes seasonal epidemics and outbreaks in public gatherings such as schools, kindergartens, and nursing homes. Certain populations are at risk for severe illness from influenza, including pregnant women, young children, the elderly, and people in any ages with certain chronic diseases.
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Affiliation(s)
- Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Peng Yang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Tao Zhang
- School of Public Health; Fudan University; Shanghai, China
| | - Juan Yang
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Chuanxi Fu
- Guangzhou Center for Disease Control and Prevention; Guangzhou, China
| | - Ying Qin
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yi Zhang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Chunna Ma
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Zhaoqiu Liu
- Hua Xin Hospital; First Hospital of Tsinghua University; Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Control and Prevention; Beijing, China
| | - Genming Zhao
- School of Public Health; Fudan University; Shanghai, China
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease; Division of Infectious Disease; Chinese Center for Disease Control and Prevention; Beijing, China
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