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Katayama Y, Kiyohara K, Hirose T, Ishida K, Tachino J, Nakao S, Noda T, Ojima M, Kiguchi T, Matsuyama T, Kitamura T. An Association of Influenza Epidemics in Children With Mobile App Data: Population-Based Observational Study in Osaka, Japan. JMIR Form Res 2022; 6:e31131. [PMID: 35142628 PMCID: PMC8874815 DOI: 10.2196/31131] [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: 06/10/2021] [Revised: 08/28/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Early surveillance to prevent the spread of influenza is a major public health concern. If there is an association of influenza epidemics with mobile app data, it may be possible to forecast influenza earlier and more easily. Objective We aimed to assess the relationship between seasonal influenza and the frequency of mobile app use among children in Osaka Prefecture, Japan. Methods This was a retrospective observational study that was performed over a three-year period from January 2017 to December 2019. Using a linear regression model, we calculated the R2 value of the regression model to evaluate the relationship between the number of “fever” events selected in the mobile app and the number of influenza patients ≤14 years of age. We conducted three-fold cross-validation using data from two years as the training data set and the data of the remaining year as the test data set to evaluate the validity of the regression model. And we calculated Spearman correlation coefficients between the calculated number of influenza patients estimated using the regression model and the number of influenza patients, limited to the period from December to April when influenza is prevalent in Japan. Results We included 29,392 mobile app users. The R2 value for the linear regression model was 0.944, and the adjusted R2 value was 0.915. The mean Spearman correlation coefficient for the three regression models was 0.804. During the influenza season (December–April), the Spearman correlation coefficient between the number of influenza patients and the calculated number estimated using the linear regression model was 0.946 (P<.001). Conclusions In this study, the number of times that mobile apps were used was positively associated with the number of influenza patients. In particular, there was a good association of the number of influenza patients with the number of “fever” events selected in the mobile app during the influenza epidemic season.
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Affiliation(s)
- Yusuke Katayama
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenichiro Ishida
- Department of Acute Medicine and Critical Care Center, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomohiro Noda
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Ojima
- Department of Acute Medicine and Critical Care Center, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - Takeyuki Kiguchi
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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The relationship between seasonal influenza and telephone triage for fever: A population-based study in Osaka, Japan. PLoS One 2020; 15:e0236560. [PMID: 32760164 PMCID: PMC7410252 DOI: 10.1371/journal.pone.0236560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/08/2020] [Indexed: 11/19/2022] Open
Abstract
Background Replacing traditional surveillance with syndromic surveillance is one of the major interests in public health. However, it is unclear whether the number of influenza patients is associated with the number of telephone triages in Japan. Methods This retrospective, observational study was conducted over the six-year period between January 2012 to December 2017. We used the dataset of a telephone triage service in Osaka, Japan and the data on influenza patients published from the Information Center of Infectious Disease in Osaka prefecture. Using a linear regression model, we calculated Spearman’s rank-order coefficient and R2 of the regression model to assess the relationship between the number of telephone triages for fever and the number of influenza patients in Osaka. Furthermore, we calculated Spearman’s rank-order coefficient and R2 between the predicted weekly number of influenza patients from the linear regression model and the actual weekly number of influenza patients for influenza outbreak season (December-April). Results There were 465,971 patients with influenza, and the number of telephone triages for fever was 420,928 among 1,065,628 total telephone triages during the study period. Our analysis showed that the Spearman rank-order coefficient was 0.932, and R2 and adjusted R2 were 0.869 and 0.842, respectively. The Spearman rank-order coefficient was 0.923 (P<0.001) and R2 was 0.832 in December-April (P<0.001). Conclusion We revealed a positive relationship in this population between the number of influenza patients and the number of telephone triages for fever.
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Relationship between the number of pediatric patients with rotavirus and telephone triage for associated symptoms. Am J Emerg Med 2020; 39:6-10. [PMID: 32241629 DOI: 10.1016/j.ajem.2020.03.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/09/2020] [Accepted: 03/19/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Earlier syndromic surveillance may be effective in preventing the spread of infectious disease. However, there has been no research on syndromic surveillance for rotavirus. The study aimed to assess the relationship between the incidence of rotavirus infections and the number of telephone triages for associated symptoms in pediatric patients under 4 years old in Osaka prefecture, Japan. METHODS This was a retrospective observational study for which the study period was the 3 years between January 2015 and December 2017. We analyzed data on children under 4 years old who were triaged by telephone triage nurses using software. The primary endpoint was the number of rotavirus patients under 4 years triaged old per week. Using a linear regression model, we calculated the R square value of the regression model to assess the relationship between the number of patients with rotavirus and the number of telephone triages made for associated symptoms. Covariates in the linear regression model were the week number indicating seasonality and the weekly number of telephone triages related to rotavirus symptoms such as stomachache and vomiting. RESULTS During the study period, there were 102,336 patients with rotavirus, and the number of people triaged by telephone was 123,720. The highest correlation coefficient was 0.921 in the regression model with the number of telephone triages for "stomachache + nausea/vomiting" and "stomachache + diarrhea + nausea/vomiting". CONCLUSION The number of telephone triage symptoms was positively related to the incidence of pediatric patients with rotavirus in a large metropolitan area of Japan.
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Tsuzuki S, Baguelin M, Pebody R, van Leeuwen E. Modelling the optimal target age group for seasonal influenza vaccination in Japan. Vaccine 2019; 38:752-762. [PMID: 31735503 DOI: 10.1016/j.vaccine.2019.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/25/2019] [Accepted: 11/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND In Japan, the current influenza vaccination programme is targeting older individuals. On the other hand, epidemics of influenza are likely to be mainly driven by children. In this study, we consider the most cost-effective target age group for a seasonal influenza vaccination programme in Japan. METHODS We constructed a deterministic compartmental Susceptible-Exposed-Infectious-Recovered (SEIR) model with data from the 2012/13 to 2014/15 influenza seasons in Japan. Bayesian inference with Markov Chain Monte Carlo method was used for parameter estimation. Cost-effectiveness analyses were conducted from public health care payer's perspective. RESULTS A scenario targeting children under 15 was expected to reduce the number of cases 6,382,345 compared to the current strategy. A scenario targeting elderly population (age over 49 years) was expected to reduce the number of cases 693,206. The children targeted scenario demonstrated negative ICER (incremental cost-effectiveness ratio) value. On the other hand, elderly targeted scenario demonstrated higher ICER value than the willingness to pay (50,000 USD/QALY). CONCLUSIONS A vaccination programme which targets children under 15 is predicted to have much larger epidemiological impact than those targeting elderly.
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Affiliation(s)
- Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Respiratory Diseases Department, Public Health England, London, United Kingdom.
| | - Marc Baguelin
- Respiratory Diseases Department, Public Health England, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, W2 1PG, United Kingdom; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Richard Pebody
- Respiratory Diseases Department, Public Health England, London, United Kingdom
| | - Edwin van Leeuwen
- Respiratory Diseases Department, Public Health England, London, United Kingdom
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Tsuzuki S, Schwehm M, Eichner M. Simulation studies to assess the long-term effects of Japan's change from trivalent to quadrivalent influenza vaccination. Vaccine 2017; 36:624-630. [PMID: 29292176 DOI: 10.1016/j.vaccine.2017.12.058] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Since 2013/2014, the WHO has been recommending quadrivalent influenza vaccines (QIV) to prevent seasonal influenza. In 2015, Japan replaced trivalent influenza vaccines (TIV) by QIV. We used computer simulations to calculate how this impacted the epidemiology and to assess its cost-effectiveness. METHODS We simulated the seasonal transmission of the four influenza strains A(H1N1), A(H3N2), B/Yamagata and B/Victoria with the individual-based simulation tool 4Flu, using official demographic data and Japanese contact patterns. The model considered maternal protection, immunity boosting, new drift variants and different immunity durations for naturally acquired and vaccination-derived immunity. Starting with the 2015/16 season, simulations were evaluated for 20 years, using either TIV or QIV with the reported vaccination coverage. Costs and years of life saved (YOLSs) were calculated and discounted at 2%, using 2015 as base year. RESULTS QIV annually prevents on average 548 influenza cases (4.7% of cases which occur when using TIV; 11.9% of influenza B), 1.62 hospitalizations and 0.078 deaths per 100,000 individuals. In Japan's population of 125.35 million, annually 915.06 YOLYs are gained by QIV and 107.52 million USD are saved (societal perspective) [corrected]. From payer perspective, the ICER is 3698 USD/YOLS. CONCLUSIONS QIV is cost-effective (payer perspective) or even cost-saving (societal perspective) in Japan.
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Affiliation(s)
- Shinya Tsuzuki
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
| | | | - Martin Eichner
- Department for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany; Epimos GmbH, Dußlingen, Germany
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Zaraket H, Saito R. Japanese Surveillance Systems and Treatment for Influenza. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016; 8:311-328. [PMID: 28035195 PMCID: PMC5155020 DOI: 10.1007/s40506-016-0085-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Influenza management and surveillance programs in Japan possess several unique features. The national influenza surveillance is affiliated with National Epidemiological Surveillance for Infectious Diseases (NESID) and features sentinel outpatient surveillance, virological surveillance, and reports on hospitalization, mortality, and influenza-associated encephalopathy. Of note, information on the number of student absences and class/grade/school closures due to influenza are also reported to the government and made publically available. A private online influenza surveillance portal by volunteer doctors provides a real-time information source for the Japanese clinicians and the general public. For influenza treatment, three classes of drugs are approved and covered by national medical insurance in Japan: M2 inhibitors, neuraminidase inhibitors (NAIs), and a polymerase inhibitor. Four NAIs, oseltamivir, zanamivir, laninamivir, and peramivir, are licensed in Japan and are prescribed to seven to eight million patients annually. NAIs are prescribed to any influenza outpatient rather than being limited to severe cases. The majority (80-95 %) of patients start the treatment within 48 h of onset. Laninamivir and peramivir were used almost solely in Japan, until the approval of the latter drug by the FDA. Observational studies showed that the two drugs have equal effectiveness as oseltamivir and zanamivir. The Japanese approach to influenza surveillance and management has facilitated bringing new influenza antivirals to the markets and has driven innovative research in this field. New classes of antivirals, including polymerase inhibitors and cap-dependent endonuclease inhibitor, provide novel tools for treatment of influenza in Japan and the rest of the world.
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Affiliation(s)
- Hassan Zaraket
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Reiko Saito
- Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, 1-757, Asahimachi-dori, Chuo-ku, Niigata City, Niigata Prefecture 951-8510 Japan
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