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Maurel M, Mazagatos C, Goerlitz L, Oroszi B, Hooiveld M, Machado A, Domegan L, Ilić M, Popescu R, Sève N, Martínez-Baz I, Larrauri A, Buda S, Túri G, Meijer A, Gomez V, O'Donnell J, Mlinarić I, Timnea O, Diez AO, Dürrwald R, Horváth JK, Dijkstra F, Rodrigues AP, McKenna A, Filipović SK, Lazar M, Kaczmarek M, Bacci S, Kissling E. Exploring the effect of clinical case definitions on influenza vaccine effectiveness estimation at primary care level: Results from the end-of-season 2022-23 VEBIS multicentre study in Europe. Vaccine 2024:S0264-410X(24)00497-3. [PMID: 38704257 DOI: 10.1016/j.vaccine.2024.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/03/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Within influenza vaccine effectiveness (VE) studies at primary care level with a laboratory-confirmed outcome, clinical case definitions for recruitment of patients can vary. We used the 2022-23 VEBIS primary care European multicentre study end-of-season data to evaluate whether the clinical case definition affected IVE estimates. METHODS We estimated VE using a multicentre test-negative case-control design. We measured VE against any influenza and influenza (sub)types, by age group (0-14, 15-64, ≥65 years) and by influenza vaccine target group, using logistic regression. We estimated IVE among patients meeting the European Union (EU) acute respiratory infection (ARI) case definition and among those meeting the EU influenza-like illness (ILI) case definition, including only sites providing information on specific symptoms and recruiting patients using an ARI case definition (as the EU ILI case definition is a subset of the EU ARI one). RESULTS We included 24 319 patients meeting the EU ARI case definition, of whom 21 804 patients (90 %) meet the EU ILI case definition, for the overall pooled VE analysis against any influenza. The overall and influenza (sub)type-specific VE varied by ≤2 % between EU ILI and EU ARI populations. DISCUSSION Among all analyses, we found similar VE estimates between the EU ILI and EU ARI populations, with few (10%) additional non-ILI ARI patients recruited. These results indicate that VE in the 2022-23 influenza season was not affected by use of a different clinical case definition for recruitment, although we recommend investigating whether this holds true for next seasons.
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Affiliation(s)
| | - Clara Mazagatos
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Lisa Domegan
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Maja Ilić
- Croatian Institue of Public Health, Zagreb, Croatia
| | | | - Noémie Sève
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | | | - Amparo Larrauri
- National Centre of Epidemiology, CIBERESP, Carlos III Health Institute, Madrid, Spain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute, Berlin, Germany
| | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joan O'Donnell
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Olivia Timnea
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Ana Ordax Diez
- Instituto de Estudios de Ciencias de la Salud de Castilla y León (IECSCYL). Consejería de Sanidad. Junta de Castilla y León, Valladolid, Spain
| | - Ralf Dürrwald
- National Reference Centre for Influenza, Robert Koch Institute, Berlin, Germany
| | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Adele McKenna
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research and Development, Bucharest, Romania
| | - Marlena Kaczmarek
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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2
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Rose AMC, Pozo F, Martínez-Baz I, Mazagatos C, Bossuyt N, Cauchi JP, Petrović G, Loghin II, Vaikutyte R, Buda S, Machado A, Duffy R, Oroszi B, Howard J, Echeverria A, Andreu C, Barbezange C, Džiugytė A, Nonković D, Popescu CP, Majauskaite F, Tolksdorf K, Gomez V, Domegan L, Horváth JK, Castilla J, García M, Demuyser T, Borg ML, Tabain I, Lazar M, Kubiliute I, Dürrwald R, Guiomar R, O'Donnell J, Kristóf K, Nicolay N, Bacci S, Kissling E. Vaccine effectiveness against influenza hospitalisation in adults during the 2022/2023 mixed season of influenza A(H1N1)pdm09, A(H3N2) and B circulation, Europe: VEBIS SARI VE hospital network. Influenza Other Respir Viruses 2024; 18:e13255. [PMID: 38403302 PMCID: PMC10894713 DOI: 10.1111/irv.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 02/27/2024] Open
Abstract
We conducted a multicentre hospital-based test-negative case-control study to measure vaccine effectiveness (VE) against PCR-confirmed influenza in adult patients with severe acute respiratory infection (SARI) during the 2022/2023 influenza season in Europe. Among 5547 SARI patients ≥18 years, 2963 (53%) were vaccinated against influenza. Overall VE against influenza A(H1N1)pdm09 was 11% (95% CI: -23-36); 20% (95% CI: -4-39) against A(H3N2) and 56% (95% CI: 22-75) against B. During the 2022/2023 season, while VE against hospitalisation with influenza B was >55%, it was ≤20% for influenza A subtypes. While influenza vaccination should be a priority for future seasons, improved vaccines against influenza are needed.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iván Martínez-Baz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - John Paul Cauchi
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | | | - Isabela I Loghin
- St Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
| | | | | | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Aitziber Echeverria
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Cristina Andreu
- Subdirección de Epidemiología, Dirección General de Salud Pública, Servicio Extremeño de Salud, Mérida, Spain
| | | | - Aušra Džiugytė
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Corneliu-Petru Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Fausta Majauskaite
- Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | | | - Verónica Gomez
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
| | - Miriam García
- Dirección General de Salud Pública, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | - Thomas Demuyser
- Department of Microbiology and Infection control, UZ Brussel, Brussels, Belgium
| | - Maria-Louise Borg
- Department for Health Regulation, Health Promotion and Disease Prevention, Msida, Malta
| | - Irena Tabain
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Mihaela Lazar
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Ieva Kubiliute
- Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Smith EM, Huff S, Wescott H, Daniel R, Ebuenyi ID, O'Donnell J, Maalim M, Zhang W, Khasnabis C, MacLachlan M. Assistive technologies are central to the realization of the Convention on the Rights of Persons with Disabilities. Disabil Rehabil Assist Technol 2024; 19:486-491. [PMID: 35900971 DOI: 10.1080/17483107.2022.2099987] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/05/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE In this paper, we highlight examples of how AT may play a role in realizing each of the fundamental rights affirmed in the UNCRPD. MATERIALS AND METHODS We conducted an indicative literature search for relevant literature to each of the substantive articles of the CRPD. RESULTS Assistive technology plays a critical role in achieving the rights affirmed by the Convention on the Rights of Persons with Disabilities. CONCLUSIONS Ensuring adequate provision of AT by states parties is critical to the progressive realization of the rights of persons with disabilities and to fulfilling commitments made by states parties upon ratification of the CRPD.Implications for rehabilitationAssistive technology (AT) is critical to enable full participation of persons with disability in society and the achievement of rights affirmed by the Convention on the Rights of Persons with Disabilities.Governments and other key stakeholders should endeavour to improve access to AT through inclusive, evidence-informed programs and services.Advocacy is required to improve access to AT through universal health coverage.
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Affiliation(s)
- Emma M Smith
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Stephanie Huff
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Holly Wescott
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rebecca Daniel
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Ikenna D Ebuenyi
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
- School of Nursing, Midwifery & Health Systems, IRIS Centre, University College Dublin, Dublin, Ireland
| | - Joan O'Donnell
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Mohamed Maalim
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Wei Zhang
- World Health Organization, Geneva, Switzerland
| | | | - Malcolm MacLachlan
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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Maurel M, Pozo F, Pérez‐Gimeno G, Buda S, Sève N, Oroszi B, Hooiveld M, Gomez V, Domegan L, Martínez‐Baz I, Ilić M, Carnahan AS, Mihai ME, Martínez A, Goerlitz L, Enouf V, Horváth JK, Dijkstra F, Rodrigues AP, Bennett C, Trobajo‐Sanmartín C, Mlinarić I, Latorre‐Margalef N, Ivanciuc A, Lopez A, Dürrwald R, Falchi A, Túri G, Meijer A, Melo A, O'Donnell J, Castilla J, Vučina VV, Hagey TS, Lazar M, Kaczmarek M, Bacci S, Kissling E. Influenza vaccine effectiveness in Europe: Results from the 2022-2023 VEBIS (Vaccine Effectiveness, Burden and Impact Studies) primary care multicentre study. Influenza Other Respir Viruses 2024; 18:e13243. [PMID: 38204584 PMCID: PMC10777262 DOI: 10.1111/irv.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Background Influenza A(H3N2) viruses dominated early in the 2022-2023 influenza season in Europe, followed by higher circulation of influenza A(H1N1)pdm09 and B viruses. The VEBIS primary care network estimated the influenza vaccine effectiveness (VE) using a multicentre test-negative study. Materials and Methods Primary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We measured VE against any influenza, influenza (sub)type and clade, by age group, by influenza vaccine target group and by time since vaccination, using logistic regression. Results We included 38 058 patients, of which 3786 were influenza A(H3N2), 1548 influenza A(H1N1)pdm09 and 3275 influenza B cases. Against influenza A(H3N2), VE was 36% (95% CI: 25-45) among all ages and ranged between 30% and 52% by age group and target group. VE against influenza A(H3N2) clade 2b was 38% (95% CI: 25-49). Overall, VE against influenza A(H1N1)pdm09 was 46% (95% CI: 35-56) and ranged between 29% and 59% by age group and target group. VE against influenza A(H1N1)pdm09 clade 5a.2a was 56% (95% CI: 46-65) and 79% (95% CI: 64-88) against clade 5a.2a.1. VE against influenza B was 76% (95% CI: 70-81); overall, 84%, 72% and 71% were among 0-14-year-olds, 15-64-year-olds and those in the influenza vaccination target group, respectively. VE against influenza B with a position 197 mutation of the hemagglutinin (HA) gene was 79% (95% CI: 73-85) and 90% (95% CI: 85-94) without this mutation. Conclusion The 2022-2023 end-of-season results from the VEBIS network at primary care level showed high VE among children and against influenza B, with lower VE against influenza A(H1N1)pdm09 and A(H3N2).
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Affiliation(s)
| | - Francisco Pozo
- National Centre for MicrobiologyInstitute of Health Carlos IIIMadridSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Gloria Pérez‐Gimeno
- National Centre for MicrobiologyInstitute of Health Carlos IIIMadridSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Silke Buda
- Department for Infectious Disease Epidemiology, Respiratory Infections UnitRobert Koch InstituteBerlinGermany
| | - Noémie Sève
- Sorbonne UniversitéINSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)ParisFrance
| | - Beatrix Oroszi
- National Laboratory for Health Security, Epidemiology and Surveillance CentreSemmelweis UniversityBudapestHungary
| | | | - Verónica Gomez
- Instituto Nacional de Saúde Dr. Ricardo JorgeLisbonPortugal
| | - Lisa Domegan
- HSE‐Health Protection Surveillance CentreDublinIreland
| | - Iván Martínez‐Baz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
- Instituto de Salud Pública de Navarra (IdiSNA)PamplonaSpain
| | - Maja Ilić
- Croatian Institute of Public HealthZagrebCroatia
| | | | - Maria Elena Mihai
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Ana Martínez
- Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública de CatalunyaBarcelonaSpain
| | - Luise Goerlitz
- Department for Infectious Disease Epidemiology, Respiratory Infections UnitRobert Koch InstituteBerlinGermany
| | - Vincent Enouf
- Centre National de Référence Virus des Infections Respiratoire (CNR VIR), Institut PasteurParisFrance
| | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance CentreSemmelweis UniversityBudapestHungary
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM)Bilthoventhe Netherlands
| | | | - Charlene Bennett
- National Virus Reference LaboratoryUniversity College DublinDublinIreland
| | - Camino Trobajo‐Sanmartín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
- Instituto de Salud Pública de Navarra (IdiSNA)PamplonaSpain
| | | | | | - Alina Ivanciuc
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Aurora Lopez
- Subdirección General de Epidemiologia y Vigilancia de la SaludValenciaSpain
| | - Ralf Dürrwald
- National Reference Centre for InfluenzaRobert Koch InstituteBerlinGermany
| | | | - Gergő Túri
- National Laboratory for Health Security, Epidemiology and Surveillance CentreSemmelweis UniversityBudapestHungary
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM)Bilthoventhe Netherlands
| | - Aryse Melo
- Instituto Nacional de Saúde Dr. Ricardo JorgeLisbonPortugal
| | | | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
- Instituto de Salud Pública de Navarra (IdiSNA)PamplonaSpain
| | | | | | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and ControlStockholmSweden
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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Baruch J, Denayer S, Seyler L, Domegan L, Launay O, Machado A, Burgui C, Vaikutyte R, Niessen FA, Loghin II, Husa P, Aouali N, Panagiotakopoulos G, Tolksdorf K, Horváth JK, Howard J, Pozo F, Gallardo V, Nonković D, Džiugytė A, Bossuyt N, Demuyser T, Duffy R, Luong Nguyen LB, Kislaya I, Martínez-Baz I, Gefenaite G, Knol MJ, Popescu C, Součková L, Simon M, Michelaki S, Reiche J, Ferenczi A, Delgado-Sanz C, Lovrić Makarić Z, Cauchi JP, Barbezange C, Van Nedervelde E, O'Donnell J, Durier C, Guiomar R, Castilla J, Jonikaite I, Bruijning-Verhagen PC, Lazar M, Demlová R, Wirtz G, Amerali M, Dürrwald R, Kunstár MP, Kissling E, Bacci S, Valenciano M. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Omicron-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021 to 2022. Euro Surveill 2023; 28:2300187. [PMID: 37997665 PMCID: PMC10668256 DOI: 10.2807/1560-7917.es.2023.28.47.2300187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionThe I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period).MethodsIn both networks, 46 hospitals (13 countries) follow a similar test-negative case-control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition.ResultsWe included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29-54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51-66) after addition of one booster dose. The VE was 85% (95% CI: 78-89), 70% (95% CI: 61-77) and 36% (95% CI: 17-51) for those with onset 14-59 days, 60-119 days and 120-179 days after booster vaccination, respectively.ConclusionsOur results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | - Judit Krisztina Horváth
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Virtudes Gallardo
- Dirección General de Salud Pública y Ordenación Farmacéutica, Junta de Andalucía, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giedre Gefenaite
- Faculty of Medicine, Lund University, Lund, Sweden
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | | | - Annamária Ferenczi
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | - Concepción Delgado-Sanz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - John Paul Cauchi
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Raquel Guiomar
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | | | - Gil Wirtz
- Centre Hospitalier de Luxembourg, Luxembourg
| | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Mihály Pál Kunstár
- National Laboratory for Health Security, Epidemiology and Surveillance Centre, Semmelweis University, Budapest, Hungary
| | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Rose AM, Nicolay N, Sandonis Martín V, Mazagatos C, Petrović G, Niessen FA, Machado A, Launay O, Denayer S, Seyler L, Baruch J, Burgui C, Loghin II, Domegan L, Vaikutytė R, Husa P, Panagiotakopoulos G, Aouali N, Dürrwald R, Howard J, Pozo F, Sastre-Palou B, Nonković D, Knol MJ, Kislaya I, Luong Nguyen LB, Bossuyt N, Demuyser T, Džiugytė A, Martínez-Baz I, Popescu C, Duffy R, Kuliešė M, Součková L, Michelaki S, Simon M, Reiche J, Otero-Barrós MT, Lovrić Makarić Z, Bruijning-Verhagen PC, Gomez V, Lesieur Z, Barbezange C, Van Nedervelde E, Borg ML, Castilla J, Lazar M, O'Donnell J, Jonikaitė I, Demlová R, Amerali M, Wirtz G, Tolksdorf K, Valenciano M, Bacci S, Kissling E. Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Alpha- and Delta-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021. Euro Surveill 2023; 28:2300186. [PMID: 37997666 PMCID: PMC10668259 DOI: 10.2807/1560-7917.es.2023.28.47.2300186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/24/2023] [Indexed: 11/25/2023] Open
Abstract
IntroductionTwo large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March-June)- and Delta (June-December)-dominant periods, 2021.MethodsForty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case-control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset.ResultsWe included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69-92) overall and 75% (95% CI: 42-90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18-74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57-98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose < 90 days before onset; ≥ 70% in those 90-179 days before onset.ConclusionsOur results from this EU multi-country hospital setting showed that VE for complete PSV alone was higher in the Alpha- than the Delta-dominant period, and addition of a first booster dose during the latter period increased VE to over 90%.
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Affiliation(s)
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Clara Mazagatos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - F Annabel Niessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ausenda Machado
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Odile Launay
- Inserm, CIC Cochin-Pasteur, Paris, France
- AP-HP, Hôpital Cochin, Paris, France
- Faculty of Medicine, University of Paris City, Paris, France
| | | | - Lucie Seyler
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Joaquin Baruch
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Isabela I Loghin
- St. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania
- Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Petr Husa
- Faculty of Medicine, Masaryk University, Brno, Czechia
- University Hospital Brno, Brno, Czechia
| | | | | | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Bartolomé Sastre-Palou
- Servicio de Medicina Preventiva Hospital Universitario Son Espases, Servicio de Epidemiología, Consellería de Salut, Palma, Spain
| | - Diana Nonković
- Teaching Public Health Institute of Split-Dalmatia County, Split, Croatia
| | - Mirjam J Knol
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Irina Kislaya
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Aušra Džiugytė
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Corneliu Popescu
- Dr Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Róisín Duffy
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Monika Kuliešė
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | | | - Marc Simon
- Centre Hospitalier de Luxembourg, Luxembourg
| | | | - María Teresa Otero-Barrós
- Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad de Galicia, Santiago de Compostela, A Coruna, Spain
| | | | - Patricia Cjl Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Verónica Gomez
- National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | | | | | | | - Maria-Louise Borg
- IDCU within Health promotion and disease prevention Directorate, G'mangia, Malta
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mihaela Lazar
- "Cantacuzino" National Military Medical Institute for Research-Development, Bucharest, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Marina Amerali
- National Public Health Organisation (EODY), Athens, Greece
| | - Gil Wirtz
- Luxembourg Institute of Health, Luxembourg
| | | | | | - Sabrina Bacci
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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7
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Brady M, Duffy R, Domegan L, Salmon A, Maharjan B, O'Broin C, Bennett C, Christle J, Connell J, Feeney L, Nurdin N, Mallon P, Doran P, McNamara R, O'Grady S, McDermott S, Petty-Saphon N, O'Donnell J. Establishing severe acute respiratory infection (SARI) surveillance in a sentinel hospital, Ireland, 2021 to 2022. Euro Surveill 2023; 28:2200740. [PMID: 37289427 PMCID: PMC10318943 DOI: 10.2807/1560-7917.es.2023.28.23.2200740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/26/2023] [Indexed: 06/09/2023] Open
Abstract
BackgroundIn 2020, due to the COVID-19 pandemic, the European Centre for Disease Prevention and Control (ECDC) accelerated development of European-level severe acute respiratory infection (SARI) surveillance.AimWe aimed to establish SARI surveillance in one Irish hospital as part of a European network E-SARI-NET.MethodsWe used routine emergency department records to identify cases in one adult acute hospital. The SARI case definition was adapted from the ECDC clinical criteria for a possible COVID-19 case. Clinical data were collected using an online questionnaire. Cases were tested for SARS-CoV-2, influenza and respiratory syncytial virus (RSV), including whole genome sequencing (WGS) on SARS-CoV-2 RNA-positive samples and viral characterisation/sequencing on influenza RNA-positive samples. Descriptive analysis was conducted for SARI cases hospitalised between July 2021 and April 2022.ResultsOverall, we identified 437 SARI cases, the incidence ranged from two to 28 cases per week (0.7-9.2/100,000 hospital catchment population). Of 431 cases tested for SARS-CoV-2 RNA, 226 (52%) were positive. Of 349 (80%) cases tested for influenza and RSV RNA, 15 (4.3%) were positive for influenza and eight (2.3%) for RSV. Using WGS, we identified Delta- and Omicron-dominant periods. The resource-intensive nature of manual clinical data collection, specimen management and laboratory supply shortages for influenza and RSV testing were challenging.ConclusionWe successfully established SARI surveillance as part of E-SARI-NET. Expansion to additional sentinel sites is planned following formal evaluation of the existing system. SARI surveillance requires multidisciplinary collaboration, automated data collection where possible, and dedicated personnel resources, including for specimen management.
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Affiliation(s)
- Melissa Brady
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Roisin Duffy
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
- Department of Microbiology, St. Vincent's Hospital, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Abigail Salmon
- Department of Microbiology, St. Vincent's Hospital, Dublin, Ireland
| | - Binita Maharjan
- University College Dublin (UCD) Clinical Research Centre, Dublin, Ireland
| | - Cathal O'Broin
- Department of Infectious Diseases, St. Vincent's Hospital, Dublin, Ireland
| | - Charlene Bennett
- University College Dublin (UCD) National Virus Reference Laboratory, Dublin, Ireland
| | - James Christle
- University College Dublin (UCD) Clinical Research Centre, Dublin, Ireland
| | - Jeff Connell
- University College Dublin (UCD) National Virus Reference Laboratory, Dublin, Ireland
| | - Laura Feeney
- University College Dublin (UCD) Clinical Research Centre, Dublin, Ireland
| | - Nadra Nurdin
- Department of Infectious Diseases, St. Vincent's Hospital, Dublin, Ireland
| | - Patrick Mallon
- University College Dublin (UCD) Centre for Experimental Pathogen Host Research, Ireland
- Department of Infectious Diseases, St. Vincent's Hospital, Dublin, Ireland
| | - Peter Doran
- University College Dublin (UCD) Clinical Research Centre, Dublin, Ireland
- University College Dublin (UCD) School of Medicine, Dublin, Ireland
| | - Rosa McNamara
- Emergency Department, St. Vincent's Hospital, Dublin, Ireland
| | - Sarah O'Grady
- University College Dublin (UCD) Clinical Research Centre, Dublin, Ireland
| | - Sinead McDermott
- Department of Microbiology, St. Vincent's Hospital, Dublin, Ireland
| | - Naomi Petty-Saphon
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
- Department of Public Health, Eastern Region of Ireland, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre (HPSC), Dublin, Ireland
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8
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Kelly D, O'Donnell K, Marron L, Dwyer R, Power M, Migone C, O'Donnell J, Walsh C. Immunocompromise among vaccinated versus unvaccinated COVID-19 cases admitted to critical care in Ireland, July to October 2021. Vaccine 2023; 41:2811-2815. [PMID: 36967284 PMCID: PMC10008797 DOI: 10.1016/j.vaccine.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/27/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
As the COVID-19 pandemic progressed, so too did the proportion of cases admitted to critical care in Ireland who were fully vaccinated. Reporting of this observation has public health implications as incorrect interpretation may affect public confidence in COVID-19 vaccines. A potential explanation is the reduced ability of those who are immunocompromised to produce an adequate, sustained immune response to vaccination. We conducted an analysis of the association between COVID-19 vaccination status and underlying degree of immunocompromise among a cohort of critical care patients all with a confirmed diagnosis of COVID-19 admitted to critical care between July and October 2021. Multinomial logistic regression was used to estimate an odds ratio of immunocompromise among vaccinated COVID-19 cases in critical care compared to unvaccinated cases. In this study, we found a statistically significant association between the vaccination status of severe COVID-19 cases requiring critical care admission and underlying immunocompromise. Fully vaccinated patients were significantly more likely to be highly (OR=19.3, 95% CI 7.7 – 48.1) or moderately immunocompromised (OR=9.6, 95% CI 5.0 – 18.1) compared to unvaccinated patients with COVID-19. These findings support our hypothesis, that highly immunocompromised patients are less likely to produce an adequate and sustained immune response to COVID-19 vaccination, and are therefore more likely to require critical care admission for COVID-19 infection.
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Affiliation(s)
- David Kelly
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland
| | - Kate O'Donnell
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland,Corresponding author
| | - Louise Marron
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland,National Immunisation Office, Health Service Executive, Dublin, Ireland
| | - Rory Dwyer
- National Office for Clinical Audit, RCSI, Dublin, Ireland
| | - Michael Power
- National Clinical Programme for Critical Care Advisory Group, Health Service Executive, Ireland
| | - Chantal Migone
- National Immunisation Office, Health Service Executive, Dublin, Ireland
| | - Joan O'Donnell
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland
| | - Cathal Walsh
- Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland,Health Research Institute and MACSI, University of Limerick, Ireland
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9
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Sinnathamby MA, Warburton F, Reynolds AJ, Cottrell S, O'Doherty M, Domegan L, O'Donnell J, Johnston J, Yonova I, Elgohari S, Boddington NL, Andrews N, Ellis J, de Lusignan S, McMenamin J, Pebody RG. An intercountry comparison of the impact of the paediatric live attenuated influenza vaccine (LAIV) programme across the UK and the Republic of Ireland (ROI), 2010 to 2017. Influenza Other Respir Viruses 2023; 17:e13099. [PMID: 36824392 PMCID: PMC9942272 DOI: 10.1111/irv.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 02/16/2023] Open
Abstract
Background The universal paediatric live attenuated influenza vaccine (LAIV) programme commenced in the United Kingdom (UK) in 2013/2014. Since 2014/2015, all pre-school and primary school children in Scotland and Northern Ireland have been offered the vaccine. England and Wales incrementally introduced the programme with additional school age cohorts being vaccinated each season. The Republic of Ireland (ROI) had no universal paediatric programme before 2017. We evaluated the potential population impact of vaccinating primary school-aged children across the five countries up to the 2016/2017 influenza season. Methods We compared rates of primary care influenza-like illness (ILI) consultations, confirmed influenza intensive care unit (ICU) admissions, and all-cause excess mortality using standardised methods. To further quantify the impact, a scoring system was developed where each weekly rate/z-score was scored and summed across each influenza season according to the weekly respective threshold experienced in each country. Results Results highlight ILI consultation rates in the four seasons' post-programme, breached baseline thresholds once or not at all in Scotland and Northern Ireland; in three out of the four seasons in England and Wales; and in all four seasons in ROI. No differences were observed in the seasons' post-programme introduction between countries in rates of ICU and excess mortality, although reductions in influenza-related mortality were seen. The scoring system also reflected similar results overall. Conclusions Findings of this study suggest that LAIV vaccination of primary school age children is associated with population-level benefits, particularly in reducing infection incidence in primary care.
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Affiliation(s)
| | | | | | | | | | - Lisa Domegan
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | - Joan O'Donnell
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | | | - Ivelina Yonova
- Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)LondonUK,University of SurreyGuilfordUK
| | | | | | | | | | - Simon de Lusignan
- Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)LondonUK,University of SurreyGuilfordUK,University of OxfordUK
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10
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Hay W, Yard J, O'Donnell J. 1343 ADVANCE CARE PLANS (ACP) IN SECONDARY CARE: WHAT ARE THE PATIENT OUTCOMES FOLLOWING DISCHARGE FROM HOSPITAL WITH AN ACP? Age Ageing 2023. [DOI: 10.1093/ageing/afac322.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Treatment escalation plans are discussed in hospital but not always communicated to community care on discharge, leading to avoidable admissions to hospital and hospital deaths which may be not what the patient wants. The project aimed to review what happened to patients discharged from hospital with an ACP over a 12-month period.
Method
Older person service (OPS) inpatients were identified for ACP discussions, using Clinical frailty score, presence of life limiting conditions, co-morbidities, significant decline. Over a 12-month period 155 ACP's were completed using the ACP document on the Trust electronic record (EPR), including the level of appropriate care and preference for location of on-going care. On discharge copies of the ACP were sent with the patient, to their GP and the ambulance service. EPR was used to review patients up to 12 months post discharge.
Results
Of patients with an ACP; the wish of all patients was to remain out of hospital and be cared for in the community; 63% were discharged to care home setting; 19% were readmitted as inpatients (43.7% Trust OPS/no ACP readmissions); 8% of patients died before discharge; 92% of patients who died after discharged, died out of hospital (47.5% Trust OPS/no ACP deaths); 25% were still alive at 12 months. The process of completing the ACP and communicating the ACP was found to be long and not user friendly with multiple steps and needed refining.
Conclusion
ACP's offer support to facilitate patient's wishes. The use of ACP's in secondary care benefits patients on discharge, it reduces readmissions and in-hospital deaths. The current ACP document is lengthy and requires simplifying. This has led to a work group to redevelop the ACP into a more user friendly/shareable document, which will encourage on-going use of ACP's and can be adopted throughout the Trust.
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Affiliation(s)
- W Hay
- University Hospitals Dorset Older People’s Service
| | - J Yard
- University Hospitals Dorset Older People’s Service
| | - J O'Donnell
- University Hospitals Dorset Older People’s Service
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11
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Kissling E, Pozo F, Martínez‐Baz I, Buda S, Vilcu A, Domegan L, Mazagatos C, Dijkstra F, Latorre‐Margalef N, Kurečić Filipović S, Machado A, Lazar M, Casado I, Dürrwald R, van der Werf S, O'Donnell J, Linares Dopido JA, Meijer A, Riess M, Višekruna Vučina V, Rodrigues AP, Mihai ME, Castilla J, Goerlitz L, Falchi A, Connell J, Castrillejo D, Hooiveld M, Carnahan A, Ilić M, Guiomar R, Ivanciuc A, Maurel M, Omokanye A, Valenciano M. Influenza vaccine effectiveness against influenza A subtypes in Europe: Results from the 2021-2022 I-MOVE primary care multicentre study. Influenza Other Respir Viruses 2022; 17:e13069. [PMID: 36702797 PMCID: PMC9835407 DOI: 10.1111/irv.13069] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In 2021-2022, influenza A viruses dominated in Europe. The I-MOVE primary care network conducted a multicentre test-negative study to measure influenza vaccine effectiveness (VE). METHODS Primary care practitioners collected information on patients presenting with acute respiratory infection. Cases were influenza A(H3N2) or A(H1N1)pdm09 RT-PCR positive, and controls were influenza virus negative. We calculated VE using logistic regression, adjusting for study site, age, sex, onset date, and presence of chronic conditions. RESULTS Between week 40 2021 and week 20 2022, we included over 11 000 patients of whom 253 and 1595 were positive for influenza A(H1N1)pdm09 and A(H3N2), respectively. Overall VE against influenza A(H1N1)pdm09 was 75% (95% CI: 43-89) and 81% (95% CI: 45-93) among those aged 15-64 years. Overall VE against influenza A(H3N2) was 29% (95% CI: 12-42) and 25% (95% CI: -41 to 61), 33% (95% CI: 14-49), and 26% (95% CI: -22 to 55) among those aged 0-14, 15-64, and over 65 years, respectively. The A(H3N2) VE among the influenza vaccination target group was 20% (95% CI: -6 to 39). All 53 sequenced A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.1. Among 410 sequenced influenza A(H3N2) viruses, all but eight belonged to clade 3C.2a1b.2a.2. DISCUSSION Despite antigenic mismatch between vaccine and circulating strains for influenza A(H3N2) and A(H1N1)pdm09, 2021-2022 VE estimates against circulating influenza A(H1N1)pdm09 were the highest within the I-MOVE network since the 2009 influenza pandemic. VE against A(H3N2) was lower than A(H1N1)pdm09, but at least one in five individuals vaccinated against influenza were protected against presentation to primary care with laboratory-confirmed influenza.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for MicrobiologyInstitute of Health Carlos IIIMadridSpain,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Iván Martínez‐Baz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | - Ana‐Maria Vilcu
- INSERM, Sorbonne UniversitéInstitut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)ParisFrance
| | - Lisa Domegan
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,National Centre for EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | | | | | - Mihaela Lazar
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Itziar Casado
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | - Sylvie van der Werf
- Unité de Génétique Moléculaire des Virus à ARN, Institut PasteurUniversité Paris Cité, UMR 3569 CNRSParisFrance,CNR virus des infections respiratoires, Institut PasteurParisFrance
| | - Joan O'Donnell
- Health Service Executive‐Health Protection Surveillance CentreDublinIreland
| | - Juan Antonio Linares Dopido
- Subdirección de Epidemiología, Dirección General de Salud Pública, Servicio Extremeño de SaludExtremaduraSpain
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | | | | | | | - Maria Elena Mihai
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | - Jesús Castilla
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)MadridSpain,Instituto de Salud Pública de Navarra ‐ IdiSNAPamplonaSpain
| | | | | | - Jeff Connell
- National Virus Reference LaboratoryUniversity College DublinDublinIreland
| | - Daniel Castrillejo
- Servicio de Epidemiología, DGSP, Consejería de Políticas Sociales, Salud Pública y Bienestar Animal, Ciudad Autónoma de MelillaMelillaSpain
| | | | | | - Maja Ilić
- Croatian Institute of Public HealthZagrebCroatia
| | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo JorgeLisbonPortugal
| | - Alina Ivanciuc
- “Cantacuzino” National Military Medical Institute for Research and DevelopmentBucharestRomania
| | | | - Ajibola Omokanye
- European Centre for Disease Prevention and ControlStockholmSweden
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12
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Funk T, Innocenti F, Gomes Dias J, Nerlander L, Melillo T, Gauci C, Melillo JM, Lenz P, Sebestova H, Slezak P, Vlckova I, Berild JD, Mauroy C, Seppälä E, Tønnessen R, Vergison A, Mossong J, Masi S, Huiart L, Cullen G, Murphy N, O'Connor L, O'Donnell J, Mook P, Pebody RG, Bundle N. Age-specific associations between underlying health conditions and hospitalisation, death and in-hospital death among confirmed COVID-19 cases: a multi-country study based on surveillance data, June to December 2020. Euro Surveill 2022; 27. [PMID: 36052721 PMCID: PMC9438397 DOI: 10.2807/1560-7917.es.2022.27.35.2100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Underlying conditions are risk factors for severe COVID-19 outcomes but evidence is limited about how risks differ with age. Aim We sought to estimate age-specific associations between underlying conditions and hospitalisation, death and in-hospital death among COVID-19 cases. Methods We analysed case-based COVID-19 data submitted to The European Surveillance System between 2 June and 13 December 2020 by nine European countries. Eleven underlying conditions among cases with only one condition and the number of underlying conditions among multimorbid cases were used as exposures. Adjusted odds ratios (aOR) were estimated using 39 different age-adjusted and age-interaction multivariable logistic regression models, with marginal means from the latter used to estimate probabilities of severe outcome for each condition–age group combination. Results Cancer, cardiac disorder, diabetes, immunodeficiency, kidney, liver and lung disease, neurological disorders and obesity were associated with elevated risk (aOR: 1.5–5.6) of hospitalisation and death, after controlling for age, sex, reporting period and country. As age increased, age-specific aOR were lower and predicted probabilities higher. However, for some conditions, predicted probabilities were at least as high in younger individuals with the condition as in older cases without it. In multimorbid patients, the aOR for severe disease increased with number of conditions for all outcomes and in all age groups. Conclusion While supporting age-based vaccine roll-out, our findings could inform a more nuanced, age- and condition-specific approach to vaccine prioritisation. This is relevant as countries consider vaccination of younger people, boosters and dosing intervals in response to vaccine escape variants.
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Affiliation(s)
- Tjede Funk
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Francesco Innocenti
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Superintendence of Public Health, Gwardamanġa, Malta
| | | | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Superintendence of Public Health, Gwardamanġa, Malta
| | - Patrik Lenz
- Department of Biostatistics, National Institute of Public Health, Prague, Czechia
| | - Helena Sebestova
- Department of Biostatistics, National Institute of Public Health, Prague, Czechia
| | - Pavel Slezak
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Iva Vlckova
- Department of Biostatistics, National Institute of Public Health, Prague, Czechia
| | - Jacob Dag Berild
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Camilla Mauroy
- Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Elina Seppälä
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild Tønnessen
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | | | - Gillian Cullen
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Niamh Murphy
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Lois O'Connor
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- HSE - Health Protection Surveillance Centre, Dublin, Ireland
| | - Piers Mook
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Richard G Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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13
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Swan D, Enright H, Desmond R, Le G, El Hassadi E, Hennessy B, Lynott F, O'Keeffe D, Crowley M, Smyth L, Perera K, Jennings C, Ni Ainle F, Coll J, Ryan K, O'Donnell J, Lavin M, O'Connell N. Vaccine-induced thrombosis and thrombocytopenia (VITT) in Ireland: A review of cases and current practices. Thromb Update 2021; 5:100086. [PMID: 38620810 PMCID: PMC8578028 DOI: 10.1016/j.tru.2021.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/20/2022] Open
Abstract
Since the beginning of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) virus pandemic, several highly effective and safe vaccines have been produced at remarkable speed. Following global implementation of vaccination programmes, cases of thrombosis with thrombocytopenia following administration of adenoviral vector-based vaccines started being reported. In this review we discuss the known pathogenesis and epidemiology of so-called vaccine induced thrombocytopenia and thrombosis (VITT). We consider the available guidelines, diagnostic laboratory tests and management options for these patients. Finally, we discuss important unanswered questions and areas for future research in this novel pathoclinical entity.
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Affiliation(s)
- D Swan
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - H Enright
- Tallaght University Hospital, Dublin, Ireland
| | - R Desmond
- Tallaght University Hospital, Dublin, Ireland
| | - G Le
- Tallaght University Hospital, Dublin, Ireland
| | - E El Hassadi
- Waterford University Hospital, Waterford, Ireland
| | - B Hennessy
- Waterford University Hospital, Waterford, Ireland
| | - F Lynott
- Waterford University Hospital, Waterford, Ireland
| | - D O'Keeffe
- University Hospital Limerick, Limerick, Ireland
| | - M Crowley
- Cork University Hospital, Cork, Ireland
| | - L Smyth
- St Vincent's University Hospital, Dublin, Ireland
| | - K Perera
- Midland Regional Hospital Tullamore, Tullamore, Ireland
| | - C Jennings
- Midland Regional Hospital Tullamore, Tullamore, Ireland
| | - F Ni Ainle
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - J Coll
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Ryan
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - J O'Donnell
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - M Lavin
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
| | - N O'Connell
- National Coagulation Centre, St James' Hospital, Dublin, Ireland
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14
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Domegan L, Garvey P, McEnery M, Fiegenbaum R, Brabazon E, Quintyne KI, O'Connor L, Cuddihy J, O'Donnell J. Establishing a COVID-19 pandemic severity assessment surveillance system in Ireland. Influenza Other Respir Viruses 2021; 16:172-177. [PMID: 34609049 PMCID: PMC8652866 DOI: 10.1111/irv.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/02/2021] [Accepted: 07/11/2021] [Indexed: 11/27/2022] Open
Abstract
We developed a COVID-19 pandemic severity assessment (PSA) monitoring system in Ireland, in order to inform and improve public health preparedness, response and recovery. The system based on the World Health Organization (WHO) Pandemic Influenza Severity Assessment (PISA) project included a panel of surveillance parameters for the following indicators: transmissibility, impact and disease severity. Age-specific thresholds were established for each parameter and data visualised using heat maps. The findings from the first pandemic wave in Ireland have shown that the WHO PISA system can be adapted for COVID-19, providing a standardised tool for early warning and monitoring pandemic severity.
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Affiliation(s)
- Lisa Domegan
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Patricia Garvey
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Maeve McEnery
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Rachel Fiegenbaum
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Elaine Brabazon
- Department of Public Health, Health Service Executive North-East, Navan, Ireland
| | - Keith Ian Quintyne
- Department of Public Health, Health Service Executive North-East, Navan, Ireland
| | - Lois O'Connor
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - John Cuddihy
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
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15
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Kissling E, Hooiveld M, Sandonis Martín V, Martínez-Baz I, William N, Vilcu AM, Mazagatos C, Domegan L, de Lusignan S, Meijer A, Machado A, Brytting M, Casado I, Murray JLK, Belhillil S, Larrauri A, O'Donnell J, Tsang R, de Lange M, Rodrigues AP, Riess M, Castilla J, Hamilton M, Falchi A, Pozo F, Dunford L, Cogdale J, Jansen T, Guiomar R, Enkirch T, Burgui C, Sigerson D, Blanchon T, Martínez Ochoa EM, Connell J, Ellis J, van Gageldonk-Lafeber R, Kislaya I, Rose AM, Valenciano M. Vaccine effectiveness against symptomatic SARS-CoV-2 infection in adults aged 65 years and older in primary care: I-MOVE-COVID-19 project, Europe, December 2020 to May 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34296676 PMCID: PMC8299744 DOI: 10.2807/1560-7917.es.2021.26.29.2100670] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We measured COVID-19 vaccine effectiveness (VE) against symptomatic SARS-CoV-2 infection at primary care/outpatient level among adults ≥ 65 years old using a multicentre test-negative design in eight European countries. We included 592 SARS-CoV-2 cases and 4,372 test-negative controls in the main analysis. The VE was 62% (95% CI: 45–74) for one dose only and 89% (95% CI: 79–94) for complete vaccination. COVID-19 vaccines provide good protection against COVID-19 presentation at primary care/outpatient level, particularly among fully vaccinated individuals.
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Affiliation(s)
| | | | | | - Iván Martínez-Baz
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Ana-Maria Vilcu
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Clara Mazagatos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ausenda Machado
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mia Brytting
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Itziar Casado
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Sylvie Belhillil
- Unité de Génétique Moléculaire des Virus à ARN, UMR 3569 CNRS, Université Paris Diderot SPC, Institut Pasteur, Paris, France.,CNR des virus des infections respiratoires, Institut Pasteur, Paris, France
| | - Amparo Larrauri
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ruby Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Royal College of General Practitioners Research and Surveillance Centre, London, UK
| | - Marit de Lange
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Jesús Castilla
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | | | - Francisco Pozo
- National Centre for Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Raquel Guiomar
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Cristina Burgui
- Instituto de Salud Pública de Navarra (IdiSNA), Pamplona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | | | - Thierry Blanchon
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Eva María Martínez Ochoa
- Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública, Consumo y Cuidados, La Rioja, Spain
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | | | - Irina Kislaya
- Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
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- The members of the I-MOVE-COVID-19 primary care study team are listed in the Investigators tab
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16
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Achilleos S, Quattrocchi A, Gabel J, Heraclides A, Kolokotroni O, Constantinou C, Pagola Ugarte M, Nicolaou N, Rodriguez-Llanes JM, Bennett CM, Bogatyreva E, Schernhammer E, Zimmermann C, Costa AJL, Lobato JCP, Fernandes NM, Semedo-Aguiar AP, Jaramillo Ramirez GI, Martin Garzon OD, Mortensen LH, Critchley JA, Goldsmith LP, Denissov G, Rüütel K, Le Meur N, Kandelaki L, Tsiklauri S, O'Donnell J, Oza A, Kaufman Z, Zucker I, Ambrosio G, Stracci F, Hagen TP, Erzen I, Klepac P, Arcos González P, Fernández Camporro Á, Burström B, Pidmurniak N, Verstiuk O, Huang Q, Mehta NK, Polemitis A, Charalambous A, Demetriou CA. Excess all-cause mortality and COVID-19-related mortality: a temporal analysis in 22 countries, from January until August 2020. Int J Epidemiol 2021; 51:35-53. [PMID: 34282450 PMCID: PMC8344815 DOI: 10.1093/ije/dyab123] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 01/22/2023] Open
Abstract
Background This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. Methods Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015–2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015–2019 average and (ii) difference between observed and expected 2020 deaths. Results Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality. Conclusions All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.
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Affiliation(s)
- Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - John Gabel
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Alexandros Heraclides
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Ourania Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Nicoletta Nicolaou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | | | | | - Ekaterina Bogatyreva
- School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Antonio Jose Leal Costa
- Institute of Studies in Collective Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Ana Paula Semedo-Aguiar
- Nature, Life and Environment Sciences Department, University Jean Piaget of Cape Verde, Praia, Cape Verde
| | | | | | - Laust Hvas Mortensen
- Department of Public Health, University of Copenhagen, Methods and Analysis, Statistics Denmark, Copenhagen, Denmark
| | - Julia A Critchley
- Population Health Research Institute, St George's, University of London, London, UK
| | - Lucy P Goldsmith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Gleb Denissov
- Department of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Kristi Rüütel
- Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia
| | - Nolwenn Le Meur
- University of Rennes, EHESP, REPERES-EA 7449, Rennes, France
| | - Levan Kandelaki
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Joan O'Donnell
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Ajay Oza
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - Zalman Kaufman
- Israel Center of Disease Control, Ministry of Health, Ramat Gan, Israel
| | - Inbar Zucker
- Israel Center of Disease Control, Ministry of Health, Ramat Gan, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Giuseppe Ambrosio
- Department of Medicine, University of Perugia School of Medicine, Perugia, Italy.,CERICLET- Interdepartmental Center for Clinical and Translational Research, University of Perugia School of Medicine, Perugia, Italy
| | - Fabrizio Stracci
- Department of Medicine, University of Perugia School of Medicine, Perugia, Italy
| | - Terje P Hagen
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Ivan Erzen
- Public Health School, National Institute of Public Health, Ljubljana, Slovenia
| | - Petra Klepac
- Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia
| | | | | | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Olesia Verstiuk
- Faculty of Medicine, Bogomolets National Medical University, Kyiv, Ukraine
| | - Qian Huang
- SC Center for Rural and Primary Health Care and Department of Geography, University of South Carolina, Columbia, SC, USA
| | - Neil Kishor Mehta
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Christiana A Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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17
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Bennett KE, Mullooly M, O'Loughlin M, Fitzgerald M, O'Donnell J, O'Connor L, Oza A, Cuddihy J. Underlying conditions and risk of hospitalisation, ICU admission and mortality among those with COVID-19 in Ireland: A national surveillance study. Lancet Reg Health Eur 2021; 5:100097. [PMID: 33880459 PMCID: PMC8049357 DOI: 10.1016/j.lanepe.2021.100097] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background To date, over 2 million people worldwide have died with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To describe the experience in Ireland, this study examined associations between underlying conditions and the following outcomes: mortality, admission to hospital or admission to the intensive care unit (ICU) among those infected with COVID-19. Methods This study used data from the Health Protection Surveillance Centre in Ireland and included confirmed cases of COVID-19 from the first wave of the pandemic between March and July 2020. Two cohorts were included: all cases (community and hospital) and hospital admissions only. For all cases, health outcome data included mortality and hospitalisation. For hospitalised cases, outcome data included mortality and ICU admission. Logistic regression was used to examine associations between underlying conditions and outcomes across both cohorts. Results are presented as adjusted odds ratios (OR) and 95% confidence intervals (CIs). Findings There were 19,789 cases included in analysis, which encompassed 1,476 (7.5%) deaths, 2,811 (14.2%) hospitalisations, and 438 (2.2%) ICU admissions of whom 90 (20.5%) died. Significantly higher risk of mortality, hospitalisation and ICU admission was associated with having chronic heart disease, a BMI ≥40kg/m2 and male sex. Additionally, diagnosis of a chronic neurological condition (OR 1.41; 95%CI:1.17, 1.69), chronic kidney disease (OR 1.74; 95%CI:1.35, 2.24) and cancer (OR 2.77; 95%CI:2.21, 3.47) were significantly associated with higher risk of mortality among all cases, with similar patterns of association observed for mortality among hospitalised cases. Interpretation The identification of underlying conditions among COVID-19 cases may help identify those at highest risk of the worst health outcomes and inform preventive strategies to improve outcomes. Funding This study was supported by the Health Service Executive, Health Protection Surveillance Centre. KEB and MM are funded by the Health Research Board (RL-15-1579 and EIA-2019-012 respectively).
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Affiliation(s)
- Kathleen E Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,Data Science Centre, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street Lower, Dublin, Ireland
| | - Maeve Mullooly
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mark O'Loughlin
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Margaret Fitzgerald
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Lois O'Connor
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Ajay Oza
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - John Cuddihy
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
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18
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Nørgaard SK, Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braye T, Athanasiadou M, Lytras T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Gkolfinopoulou K, Bobvos J, Paldy A, Rotem N, Kornilenko I, Domegan L, O'Donnell J, Donato FD, Scortichini M, Hoffmann P, Velez T, England K, Calleja N, van Asten L, Stoeldraijer L, White RA, Paulsen TH, da Silva SP, Rodrigues AP, Klepac P, Zaletel M, Fafangel M, Larrauri A, León I, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty MG, Irwin D, Kennedy S, McMenamin J, Adlhoch C, Bundle N, Penttinen P, Pukkila J, Pebody R, Krause TG, Mølbak K. Real-time monitoring shows substantial excess all-cause mortality during second wave of COVID-19 in Europe, October to December 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 33446304 PMCID: PMC7809719 DOI: 10.2807/1560-7917.es.2021.26.1.2002023] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality. Europe is currently seeing another upsurge in COVID-19 cases, and EuroMOMO is again witnessing a substantial excess all-cause mortality attributable to COVID-19.
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Affiliation(s)
| | | | - Jens Nielsen
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | - Janos Bobvos
- National Public Health Center, Budapest, Hungary
| | - Anna Paldy
- National Public Health Center, Budapest, Hungary
| | - Naama Rotem
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Irene Kornilenko
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | | | - Neville Calleja
- Directorate for Health Information and Research, Pieta, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Petra Klepac
- National Institute of Public Health, Ljubljana, Slovenia
| | - Metka Zaletel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mario Fafangel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Inmaculada León
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | - Mary Sinnathamby
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Nick Andrews
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Mark G O'Doherty
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - David Irwin
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Sharon Kennedy
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Jim McMenamin
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jukka Pukkila
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Tyra G Krause
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
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19
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Beale A, O'Donnell J, Nakai M, Nanayakkara S, Vizi D, Carter K, Dean E, Ribiero R, Yiallourou S, Carrington M, Marques F, Kaye D. The Gut Microbiome of Heart Failure With Preserved Ejection Fraction. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Brehony C, Dunford L, Bennett C, O'Donnell J, Domegan L, McNamara E, De Gascun CF. Neuraminidase characterisation reveals very low levels of antiviral resistance and the presence of mutations associated with reduced antibody effectiveness in the Irish influenza 2018/2019 season. J Clin Virol 2020; 132:104653. [PMID: 33038626 PMCID: PMC7527353 DOI: 10.1016/j.jcv.2020.104653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/29/2020] [Accepted: 09/27/2020] [Indexed: 11/24/2022]
Abstract
Very low antiviral resistance in Irish 2018/2019 influenza season. Supports current antiviral use. Continued molecular neuraminidase surveillance essential for resistance emergence. Surveillance also useful for monitoring vaccine effectiveness. Mutations associated with reduced antibody effectiveness detected.
Neuraminidase inhibitor (NAI) resistance levels globally are currently low. However, as antivirals are increasingly being used, and even in the absence of selective pressure, resistance may increase or emerge. The neuraminidase (NA) genes from influenza viruses from the Irish 2018/2019 season were sequenced: 1/144 (0.7 %) A(H1N1)pdm09 sequences harboured a substitution associated with highly-reduced susceptibility to NAIs. The very low NAI resistance we describe supports current Irish NAI use recommendations. However, continued monitoring is essential. NA characterisation also identified substitutions associated with reduced antibody effectiveness, thereby highlighting the potential of NA sequence surveillance as an additional tool for investigating influenza vaccine effectiveness (VE).
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Affiliation(s)
- Carina Brehony
- Public Health Laboratory, Health Service Executive, Dublin, Ireland; European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Control and Prevention, Stockholm, Sweden.
| | - Linda Dunford
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Charlene Bennett
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive, Health Protection Surveillance Centre, Dublin, Ireland; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Eleanor McNamara
- Public Health Laboratory, Health Service Executive, Dublin, Ireland
| | - Cillian F De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
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21
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Troya MI, Khashan A, Kearney PM, Arensman E, Hoevel P, Buckley C, Fitzgerald M, Humphries R, Kiely E, Mulchrone K, Murphy M, O'Connor L, O'Donnell J, O’Reilly E, O'Riordain M, Spillane M, Wieczorek S, Perry IJ. Covid-19 Estimating the burden of symptomatic disease in the community and the impact of public health measures on physical, mental and social wellbeing: a study protocol. HRB Open Res 2020. [DOI: 10.12688/hrbopenres.13103.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Covid-19 was declared a pandemic in March 2020. Since then, governments have implemented unprecedented public health measures to contain the virus. This study will provide evidence to inform responses to the pandemic by: i) estimating population prevalence and trends of self-reported symptoms of Covid-19 and the proportions of symptomatic individuals and household contacts testing positive for Covid-19; ii) describing acceptance and compliance with physical-distancing measures, explore effects of public health measures on physical, mental and social wellbeing; iii) developing a mathematical network model to inform decisions on the optimal levels of physical distancing measures. Methods: Two cross-sectional nationally-representative telephone surveys will be conducted in Ireland using random digit-dialling, with response rates estimates based on proportion of non-operational and non-answering numbers. The first survey with four waves in May and June will address adherence to social distancing measures and whether the respondent or other household members are or have been unwell during the preceding two weeks with one or more symptoms of Covid-19. The second survey with three waves in June, July and September will address knowledge, attitudes, and compliance towards physical-distancing measures and physical, mental and social wellbeing. The mathematical network model will be developed for all-Ireland (on various levels of spatial granularity including the scale of counties and electoral divisions) based on outputs from both cross-sectional surveys and relevant publicly available data to inform decisions on optimal levels and duration of physical distancing measures. Discussion: This study will contribute to our understanding of the impact and sustainability of public health measures of the Covid-19 pandemic. Findings will have long-lasting benefits, informing decision-making on the best levels, and duration of physical-distancing measures, balancing a range of factors including capacity of the health service with the effects on individuals’ wellbeing and economic disruption. Findings will be shared with key policy-makers.
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22
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Kissling E, Pozo F, Buda S, Vilcu AM, Gherasim A, Brytting M, Domegan L, Gómez V, Meijer A, Lazar M, Vučina VV, Dürrwald R, van der Werf S, Larrauri A, Enkirch T, O'Donnell J, Guiomar R, Hooiveld M, Petrović G, Stoian E, Penttinen P, Valenciano M. Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15-64-year-olds in Europe: exploration by birth cohort. ACTA ACUST UNITED AC 2020; 24. [PMID: 31796152 PMCID: PMC6891946 DOI: 10.2807/1560-7917.es.2019.24.48.1900604] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-year-olds (1964–86) and 55–64-year-olds (1954–63), respectively. Discussion The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.
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Affiliation(s)
| | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Alin Gherasim
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Verónica Gómez
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mihaela Lazar
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Vesna Višekruna Vučina
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Ralf Dürrwald
- Robert Koch Institute, National Reference Center for Influenza, Germany
| | - Sylvie van der Werf
- CNR des virus des infections respiratoires, WHO National Influenza Center, Institut Pasteur, Paris, France.,Unité de Génétique Moléculaire des Virus à ARN, Institut Pasteur, CNRS UMR3569, Université Paris Diderot SPC, France
| | - Amparo Larrauri
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain
| | | | - Joan O'Donnell
- Health Service Executive- Health Protection Surveillance Centre, Dublin, Ireland
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Mariëtte Hooiveld
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
| | - Goranka Petrović
- Croatian Institute of Public Health, Division for epidemiology of communicable diseases, Zagreb, Croatia
| | - Elena Stoian
- "Cantacuzino" National Military-Medical Institute for Research and Development, Bucharest, Romania
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | -
- The I-MOVE primary care study team members are listed at the end of the article
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23
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Troya MI, Khashan A, Kearney P, Arensman E, Hoevel P, Buckley C, Fitzgerald M, Humphries R, Kiely E, Mulchrone K, Murphy M, O'Connor L, O'Donnell J, O’Reilly E, O'Riordain M, Spillane M, Wieczorek S, Perry IJ. Covid-19 Estimating the burden of symptomatic disease in the community and the impact of public health measures on physical, mental and social wellbeing: a study protocol. HRB Open Res 2020; 3:49. [PMID: 33029573 PMCID: PMC7525335 DOI: 10.12688/hrbopenres.13103.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Covid-19 was declared a pandemic in March 2020. Since then, governments have implemented unprecedented public health measures to contain the virus. This study will provide evidence to inform responses to the pandemic by: i) estimating population prevalence and trends of self-reported symptoms of Covid-19 and the proportions of symptomatic individuals and household contacts testing positive for Covid-19; ii) describing acceptance and compliance with physical-distancing measures, explore effects of public health measures on physical, mental and social wellbeing; iii) developing a mathematical network model to inform decisions on the optimal levels of physical distancing measures. Methods: Two cross-sectional nationally-representative telephone surveys will be conducted in Ireland using random digit-dialling, with response rates estimates based on proportion of non-operational and non-answering numbers. The first survey with four waves in May and June will address adherence to social distancing measures and whether the respondent or other household members are or have been unwell during the preceding two weeks with one or more symptoms of Covid-19. The second survey with three waves in June, July and September will address knowledge, attitudes, and compliance towards physical-distancing measures and physical, mental and social wellbeing. The mathematical network model will be developed for all-Ireland (on various levels of spatial granularity including the scale of counties and electoral divisions) based on outputs from both cross-sectional surveys and relevant publicly available data to inform decisions on optimal levels and duration of physical distancing measures. Discussion: This study will contribute to our understanding of the impact and sustainability of public health measures of the Covid-19 pandemic. Findings will have long-lasting benefits, informing decision-making on the best levels, and duration of physical-distancing measures, balancing a range of factors including capacity of the health service with the effects on individuals' wellbeing and economic disruption. Findings will be shared with key policy-makers.
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Affiliation(s)
- M. Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Ali Khashan
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Patricia Kearney
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Philipp Hoevel
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - Claire Buckley
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Margaret Fitzgerald
- Health Protection Surveillance Centre, Health Services Executive, Dublin, Ireland
| | - Rory Humphries
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - Elizabeth Kiely
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Kieran Mulchrone
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Psychology, University College Cork, Cork, Ireland
| | - Lois O'Connor
- Health Protection Surveillance Centre, Health Services Executive, Dublin, Ireland
| | - Joan O'Donnell
- Health Protection Surveillance Centre, Health Services Executive, Dublin, Ireland
| | - Eilis O’Reilly
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Micheal O'Riordain
- School of Mathematical Sciences, University College Cork, Cork, Ireland
- Department of Surgery, Mercy University Hospital, Cork, Ireland
| | - Mary Spillane
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | | | - Ivan J Perry
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
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24
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Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braeye T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Lytras T, Gkolfinopoulou K, Paldy A, Domegan L, O'Donnell J, De' Donato F, Noccioli F, Hoffmann P, Velez T, England K, van Asten L, White RA, Tønnessen R, da Silva SP, Rodrigues AP, Larrauri A, Delgado-Sanz C, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty M, Marquess DF, Kennedy S, Olsen SJ, Pebody R, Krause TG, Mølbak K. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32643601 PMCID: PMC7346364 DOI: 10.2807/1560-7917.es.2020.25.26.2001214] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A remarkable excess mortality has coincided with the COVID-19 pandemic in Europe. We present preliminary pooled estimates of all-cause mortality for 24 European countries/federal states participating in the European monitoring of excess mortality for public health action (EuroMOMO) network, for the period March–April 2020. Excess mortality particularly affected ≥ 65 year olds (91% of all excess deaths), but also 45–64 (8%) and 15–44 year olds (1%). No excess mortality was observed in 0–14 year olds.
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Affiliation(s)
| | | | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Public Health Institute, Budapest, Hungary
| | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg
| | - Kathleen England
- Directorate for Health Information and Research, Ministry for Health, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | | | - Nick Andrews
- Public Health England, Colindale, United Kingdom
| | | | | | | | - Sonja J Olsen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | -
- The members of the ECDC Public Health Emergency Team for COVID-19 are listed below
| | | | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,Statens Serum Institut, Copenhagen, Denmark
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25
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Danis K, Fonteneau L, Georges S, Daniau C, Bernard-Stoecklin S, Domegan L, O'Donnell J, Hauge SH, Dequeker S, Vandael E, Van der Heyden J, Renard F, Sierra NB, Ricchizzi E, Schweickert B, Schmidt N, Abu Sin M, Eckmanns T, Paiva JA, Schneider E. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, May 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32524949 PMCID: PMC7336111 DOI: 10.2807/1560-7917.es.2020.25.22.2000956] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Residents in long-term care facilities (LTCF) are a vulnerable population group. Coronavirus disease (COVID-19)-related deaths in LTCF residents represent 30–60% of all COVID-19 deaths in many European countries. This situation demands that countries implement local and national testing, infection prevention and control, and monitoring programmes for COVID-19 in LTCF in order to identify clusters early, decrease the spread within and between facilities and reduce the size and severity of outbreaks.
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Affiliation(s)
| | - Kostas Danis
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Laure Fonteneau
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Scarlett Georges
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Côme Daniau
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | | | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | - Enrico Ricchizzi
- Regional Health and Social Agency - Emilia Romagna, Bologna, Italy
| | | | | | | | | | | | - Elke Schneider
- European Agency for Safety and Health at Work, Bilbao, Spain
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26
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Danis K, Fonteneau L, Georges S, Daniau C, Bernard-Stoecklin S, Domegan L, O'Donnell J, Hauge SH, Dequeker S, Vandael E, Van der Heyden J, Renard F, Sierra NB, Ricchizzi E, Schweickert B, Schmidt N, Abu Sin M, Eckmanns T, Paiva JA, Schneider E. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, May 2020. Euro Surveill 2020. [PMID: 32524949 DOI: 10.2807/1560-7917.es.2020.25.22.200095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Residents in long-term care facilities (LTCF) are a vulnerable population group. Coronavirus disease (COVID-19)-related deaths in LTCF residents represent 30-60% of all COVID-19 deaths in many European countries. This situation demands that countries implement local and national testing, infection prevention and control, and monitoring programmes for COVID-19 in LTCF in order to identify clusters early, decrease the spread within and between facilities and reduce the size and severity of outbreaks.
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Affiliation(s)
- Kostas Danis
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Laure Fonteneau
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Scarlett Georges
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | - Côme Daniau
- Santé Publique France (SpFrance), the French National Public Health Agency, St Maurice, France
| | | | - Lisa Domegan
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | - Enrico Ricchizzi
- Regional Health and Social Agency - Emilia Romagna, Bologna, Italy
| | | | | | | | | | | | - Elke Schneider
- European Agency for Safety and Health at Work, Bilbao, Spain
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27
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O'Donnell J, Klaber I, Takla A. Ligamentum teres reconstruction: indications, technique and minimum 1-year results in nine patients. J Hip Preserv Surg 2020; 7:140-146. [PMID: 32382441 PMCID: PMC7195921 DOI: 10.1093/jhps/hnz070] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/24/2019] [Accepted: 12/26/2019] [Indexed: 11/12/2022] Open
Abstract
Ligamentum teres (LT) tear is a recognized cause of hip pain. Debridement of tears and capsule plication has shown satisfactory results. However, a group of patients with complete tears do not improve after debridement and physiotherapy. The purpose of this work was to describe the senior author's technique and clinical results for the early series of LT reconstructions. Retrospective analysis of prospectively collected data. Patients who underwent isolated LT reconstruction between 2013 and 2018. All the patients had previous debridement of a completely torn LT, capsule plication and rehabilitation. Patients who had any other associated procedure during LT reconstruction surgery and dysplastic acetabular features were excluded. Demographic and clinical data was reviewed. Complications, type of graft and modified Harris hip scores (mHHSs) were recorded preoperatively and at 1-year follow-up. Fifteen LT reconstructions were performed during the study period. Six were excluded (as they had additional procedures performed during surgery) and nine patients aged a mean 30 (range: 22-48) years old were included. The patients had a mean of 2 (range: 1-4) prior surgeries. At minimum 12 months (range: 12-24) 9/9 patients reported reduction of pain and instability symptoms with mHHSs of 84.2 (73.7-100) versus 51.7 (36.3-70.4) preoperatively (P = 0.00094). Three patients (of the total cohort of 15) underwent second-look arthroscopy (11-22 months after reconstruction). None of these patients underwent total hip replacement at a mean of 4 (range: 1-6) years. Arthroscopic LT reconstruction improved function and pain in patients with persistent pain and instability after resection of the LT.
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Affiliation(s)
- J O'Donnell
- Department of Orthopaedics, Swinburne University of Technology, Melbourne 3122, Australia.,Hip Arthroscopy Australia, Melbourne 3121, Australia
| | - I Klaber
- Orthopedic Surgery Department, School of Medicine, Pontifical Catholic University of Chile, Santiago 8330077, Chile
| | - A Takla
- Department of Orthopaedics, Swinburne University of Technology, Melbourne 3122, Australia.,Sports Physiotherapy, Bond University, Gold Coast, Robina, QLD 4226, Australia
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28
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Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Domínguez JA, Delgado-Sanz C, Brytting M, Carnahan A, Popovici O, Lupulescu E, O'Donnell J, Domegan L, Van Gageldonk-Lafeber AB, Meijer A, Kynčl J, Slezák P, Guiomar R, Orta Gomes CM, Popow-Kraupp T, Mikas J, Staroňová E, Melillo JM, Melillo T, Ikonen N, Lyytikäinen O, Snacken R, Penttinen P. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis 2019; 6:ofz462. [PMID: 32258201 PMCID: PMC7105050 DOI: 10.1093/ofid/ofz462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
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Affiliation(s)
- Cornelia Adlhoch
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana Gomes Dias
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Bruno Hubert
- Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús A Oliva Domínguez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mia Brytting
- The Public Health Agency of Sweden, Solna, Sweden
| | | | - Odette Popovici
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Emilia Lupulescu
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavel Slezák
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge (National Institute of Health Dr. Ricardo Jorge), Lisboa, Portugal
| | - Carlos M Orta Gomes
- Department of Public Health of Regional Health Administration of Lisbon and Tagus Valley, Lisboa, Portugal
| | | | - Ján Mikas
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Edita Staroňová
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - René Snacken
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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Snee M, Cheeseman S, Thompson M, Bowman R, Lacoin L, Sopwith W, Chaib C, Juarez-Garcia A, Daumont M, Penrod J, O'Donnell J, Hall G. P2.12-01 Small Cell Lung Cancer (SCLC) Treatment and Survival in the UK: A REAL-Oncology Analysis from the I-O Optimise Initiative. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kissling E, Pozo F, Buda S, Vilcu AM, Rizzo C, Gherasim A, Horváth JK, Brytting M, Domegan L, Meijer A, Paradowska-Stankiewicz I, Machado A, Vučina VV, Lazar M, Johansen K, Dürrwald R, van der Werf S, Bella A, Larrauri A, Ferenczi A, Zakikhany K, O'Donnell J, Dijkstra F, Bogusz J, Guiomar R, Filipović SK, Pitigoi D, Penttinen P, Valenciano M. Effectiveness of influenza vaccine against influenza A in Europe in seasons of different A(H1N1)pdm09 and the same A(H3N2) vaccine components (2016-17 and 2017-18). Vaccine X 2019; 3:100042. [PMID: 31660536 PMCID: PMC6807025 DOI: 10.1016/j.jvacx.2019.100042] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 11/09/2022] Open
Abstract
Influenza A(H3N2) circulated in Europe in 2016–17 and 2017–18 and A(H1N1)pdm09 in 2017–18. Changed A(H1N1)pdm09 vaccine component VE was 58% against A(H1N1)pdm09 in 2017–18. A(H3N2) VE was 13% and 28% among all ages in 2016–17 and 2017–18, respectively.
Introduction Influenza A(H3N2) viruses predominated in Europe in 2016–17. In 2017–18 A(H3N2) and A(H1N1)pdm09 viruses co-circulated. The A(H3N2) vaccine component was the same in both seasons; while the A(H1N1)pdm09 component changed in 2017–18. In both seasons, vaccine seed A(H3N2) viruses developed adaptations/alterations during propagation in eggs, impacting antigenicity. Methods We used the test-negative design in a multicentre primary care case-control study in 12 European countries to measure 2016–17 and 2017–18 influenza vaccine effectiveness (VE) against laboratory-confirmed influenza A(H1N1)pdm09 and A(H3N2) overall and by age group. Results During the 2017–18 season, the overall VE against influenza A(H1N1)pdm09 was 59% (95% CI: 47–69). Among those aged 0–14, 15–64 and ≥65 years, VE against A(H1N1)pdm09 was 64% (95% CI: 37–79), 50% (95% CI: 28–66) and 66% (95% CI: 42–80), respectively. Overall VE against influenza A(H3N2) was 28% (95% CI: 17–38) in 2016–17 and 13% (95% CI: −15 to 34) in 2017–18. Among 0–14-year-olds VE against A(H3N2) was 28% (95%CI: −10 to 53) and 29% (95% CI: −87 to 73), among 15–64-year-olds 34% (95% CI: 18–46) and 33% (95% CI: −3 to 56) and among those aged ≥65 years 15% (95% CI: −10 to 34) and −9% (95% CI: −74 to 32) in 2016–17 and 2017–18, respectively. Conclusions Our study suggests the new A(H1N1)pdm09 vaccine component conferred good protection against circulating strains, while VE against A(H3N2) was <35% in 2016–17 and 2017–18. The egg propagation derived antigenic mismatch of the vaccine seed virus with circulating strains may have contributed to this low effectiveness. A(H3N2) seed viruses for vaccines in subsequent seasons may be subject to the same adaptations; in years with lower than expected VE, recommendations of preventive measures other than vaccination should be given in a timely manner.
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Affiliation(s)
- Esther Kissling
- Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France
| | - Francisco Pozo
- National Centre for Microbiology, National Influenza Reference Laboratory, WHO-National Influenza Centre, Institute of Health Carlos III, Madrid, Spain
| | - Silke Buda
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Respiratory Infections Unit, Seestrasse 10, 13353 Berlin, Germany
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F-75012, Paris, France
| | - Caterina Rizzo
- Department of Infectious Diseases, National Institute of Health, Rome, Italy.,Bambino Gesù Children's Hospital, Rome, Italy
| | - Alin Gherasim
- National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid Spain
| | | | - Mia Brytting
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Ausenda Machado
- Departamento de Epidemiologia, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | | | - Mihaela Lazar
- "Cantacuzino" National Medico-Military Institute for Research and Development, Bucharest, Romania
| | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden
| | - Ralf Dürrwald
- Robert Koch Institute, National Reference Center for Influenza, Seestrasse 10, 13353 Berlin, Germany
| | - Sylvie van der Werf
- Unité de Génétique Moléculaire des Virus à ARN, Institut Pasteur, CNRS UMR3569, Université Paris Diderot SPC, France.,CNR des Virus des Infections Respiratoires, WHO National Influenza Center, Institut Pasteur, France
| | - Antonino Bella
- Department of Infectious Diseases, National Institute of Health, Rome, Italy
| | - Amparo Larrauri
- National Epidemiology Centre, Institute of Health Carlos III, Madrid, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid Spain
| | | | | | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1 D01 A4A3, Ireland
| | - Frederika Dijkstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joanna Bogusz
- National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Raquel Guiomar
- Departamento de Doenças Infeciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Portugal
| | | | - Daniela Pitigoi
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s boulevard 40, 169 73 Solna, Sweden
| | - Marta Valenciano
- Epidemiology Department, Epiconcept, 47 rue de Charenton, 75012 Paris, France
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Snee M, Cheeseman S, Thompson M, Lacoin L, Sopwith W, Chaib C, Daumont M, Penrod J, O'Donnell J, Hall G. P2.01-91 Treatment Patterns in Patients with Stage IIIB-IV NSCLC in Clinical Practice: Retrospective Analysis of a UK Trust Database. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Valenciano M, Kissling E, Larrauri A, Nunes B, Pitigoi D, O'Donnell J, Reuss A, Horváth JK, Paradowska‐Stankiewicz I, Rizzo C, Falchi A, Daviaud I, Brytting M, Meijer A, Kaic B, Gherasim A, Machado A, Ivanciuc A, Domegan L, Schweiger B, Ferenczi A, Korczyńska M, Bella A, Vilcu A, Mosnier A, Zakikhany K, de Lange M, Kurečić Filipovićović S, Johansen K, Moren A. Exploring the effect of previous inactivated influenza vaccination on seasonal influenza vaccine effectiveness against medically attended influenza: Results of the European I-MOVE multicentre test-negative case-control study, 2011/2012-2016/2017. Influenza Other Respir Viruses 2018; 12:567-581. [PMID: 29659149 PMCID: PMC6086844 DOI: 10.1111/irv.12562] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Results of previous influenza vaccination effects on current season influenza vaccine effectiveness (VE) are inconsistent. OBJECTIVES To explore previous influenza vaccination effects on current season VE among population targeted for vaccination. METHODS We used 2011/2012 to 2016/2017 I-MOVE primary care multicentre test-negative data. For each season, we compared current season adjusted VE (aVE) between individuals vaccinated and unvaccinated in previous season. Using unvaccinated in both seasons as a reference, we then compared aVE between vaccinated in both seasons, current only, and previous only. RESULTS We included 941, 2645 and 959 influenza-like illness patients positive for influenza A(H1N1)pdm09, A(H3N2) and B, respectively, and 5532 controls. In 2011/2012, 2014/2015 and 2016/2017, A(H3N2) aVE point estimates among those vaccinated in previous season were -68%, -21% and -19%, respectively; among unvaccinated in previous season, these were 33%, 48% and 46%, respectively (aVE not computable for influenza A(H1N1)pdm09 and B). Compared to current season vaccination only, VE for both seasons' vaccination was (i) similar in two of four seasons for A(H3N2) (absolute difference [ad] 6% and 8%); (ii) lower in three of four seasons for influenza A(H1N1)pdm09 (ad 18%, 26% and 29%), in two seasons for influenza A(H3N2) (ad 27% and 39%) and in two of three seasons for influenza B (ad 26% and 37%); (iii) higher in one season for influenza A(H1N1)pdm09 (ad 20%) and influenza B (ad 24%). CONCLUSIONS We did not identify any pattern of previous influenza vaccination effect. Prospective cohort studies documenting influenza infections, vaccinations and vaccine types are needed to understand previous influenza vaccinations' effects.
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Affiliation(s)
| | | | - Amparo Larrauri
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Baltazar Nunes
- Department of EpidemiologyInstituto Nacional de Saúde, Doctor Ricardo JorgeLisboaPortugal
| | - Daniela Pitigoi
- University of Medicine and Pharmacy Carol DavilaBucharestRomania
- Cantacuzino InstituteNational Institute of Research – Development for Microbiology and ImmunologyBucharestRomania
| | - Joan O'Donnell
- Health Service Executive – Health Protection Surveillance CentreDublinIreland
| | - Annicka Reuss
- Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
| | - Judit Krisztina Horváth
- Department of Disease Prevention and SurveillanceNational Centre for EpidemiologyBudapestHungary
| | | | - Caterina Rizzo
- National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di SanitàRomeItaly
| | | | | | - Mia Brytting
- The Public Health Agency of SwedenStockholmSweden
| | - Adam Meijer
- Centre for Infectious Disease ControlNational Institute of Public Health and Environment (RIVM)BilthovenThe Netherlands
| | | | - Alin Gherasim
- National Centre of EpidemiologyInstitute of Health Carlos IIIMadridSpain
| | - Ausenda Machado
- Department of EpidemiologyInstituto Nacional de Saúde, Doctor Ricardo JorgeLisboaPortugal
| | - Alina Ivanciuc
- Cantacuzino InstituteNational Institute of Research – Development for Microbiology and ImmunologyBucharestRomania
| | - Lisa Domegan
- Health Service Executive – Health Protection Surveillance CentreDublinIreland
| | - Brunhilde Schweiger
- Department for Infectious Disease EpidemiologyRobert Koch InstituteBerlinGermany
| | - Annamária Ferenczi
- Department of Disease Prevention and SurveillanceNational Centre for EpidemiologyBudapestHungary
| | - Monika Korczyńska
- National Institute of Public Health – National Institute of HygieneWarsawPoland
| | - Antonino Bella
- National Center for Epidemiology, Surveillance and Health PromotionIstituto Superiore di SanitàRomeItaly
| | - Ana‐Maria Vilcu
- Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)UPMC Univ Paris 06, INSERMSorbonne UniversitésParisFrance
| | | | | | - Marit de Lange
- Centre for Infectious Disease ControlNational Institute of Public Health and Environment (RIVM)BilthovenThe Netherlands
| | | | - Kari Johansen
- European Centre for Disease Prevention and Control (ECDC)StockholmSweden
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Conrad N, Judge A, O'Donnell J, Tran J, Nazarzadeh M, Canoy D, McMurray JJV, Rahimi K. 1147Patients' journey of care following incident heart failure: diagnostic tests, treatments and care pathways in 93,000 patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Conrad
- University of Oxford, Oxford, United Kingdom
| | - A Judge
- University of Oxford, Oxford, United Kingdom
| | - J O'Donnell
- University of Oxford, Oxford, United Kingdom
| | - J Tran
- University of Oxford, Oxford, United Kingdom
| | | | - D Canoy
- University of Oxford, Oxford, United Kingdom
| | | | - K Rahimi
- University of Oxford, Oxford, United Kingdom
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Vestergaard LS, Nielsen J, Krause TG, Espenhain L, Tersago K, Bustos Sierra N, Denissov G, Innos K, Virtanen MJ, Fouillet A, Lytras T, Paldy A, Bobvos J, Domegan L, O'Donnell J, Scortichini M, de Martino A, England K, Calleja N, van Asten L, Teirlinck AC, Tønnessen R, White RA, P Silva S, Rodrigues AP, Larrauri A, Leon I, Farah A, Junker C, Sinnathamby M, Pebody RG, Reynolds A, Bishop J, Gross D, Adlhoch C, Penttinen P, Mølbak K. Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017. ACTA ACUST UNITED AC 2017; 22:30506. [PMID: 28424146 PMCID: PMC5388126 DOI: 10.2807/1560-7917.es.2017.22.14.30506] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/06/2017] [Indexed: 11/25/2022]
Abstract
Since December 2016, excess all-cause mortality was observed in many European countries, especially among people aged ≥ 65 years. We estimated all-cause and influenza-attributable mortality in 19 European countries/regions. Excess mortality was primarily explained by circulation of influenza virus A(H3N2). Cold weather snaps contributed in some countries. The pattern was similar to the last major influenza A(H3N2) season in 2014/15 in Europe, although starting earlier in line with the early influenza season start.
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Affiliation(s)
| | | | | | | | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | - Kaire Innos
- National Institute for Health Development, Tallinn, Estonia
| | | | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | - Theodore Lytras
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Anna Paldy
- National Public Health Center, Budapest, Hungary
| | - Janos Bobvos
- National Public Health Center, Budapest, Hungary
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | - Liselotte van Asten
- National Institute of Public Health and the Environment (RIVM), The Netherlands
| | - Anne C Teirlinck
- National Institute of Public Health and the Environment (RIVM), The Netherlands
| | | | | | - Susana P Silva
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Leon
- CIBER Epidemiología y Salud Pública (CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
| | - Ahmed Farah
- The Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | | | | | | | - Diane Gross
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Roycroft E, O'Toole RF, Fitzgibbon MM, Montgomery L, O'Meara M, Downes P, Jackson S, O'Donnell J, Laurenson IF, McLaughlin AM, Keane J, Rogers TR. Molecular epidemiology of multi- and extensively-drug-resistant Mycobacterium tuberculosis in Ireland, 2001-2014. J Infect 2017; 76:55-67. [PMID: 29031637 DOI: 10.1016/j.jinf.2017.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/05/2017] [Accepted: 10/03/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The primary objective of this work was to examine the acquisition and spread of multi-drug resistant (MDR) tuberculosis (TB) in Ireland. METHODS All available Mycobacterium tuberculosis complex (MTBC) isolates (n = 42), from MDR-TB cases diagnosed in Ireland between 2001 and 2014, were analysed using phenotypic drug-susceptibility testing, Mycobacterial-Interspersed-Repetitive-Units Variable-Number Tandem-Repeat (MIRU-VNTR) genotyping, and whole-genome sequencing (WGS). RESULTS The lineage distribution of the MDR-TB isolates comprised 54.7% Euro-American, 33.3% East Asian, 7.2% East African Indian, and 4.8% Indo-Oceanic. A significant association was identified between the East Asian Beijing sub-lineage and the relative risk of an isolate being MDR. Over 75% of MDR-TB cases were confirmed in non-Irish born individuals and 7 MIRU-VNTR genotypes were identical to clusters in other European countries indicating cross-border spread of MDR-TB to Ireland. WGS data provided the first evidence in Ireland of in vivo microevolution of MTBC isolates from drug-susceptible to MDR, and from MDR to extensively-drug resistant (XDR). In addition, they found that the katG S315T isoniazid and rpoB S450L rifampicin resistance mutations were dominant across the different MTBC lineages. CONCLUSIONS Our molecular epidemiological analyses identified the spread of MDR-TB to Ireland from other jurisdictions and its potential to evolve to XDR-TB.
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Affiliation(s)
- E Roycroft
- Irish Mycobacteria Reference Laboratory, Labmed Directorate, St. James's Hospital, Dublin, Ireland; Department of Clinical Microbiology, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland.
| | - R F O'Toole
- Department of Clinical Microbiology, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland; School of Medicine, Faculty of Health, University of Tasmania, Hobart, Australia
| | - M M Fitzgibbon
- Irish Mycobacteria Reference Laboratory, Labmed Directorate, St. James's Hospital, Dublin, Ireland; Department of Clinical Microbiology, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
| | - L Montgomery
- Irish Mycobacteria Reference Laboratory, Labmed Directorate, St. James's Hospital, Dublin, Ireland
| | - M O'Meara
- Department of Public Health, Dr. Steeven's Hospital, Dublin, Ireland
| | - P Downes
- Department of Public Health, Dr. Steeven's Hospital, Dublin, Ireland
| | - S Jackson
- Health Protection Surveillance Centre, Dublin, Ireland
| | - J O'Donnell
- Health Protection Surveillance Centre, Dublin, Ireland
| | - I F Laurenson
- Scottish Mycobacteria Reference Laboratory, Edinburgh, UK
| | - A M McLaughlin
- Department of Respiratory Medicine, St. James's Hospital and Trinity Translational Medicine Institute Trinity College Dublin, Ireland
| | - J Keane
- Department of Respiratory Medicine, St. James's Hospital and Trinity Translational Medicine Institute Trinity College Dublin, Ireland
| | - T R Rogers
- Irish Mycobacteria Reference Laboratory, Labmed Directorate, St. James's Hospital, Dublin, Ireland; Department of Clinical Microbiology, Trinity Translational Medicine Institute, Trinity College, Dublin, Ireland
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Chaintarli K, Barrassa A, Cotter S, Mereckiene J, O'Donnell J, Domegan L. Decrease in the Uptake of Seasonal Influenza Vaccine in Persons Aged 65 Years and Older In Ireland since the 2009 Influenza A (H1N1) Pdm09 Pandemic. Ir Med J 2017; 110:630. [PMID: 29372945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In Ireland, there is year-on-year variation in the seasonal influenza vaccine uptake for people aged 65 years and older. We obtained aggregate vaccine uptake data (2004/05-2014/15) by area and age group and applied the 2011 relative deprivation score and GP-density by area. Using Poisson regression model, we estimated the associations between those variables and uptake before and after the 2009 pandemic. After adjusting for age, deprivation status and GP-density, overall persons aged ?65 years were less likely to receive the vaccine after the pandemic compared to before (RR=0.89, 95%CI: 0.82-0.96). Uptake increased with age; both those in the 70-74 and ?75 year age groups were more likely to receive the vaccine compared to those aged 65-69 years (RR=1.18, 95%CI:1.14-1.24; RR=1.34, 95%CI:1.28-1.39 respectively). Qualitative studies should be undertaken to explore whether changes in public perception on risks of the disease and the vaccine and/or public funding and policy influenced the uptake.
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Affiliation(s)
- K Chaintarli
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Solna, Sweden
- Health Protection Surveillance Centre, Dublin, Ireland
| | - A Barrassa
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Solna, Sweden
- Institute of Health Carlos III, Spain
| | - S Cotter
- Health Protection Surveillance Centre, Dublin, Ireland
| | - J Mereckiene
- Health Protection Surveillance Centre, Dublin, Ireland
| | - J O'Donnell
- Health Protection Surveillance Centre, Dublin, Ireland
| | - L Domegan
- Health Protection Surveillance Centre, Dublin, Ireland
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Kennedy N, Keating P, O'Donnell J. HMGCR-associated myositis: a New Zealand case series and estimate of incidence. Intern Med J 2017; 46:622-5. [PMID: 27170241 DOI: 10.1111/imj.13023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/10/2015] [Accepted: 12/11/2015] [Indexed: 11/30/2022]
Abstract
Statins are one of the most commonly prescribed drugs in New Zealand, with 525 772 or 16.5% of the adult New Zealand population prescribed a statin between June 2013 and July 2014. While generally well-tolerated, statins are known to cause a range of muscle-related side effects, ranging from myalgia to life-threatening rhabdomyolysis. Recently, it has been recognised that in rare instances, statins can induce an immune-mediated necrotising myositis with antibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), the enzymatic target of statins. In 2014, anti-HMGCR antibody testing was introduced to Canterbury Health Laboratories (CHL), with this being the only laboratory in New Zealand performing this test during the period of this case series. This article describes an index case and characterises the clinical features of a subsequent 12-month series. From this series, we estimated the yearly incidence of HMGCR-associated myositis at 1.7/million/year or ~1/90 000 New Zealand statin users.
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Affiliation(s)
- N Kennedy
- Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand
| | - P Keating
- Canterbury Health Laboratory, Addington, New Zealand
| | - J O'Donnell
- Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, New Zealand.,Canterbury Health Laboratory, Addington, New Zealand
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Griffin DR, Dickenson EJ, O'Donnell J, Agricola R, Awan T, Beck M, Clohisy JC, Dijkstra HP, Falvey E, Gimpel M, Hinman RS, Hölmich P, Kassarjian A, Martin HD, Martin R, Mather RC, Philippon MJ, Reiman MP, Takla A, Thorborg K, Walker S, Weir A, Bennell KL. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 2017; 50:1169-76. [PMID: 27629403 DOI: 10.1136/bjsports-2016-096743] [Citation(s) in RCA: 568] [Impact Index Per Article: 81.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2016] [Indexed: 12/29/2022]
Abstract
The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.Author note The Warwick Agreement on femoroacetabular impingement syndrome has been endorsed by the following 25 clinical societies: American Medical Society for Sports Medicine (AMSSM), Association of Chartered Physiotherapists in Sports and Exercise Medicine (ACPSEM), Australasian College of Sports and Exercise Physicians (ACSEP), Austian Sports Physiotherapists, British Association of Sports and Exercise Medicine (BASEM), British Association of Sport Rehabilitators and Trainers (BASRaT), Canadian Academy of Sport and Exercise Medicine (CASEM), Danish Society of Sports Physical Therapy (DSSF), European College of Sports and Exercise Physicians (ECOSEP), European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), Finnish Sports Physiotherapist Association (SUFT), German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), International Federation of Sports Physical Therapy (IFSPT), International Society for Hip Arthroscopy (ISHA), Groupo di Interesse Specialistico dell'A.I.F.I., Norwegian Association of Sports Medicine and Physical Activity (NIMF), Norwegian Sports Physiotherapy Association (FFI), Society of Sports Therapists (SST), South African Sports Medicine Association (SASMA), Sports Medicine Australia (SMA), Sports Doctors Australia (SDrA), Sports Physiotherapy New Zealand (SPNZ), Swedish Society of Exercise and Sports Medicine (SFAIM), Swiss Society of Sports Medicine (SGMS/SGSM), Swiss Sports Physiotherapy Association (SSPA).
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Affiliation(s)
- D R Griffin
- Warwick Medical School, University of Warwick, Coventry, UK University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
| | - E J Dickenson
- Warwick Medical School, University of Warwick, Coventry, UK University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
| | - J O'Donnell
- Hip Arthroscopy Australia, Melbourne, Victoria, Australia St Vincents Private Hospital, East Melbourne, Victoria, Australia
| | - R Agricola
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - T Awan
- Medsport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - M Beck
- Department of Clinic of Orthopaedic and Trauma Surgery, Luzerner Kantonspital, Luzern, Switzerland
| | - J C Clohisy
- Department of Orthopaedic Surgery, Washington University School of Medicine St. Louis, St. Louis, Missouri, USA
| | - H P Dijkstra
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - E Falvey
- Sports Surgery Clinic, Dublin, Ireland Department of Medicine, University College Cork, Cork, Ireland
| | | | - R S Hinman
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Hölmich
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Orthopaedic Surgery, Sports Orthopaedic Research Center (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - A Kassarjian
- Corades, LLC, Brookline, Massachusetts, USA Medical Service, Madrid Open Tennis, Madrid, Spain
| | - H D Martin
- Hip Preservation Center, Baylor University Medical Center at Dallas, Dallas, Texas, USA
| | - R Martin
- Rangos School of Health Sciences, Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA
| | - R C Mather
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - M J Philippon
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - M P Reiman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - A Takla
- Hip Arthroscopy Australia, Melbourne, Victoria, Australia Australian Sports Physiotherapy Department of Physiotherapy, The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia Bond University
| | - K Thorborg
- Department of Orthopaedic Surgery, Sports Orthopaedic Research Center (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - A Weir
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Amsterdam Centre for Evidence-based Sports Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - K L Bennell
- Department of Physiotherapy, The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia
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Long S, Banes D, O'Donnell J, Richardson P. Introducing an AT Passport: A Key to Managing Transitions Across the Lifespan. Stud Health Technol Inform 2017; 242:76-79. [PMID: 28873780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The service delivery of Assistive Technology for access to information and communications technology is frequently fragmented and inconsistent as evidenced by experience in the US and much of Europe (AAATE 2012). AT users can experience hiatuses in their access to appropriate assistive technologies as they transition from home to education, to employment and in the community. An AT Passport can provide a record of Assistive Technology requirement and use across the lifespan.
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Flanagan P, O'Donnell J, Mereckiene J, O'Flanagan D. Tuberculosis contact investigations associated with air travel in Ireland, September 2011 to November 2014. ACTA ACUST UNITED AC 2016; 21:30358. [PMID: 27748251 PMCID: PMC5071608 DOI: 10.2807/1560-7917.es.2016.21.40.30358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/23/2016] [Indexed: 11/22/2022]
Abstract
The risk of communicable disease transmission during air travel is of public health concern and has received much attention over the years. We retrospectively reviewed information from nine flights (≥ 8 hours) associated with infectious tuberculosis (TB) cases in Ireland between September 2011 and November 2014 to investigate whether possible transmission had occurred. Twenty-four flights notified in Ireland associated with sputum smear-positive pulmonary TB cases with a history of air travel were reviewed. Nine were suitable for inclusion and analysed. Six cases of infectious TB travelled on nine flights. A total of 232 passengers were identified for contact tracing; 85.3% (n = 198) had sufficient information available for follow-up. In total, 12.1% (n = 24) were reported as screened for TB. The results revealed no active TB cases among passengers and 16.7% (n = 4) were diagnosed with latent TB infection (LTBI) all of whom had other risk factors. Despite the limited sample size, we found no evidence of M. tuberculosis transmission from infectious passengers. This study identified challenges in obtaining complete timely airline manifests, leading to inadequate passenger information for follow-up. Receipt of TB screening results from international colleagues was also problematic. The challenge of interpreting the tuberculin skin test results in determining recent vs earlier infection was encountered.
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O'Donnell J, Hadden DR, Weaver JA, Montgomery DA. Thyrotoxicosis Recurring after Surgical Removal of a Thyrotrophin-Secreting Pituitary Tumour. Proc R Soc Med 2016. [DOI: 10.1177/003591577306600511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- J O'Donnell
- Metabolic Unit, Royal Victoria Hospital, Belfast, BT12 6BA
| | - D R Hadden
- Metabolic Unit, Royal Victoria Hospital, Belfast, BT12 6BA
| | - J A Weaver
- Metabolic Unit, Royal Victoria Hospital, Belfast, BT12 6BA
| | - D A Montgomery
- Metabolic Unit, Royal Victoria Hospital, Belfast, BT12 6BA
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Usher C, Adams R, Schmitz S, Kieran J, O'Flanagan D, O'Donnell J, Connolly K, Corcoran B, Butler K, Barry M, Walsh C. Evaluating the neonatal BCG vaccination programme in Ireland. ACTA ACUST UNITED AC 2016; 74:28. [PMID: 27413531 PMCID: PMC4942954 DOI: 10.1186/s13690-016-0141-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/18/2016] [Indexed: 11/27/2022]
Abstract
Background The aim of this study was to compare the cost effectiveness of the current Irish programme of universal BCG vaccination of infants versus a programme which considered selectively vaccinating high risk infants using decision analytical modelling. Methods The efficacy of the BCG vaccine was re-evaluated to inform a decision analytical model constructed to follow a birth cohort of vaccinated and unvaccinated infants over a 15 year time horizon. The number of life years gained (LYG) was the primary outcome measure and this was compared to the net cost of the vaccination strategies. Results In the base case analysis, the incremental cost effectiveness ratios (ICERs) for the universal strategy and selective strategy vs no vaccination were €204,373/LYG and €143,233/LYG respectively. When comparing the incremental difference in moving from the universal to the selective strategy, the selective strategy costs €1,055,692 less per 4.8 life years lost per birth cohort. One way sensitivity analyses highlighted that a move from the universal to the selective strategy was particularly sensitive to the estimate of vaccine efficacy against deaths, the cost of administering the vaccine and the multiplier used to apportion risk of contracting tuberculosis. Probabilistic analysis suggested that a move from a universal based strategy to a selective based strategy could be deemed cost effective (probability of cost effectiveness is 76.8 %). Conclusion The results of the study support the protective effect of the BCG vaccine in infants and quantified the cost effectiveness of the current BCG vaccination strategy and the decremental difference in moving to a selective strategy. This analysis highlights that the additional protection offered by the universal vaccination strategy is small compared to that of the selective strategy. Consideration should therefore be given to the implementation of a selective vaccination strategy, and diverting resources to improve TB case management and control. Electronic supplementary material The online version of this article (doi:10.1186/s13690-016-0141-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cara Usher
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland
| | - Roisin Adams
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland
| | - Susanne Schmitz
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland ; Department of Pharmacology & Therapeutics, Trinity Centre, St. James's Hospital, Dublin 8, Ireland
| | - Jennifer Kieran
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland ; Department of Pharmacology & Therapeutics, Trinity Centre, St. James's Hospital, Dublin 8, Ireland
| | - Darina O'Flanagan
- Health Protection Surveillance Centre, Dublin 1, Ireland ; National Immunisation Advisory Committee, Dublin 2, Ireland
| | - Joan O'Donnell
- Health Protection Surveillance Centre, Dublin 1, Ireland ; National Immunisation Advisory Committee, Dublin 2, Ireland
| | - Kevin Connolly
- Health Protection Surveillance Centre, Dublin 1, Ireland ; National Immunisation Advisory Committee, Dublin 2, Ireland
| | - Brenda Corcoran
- National Immunisation Advisory Committee, Dublin 2, Ireland ; National Immunisation Office, Dublin 7, Ireland
| | - Karina Butler
- National Immunisation Advisory Committee, Dublin 2, Ireland ; Department of Infectious Diseases, Our Lady's Childrens Hospital, Crumlin, Dublin 12, Ireland
| | - Michael Barry
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland ; Department of Pharmacology & Therapeutics, Trinity Centre, St. James's Hospital, Dublin 8, Ireland
| | - Cathal Walsh
- National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland ; Department of Maths & Statistics, Centre for Health Decision Sciences (CHeDS), University of Limerick, Limerick, Ireland
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O'Donnell J, Finer NN, Rich W. Role of l-Carnitine in Apnea of Prematurity: A Randomized, Controlled Trial. Nutr Clin Pract 2016. [DOI: 10.1177/0115426502017006381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Collins P, Chalmers E, Chowdary P, Keeling D, Mathias M, O'Donnell J, Pasi KJ, Rangarajan S, Thomas A. The use of enhanced half-life coagulation factor concentrates in routine clinical practice: guidance from UKHCDO. Haemophilia 2016; 22:487-98. [DOI: 10.1111/hae.13013] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 01/19/2023]
Affiliation(s)
- P. Collins
- Arthur Bloom Haemophilia Centre; University Hospital of Wales; Cardiff UK
| | - E. Chalmers
- Haemophilia Centre; Royal Hospital for Sick Children; Glasgow UK
| | - P. Chowdary
- Katharine Dormandy Haemophilia Centre; Royal Free Hospital; London UK
| | - D. Keeling
- Haemophilia Centre; Churchill Hospital; Oxford UK
| | - M. Mathias
- Haemophilia Centre; Great Ormond Street Hospital; London UK
| | - J. O'Donnell
- Haemophilia Centre; St. James Hospital; Dublin Ireland
| | - K. J. Pasi
- Haemophilia Centre; Royal London Hospital; London UK
| | - S. Rangarajan
- Haemophilia Centre; Basingstoke and North Hampshire Hospital; Basingstoke UK
| | - A. Thomas
- Haemophilia Centre; Royal Infirmary of Edinburgh; Edinburgh UK
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Valls L, Badve C, Avril S, Herrmann K, Faulhaber P, O'Donnell J, Avril N. FDG-PET imaging in hematological malignancies. Blood Rev 2016; 30:317-31. [PMID: 27090170 DOI: 10.1016/j.blre.2016.02.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 02/12/2016] [Accepted: 02/19/2016] [Indexed: 12/12/2022]
Abstract
The majority of aggressive lymphomas is characterized by an up regulated glycolytic activity, which enables the visualization by F-18 FDG-PET/CT. One-stop hybrid FDG-PET/CT combines the functional and morphologic information, outperforming both, CT and FDG-PET as separate imaging modalities. This has resulted in several recommendations using FDG-PET/CT for staging, restaging, monitoring during therapy, and assessment of treatment response as well as identification of malignant transformation. FDG-PET/CT may obviate the need for a bone marrow biopsy in patients with Hodgkin's lymphoma and diffuse large B cell lymphoma. FDG-PET/CT response assessment is recommended for FDG-avid lymphomas, whereas CT-based response evaluation remains important in lymphomas with low or variable FDG avidity. The treatment induced change in metabolic activity allows for assessment of response after completion of therapy as well as prediction of outcome early during therapy. The five-point scale Deauville Criteria allows the assessment of treatment response based on visual FDG-PET analysis. Although the use of FDG-PET/CT for prediction of therapeutic response is promising it should only be conducted in the context of clinical trials. Surveillance FDG-PET/CT after complete remission is discouraged due to the relative high number of false-positive findings, which in turn may result in further unnecessary investigations. Future directions include the use of new PET tracers such as F-18 fluorothymidine (FLT), a surrogate biomarker of cellular proliferation and Ga-68 CXCR4, a chemokine receptor imaging biomarker as well as innovative digital PET/CT and PET/MRI techniques.
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Affiliation(s)
- L Valls
- Department of Radiology, University Hospitals Case Medical Center, Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH 44106, USA
| | - C Badve
- Department of Radiology, University Hospitals Case Medical Center, Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH 44106, USA
| | - S Avril
- Department of Pathology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - K Herrmann
- Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany; Ahmanson Translational Imaging Division, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7370, USA
| | - P Faulhaber
- Department of Radiology, University Hospitals Case Medical Center, Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH 44106, USA
| | - J O'Donnell
- Department of Radiology, University Hospitals Case Medical Center, Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH 44106, USA
| | - N Avril
- Department of Radiology, University Hospitals Case Medical Center, Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH 44106, USA.
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Brundage M, Rouette J, Foxcroft S, Hart M, Gutierrez E, Reddeman L, O'Donnell J, Mitera G, Warde P. Implementing a Program of Radiation Oncology Peer Review Across Multiple Cancer Centers in Ontario: A Quantitative and Qualitative Analysis. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lönnroth K, Migliori GB, Abubakar I, D'Ambrosio L, de Vries G, Diel R, Douglas P, Falzon D, Gaudreau MA, Goletti D, González Ochoa ER, LoBue P, Matteelli A, Njoo H, Solovic I, Story A, Tayeb T, van der Werf MJ, Weil D, Zellweger JP, Abdel Aziz M, Al Lawati MR, Aliberti S, Arrazola de Oñate W, Barreira D, Bhatia V, Blasi F, Bloom A, Bruchfeld J, Castelli F, Centis R, Chemtob D, Cirillo DM, Colorado A, Dadu A, Dahle UR, De Paoli L, Dias HM, Duarte R, Fattorini L, Gaga M, Getahun H, Glaziou P, Goguadze L, del Granado M, Haas W, Järvinen A, Kwon GY, Mosca D, Nahid P, Nishikiori N, Noguer I, O'Donnell J, Pace-Asciak A, Pompa MG, Popescu GG, Robalo Cordeiro C, Rønning K, Ruhwald M, Sculier JP, Simunović A, Smith-Palmer A, Sotgiu G, Sulis G, Torres-Duque CA, Umeki K, Uplekar M, van Weezenbeek C, Vasankari T, Vitillo RJ, Voniatis C, Wanlin M, Raviglione MC. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J 2015; 45:928-52. [PMID: 25792630 PMCID: PMC4391660 DOI: 10.1183/09031936.00214014] [Citation(s) in RCA: 528] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/02/2015] [Indexed: 12/31/2022]
Abstract
This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.
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Affiliation(s)
- Knut Lönnroth
- Global TB Programme, World Health Organization, Geneva, Switzerland
- Both authors contributed equally
| | - Giovanni Battista Migliori
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
- Both authors contributed equally
| | - Ibrahim Abubakar
- TB Section, University College London and Public Health England, London, UK
| | - Lia D'Ambrosio
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | - Roland Diel
- University Hospital Schleswig Holstein, Institute for Epidemiology, Kiel, Germany
| | - Paul Douglas
- Global Health Borders Refugee and Onshore Services, Dept of Immigration and Border Protection, Sydney, Australia
| | - Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Marc-Andre Gaudreau
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Delia Goletti
- National Institute for Infectious Diseases, Rome, Italy
| | - Edilberto R. González Ochoa
- Research and Surveillance Group on TB, Leprosy and ARI, Epidemiology Board, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Philip LoBue
- Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Howard Njoo
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Ivan Solovic
- TB Dept, National Institute for TB, Respiratory Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ružomberok, Slovakia
| | | | - Tamara Tayeb
- National TB Control Programme, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Diana Weil
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | - Stefano Aliberti
- Università degli Studi di Milano – Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy
| | | | | | - Vineet Bhatia
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Francesco Blasi
- Dipartimento Fisiopatologia Medico-Chirurgica e dei Trapianti, University of Milan, IRCCS Fondazione Cà Granda, Milan, Italy
| | - Amy Bloom
- US Agency for International Development, Washington, DC, USA
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Institution of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden
| | | | - Rosella Centis
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | | | | | - Andrei Dadu
- TB and M/XDR-TB Control Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ulf R. Dahle
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Hannah M. Dias
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Mina Gaga
- National Referral Centre for Mycobacteria, Athens Chest Hospital, Ministry of Health, Athens, Greece
| | | | - Philippe Glaziou
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Lasha Goguadze
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | | | - Walter Haas
- Dept of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Asko Järvinen
- Finnish Lung Health Association, Helsinki, Finland
- Helsinki University Central Hospital, Division of Infectious Diseases, Helsinki, Finland
| | - Geun-Yong Kwon
- Korea Centers for Disease Control and Prevention (KCDC), Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Davide Mosca
- International Organization for Migration, Geneva, Switzerland
| | - Payam Nahid
- University of California, San Francisco, CA, USA
- American Thoracic Society (ATS), New York, NY, USA
| | - Nobuyuki Nishikiori
- Stop TB and Leprosy Elimination, WHO Regional Office for the Western Pacific, Manila, Philippines
| | | | - Joan O'Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | | | | | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Giorgia Sulis
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Carlos A. Torres-Duque
- Asociacion Latinoamericana de Torax (ALAT) - Fundacion Neumologica Colombiana, Bogota, Colombia
| | | | - Mukund Uplekar
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Maryse Wanlin
- Fonds des Affections Respiratoires (FARES), Brussels, Belgium
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O'Donnell J, Morgan MK. Response. J Neurosurg 2015; 122:985-986. [PMID: 26000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Subbaiah P, Dammanahalli K, Yang P, Malhotra P, Bi J, O'Donnell J, Alrefai W. Absorption of Molecular Forms of Dietary Docosahexaenoic acid (DHA) and Their Potential to Provide DHA to the Brain. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.715.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Papasani Subbaiah
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
- Research & Development Jesse Brown VA Medical CenterChicagoIllinoisUnited States
| | | | - Peng Yang
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
| | - Pooja Malhotra
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
| | - Jian Bi
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
| | - J O'Donnell
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
| | - Waddah Alrefai
- MedicineUniversity of Illinois at ChicagoChicagoILUnited States
- Research & Development Jesse Brown VA Medical CenterChicagoIllinoisUnited States
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