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Nunes MC, Thommes E, Fröhlich H, Flahault A, Arino J, Baguelin M, Biggerstaff M, Bizel-Bizellot G, Borchering R, Cacciapaglia G, Cauchemez S, Barbier--Chebbah A, Claussen C, Choirat C, Cojocaru M, Commaille-Chapus C, Hon C, Kong J, Lambert N, Lauer KB, Lehr T, Mahe C, Marechal V, Mebarki A, Moghadas S, Niehus R, Opatowski L, Parino F, Pruvost G, Schuppert A, Thiébaut R, Thomas-Bachli A, Viboud C, Wu J, Crépey P, Coudeville L. Redefining pandemic preparedness: Multidisciplinary insights from the CERP modelling workshop in infectious diseases, workshop report. Infect Dis Model 2024; 9:501-518. [PMID: 38445252 PMCID: PMC10912817 DOI: 10.1016/j.idm.2024.02.008] [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: 01/18/2024] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024] Open
Abstract
In July 2023, the Center of Excellence in Respiratory Pathogens organized a two-day workshop on infectious diseases modelling and the lessons learnt from the Covid-19 pandemic. This report summarizes the rich discussions that occurred during the workshop. The workshop participants discussed multisource data integration and highlighted the benefits of combining traditional surveillance with more novel data sources like mobility data, social media, and wastewater monitoring. Significant advancements were noted in the development of predictive models, with examples from various countries showcasing the use of machine learning and artificial intelligence in detecting and monitoring disease trends. The role of open collaboration between various stakeholders in modelling was stressed, advocating for the continuation of such partnerships beyond the pandemic. A major gap identified was the absence of a common international framework for data sharing, which is crucial for global pandemic preparedness. Overall, the workshop underscored the need for robust, adaptable modelling frameworks and the integration of different data sources and collaboration across sectors, as key elements in enhancing future pandemic response and preparedness.
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Affiliation(s)
- Marta C. Nunes
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL) and Centre International de Recherche en Infectiologie (CIRI), Équipe Santé Publique, Épidémiologie et Écologie Évolutive des Maladies Infectieuses (PHE3ID), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Edward Thommes
- New Products and Innovation (NPI), Sanofi Vaccines (Global), Toronto, Ontario, Canada
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
| | - Holger Fröhlich
- Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Department of Bioinformatics, Schloss Birlinghoven, Sankt Augustin, Germany
- University of Bonn, Bonn-Aachen International Center for IT (b-it), Bonn, Germany
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland and Swiss School of Public Health, Zürich, Switzerland
| | - Julien Arino
- Department of Mathematics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marc Baguelin
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Biggerstaff
- National Center for Immunization and Respiratory Diseases (NCIRD), US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Gaston Bizel-Bizellot
- Departement of Computational Biology, Departement of Global Health, Institut Pasteur, Paris, France
| | - Rebecca Borchering
- National Center for Immunization and Respiratory Diseases (NCIRD), US Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Giacomo Cacciapaglia
- Institut de Physique des Deux Infinis de Lyon (IP2I), UMR5822, IN2P3/CNRS, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, UMR2000 CNRS, Paris, France
| | - Alex Barbier--Chebbah
- Decision and Bayesian Computation, Institut Pasteur, Université Paris Cité, CNRS UMR 3571, France
| | - Carsten Claussen
- Fraunhofer-Institute for Translational Medicine and Pharmacology, Hamburg, Germany
| | - Christine Choirat
- Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
| | - Monica Cojocaru
- Mathematics & Statistics Department, College of Engineering and Physical Sciences, University of Guelph, Guelph, Ontario, Canada
| | | | - Chitin Hon
- Respiratory Disease AI Laboratory on Epidemic Intelligence and Medical Big Data Instrument Applications, Department of Engineering Science, Faculty of Innovation Engineering, Macau University of Science and Technology, Taipa, Macau, China
| | - Jude Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | | | | | - Thorsten Lehr
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | | | - Vincent Marechal
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, Paris, France
| | | | - Seyed Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, Ontario, Canada
| | - Rene Niehus
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lulla Opatowski
- UMR 1018, Team “Anti-infective Evasion and Pharmacoepidemiology”, Université Paris-Saclay, UVSQ, INSERM, France
- Epidemiology and Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris Cité, Paris, France
| | - Francesco Parino
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | | | - Andreas Schuppert
- Institute for Computational Biomedicine, RWTH Aachen University, Aachen, Germany
| | - Rodolphe Thiébaut
- Bordeaux University, Department of Public Health, Inserm UMR 1219 Bordeaux Population Health Research Center, Inria SISTM, Bordeaux, France
| | | | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Jianhong Wu
- York Emergency Mitigation, Engagement, Response, and Governance Institute, Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
| | - Pascal Crépey
- EHESP, Université de Rennes, CNRS, IEP Rennes, Arènes - UMR 6051, RSMS – Inserm U 1309, Rennes, France
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de Fougerolles TR, Baïssas T, Perquier G, Vitoux O, Crépey P, Bartelt-Hofer J, Bricout H, Petitjean A. Public health and economic benefits of seasonal influenza vaccination in risk groups in France, Italy, Spain and the UK: state of play and perspectives. BMC Public Health 2024; 24:1222. [PMID: 38702667 DOI: 10.1186/s12889-024-18694-5] [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: 02/15/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Seasonal influenza epidemics have a substantial public health and economic burden, which can be alleviated through vaccination. The World Health Organization (WHO) recommends a 75% vaccination coverage rate (VCR) in: older adults (aged ≥ 65 years), individuals with chronic conditions, pregnant women, children aged 6-24 months and healthcare workers. However, no European country achieves this target in all risk groups. In this study, potential public health and economic benefits achieved by reaching 75% influenza VCR was estimated in risk groups across four European countries: France, Italy, Spain, and the UK. METHODS A static epidemiological model was used to estimate the averted public health and economic burden of increasing the 2021/2022 season VCR to 75%, using the efficacy data of standard-dose quadrivalent influenza vaccine. For each country and risk group, the most recent data on population size, VCR, pre-pandemic influenza epidemiology, direct medical costs and absenteeism were identified through a systematic literature review, supplemented by manual searching. Outcomes were: averted influenza cases, general practitioner (GP) visits, hospitalisations, case fatalities, number of days of work lost, direct medical costs and absenteeism-related costs. RESULTS As of the 2021/2022 season, the UK achieved the highest weighted VCR across risk groups (65%), followed by Spain (47%), France (44%) and Italy (44%). Based on modelling, the 2021/2022 VCR prevented an estimated 1.9 million influenza cases, avoiding 375,200 GP visits, 73,200 hospitalisations and 38,400 deaths. To achieve the WHO 75% VCR target, an additional 24 million at-risk individuals would need to be vaccinated, most of which being older adults and patients with chronic conditions. It was estimated that this could avoid a further 918,200 influenza cases, 332,000 GP visits, 16,300 hospitalisations and 6,300 deaths across the four countries, with older adults accounting for 52% of hospitalisations and 80% of deaths. An additional €84 million in direct medical costs and €79 million in absenteeism costs would be saved in total, with most economic benefits delivered in France. CONCLUSIONS Older adults represent most vaccine-preventable influenza cases and deaths, followed by individuals with chronic conditions. Health authorities should prioritise vaccinating these populations for maximum public health and economic benefits.
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Affiliation(s)
| | | | | | | | - Pascal Crépey
- Univ Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
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Luong Nguyen LB, Goupil de Bouillé J, Menant L, Noret M, Dumas A, Salmona M, Le Goff J, Delaugerre C, Crépey P, Zeggagh J. A randomised controlled trial to study the transmission of SARS-CoV-2 and other respiratory viruses during indoor clubbing events (ANRS0066s ITOC study). Clin Infect Dis 2023; 77:ciad603. [PMID: 37795682 PMCID: PMC10724450 DOI: 10.1093/cid/ciad603] [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: 03/11/2023] [Revised: 07/05/2023] [Accepted: 10/04/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND In the context of the circulation of the SARS-CoV-2 B.1.617.2 (Delta) variant, vaccination re-authorised mass indoor gatherings. The "Indoor Transmission of COVID-19" (ITOC) trial (ClinicalTrials.gov, NCT05311865) aimed to assess the risk of transmission of SARS-CoV-2 and other respiratory viruses during an indoor clubbing event among participants fully-vaccinated against COVID-19. METHODS ITOC, a randomised, controlled trial in the Paris region (France), enrolled healthy volunteers aged 18-49 years, fully-vaccinated against COVID-19, with no co-morbidities or symptoms, randomised 1:1 to be interventional group "attendees" or control "non-attendees". The intervention, a 7-hour indoor event in a nightclub at full capacity, with no masking, prior SARS-CoV-2 test result or social distancing required. The primary-outcome measure was the numbers of RT-PCR-determined SARS-CoV-2-positive subjects on self-collected saliva 7 days post-gathering in the per-protocol population. Secondary endpoints focused on 20 other respiratory viruses. RESULTS Healthy participants (n = 1,216) randomised 2:1 by blocks up to 10, 815 attendees and 401 non-attendees, yielding 529 and 287 subjects, respectively, with day-7 saliva samples. One day-7 sample from each group was positive. Looking at all respiratory viruses together, the clubbing event was associated with an increased risk of infection of 1.59 [95% CI 1.04-2.61]. CONCLUSIONS In the context of low Delta-VOC circulation, no evidence of SARS-CoV-2 transmission among asymptomatic and vaccinated participants was found, but the risk of other respiratory virus transmission was higher.
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Affiliation(s)
- Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin Port-Royal, AP-HP, Université de Paris Cité, Paris, France
| | - Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France
- LEPS Laboratoire Éducations et Promotion de Santé, Université Paris 13, Bobigny, France
| | - Lola Menant
- Université de Rennes, EHESP, CNRS, Inserm, Arènes—UMR 6051, RSMS—U 1309, Rennes, France
| | - Marion Noret
- Réseau National de Recherche Clinique en Infectiologie (RENARCI), Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Audrey Dumas
- ANRS∣Emerging Infectious Diseases, Paris, France
| | - Maud Salmona
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Jérôme Le Goff
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, Université de Paris Cité, Paris, France
| | - Pascal Crépey
- Université de Rennes, EHESP, CNRS, Inserm, Arènes—UMR 6051, RSMS—U 1309, Rennes, France
| | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
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Chicoye A, Crépey P, Nguyen VH, Márquez-Peláez S, Postma M, Pugliese A, Ruiz-Aragón J, Mould-Quevedo J. Contributions of cost-effectiveness analyses (CEA) to influenza vaccination policy for older adults in Europe. Vaccine 2023; 41:5518-5524. [PMID: 37550142 DOI: 10.1016/j.vaccine.2023.07.073] [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: 06/16/2023] [Revised: 07/28/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023]
Abstract
This review describes the importance of economic evaluations and real-world evidence (RWE) for the assessment of enhanced influenza vaccines for older adults in Europe. Individuals ≥65 years of age are at increased risk of severe influenza outcomes and many countries in Europe recommend enhanced vaccines for this population to mitigate immunosenescence. Some National Immunization Technical Advisory Groups (NITAGs) may preferentially recommend a specific enhanced vaccine, necessitating comparative economic evaluation and estimation of relative vaccine effectiveness between enhanced vaccine options in the absence of direct head-to-head efficacy data. Distinct approaches to economic modeling and cost-effectiveness analysis (CEA) guide national vaccination policies in Europe, including how underlying data, such as RWE, are used in these models. RWE is an important evidence source for input into CEA models based on disease factors (e.g., antigenic shift and seasonal variation) and practical factors (e.g., limitations of performing multiple randomized clinical trials to capture seasonal variation; the need to obtain relevant patient-oriented, real-world endpoints, such as hospitalizations). CEA is considered crucial to vaccine assessment among certain countries in Europe, but further harmonization of economic evaluations, including the use of RWE, across NITAGs in Europe may be of benefit, alongside standardized approaches for vaccine appraisal. In the future, more countries may use RWE as an input in CEA models to support NITAG recommendations for enhanced influenza vaccines in older populations, especially considering the value of RWE for the assessment of influenza epidemiology and vaccine effectiveness as stated by the World Health Organization, and the availability of a broad RWE base for certain enhanced vaccines.
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Affiliation(s)
- Annie Chicoye
- Sciences Po Paris, 27 Rue Saint-Guillaume, 75007 Paris, France
| | - Pascal Crépey
- EHESP School of Public Health, University of Rennes, CNRS, Arènes - UMR 6051, RSMS - Inserm U 1309, Rennes, France
| | | | - Sergio Márquez-Peláez
- Department of Economics, Economic Analysis, Faculty of Business Pablo de Olavide University, 41013 Seville, Spain
| | - Maarten Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands; Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9713 AV Groningen, The Netherlands; Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363, Bandung, Indonesia
| | - Andrea Pugliese
- Department of Mathematics, University of Trento, 38123 Trento, Italy
| | - Jesús Ruiz-Aragón
- Department of Clinical Microbiology, Lab. Clinical Analysis, Hospital de la Línea, Cádiz, Spain
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5
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Pinquier D, Crépey P, Tissières P, Vabret A, Roze JC, Dubos F, Cahn-Sellem F, Javouhey E, Cohen R, Weil-Olivier C. Correction to: Preventing Respiratory Syncytial Virus in Children in France: A Narrative Review of the Importance of a Reinforced Partnership Between Parents, Healthcare Professionals, and Public Health Authorities. Infect Dis Ther 2023:10.1007/s40121-023-00807-z. [PMID: 37179278 DOI: 10.1007/s40121-023-00807-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Affiliation(s)
- Didier Pinquier
- Department of Neonatal and Pediatric Intensive Care Medicine, Normadie University, UNIROUEN, INSERM U1245, CHU Rouen, 7600, Rouen, France
| | - Pascal Crépey
- University of Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, Rennes, France
| | - Pierre Tissières
- Pediatric Intensive Care and Neonatal Medicine, AP-HP Paris Saclay University, Bicêtre Hospital, Le Kremlin-Bicêtre, Paris, France
- Institute of Integrative Biology of the Cell, Paris Saclay University, CNRS, DEA, Gif Sur Yvette, France
- FUH SEPSIS, APHP, Inserm, Paris Saclay University, Le Kremlin-Bicêtre, France
| | - Astrid Vabret
- Department of Virology, Normandie University, UNICAEN, UNIROUEN, DYNAMICURE U1311, Caen University Hospital, Caen, France
| | - Jean-Christophe Roze
- Hôpital Mère Enfant, CHU de Nantes, 36 Boulevard Jean Monnet, 44093, Nantes, France
| | - François Dubos
- University of Lille, CHU Lille, Urgences Pédiatriques and Maladies Infectieuses, ULR2694 METRICS, Lille, France
| | - Fabienne Cahn-Sellem
- Private Practice, 24 Rue Volta, 92800, Puteaux, France
- AFPA (Association Française de Pédiatrie Ambulatoire), 155 Rue Edouard Branly, Zone de la Fouquetière, 44150, Ancenis, France
| | - Etienne Javouhey
- Pediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France
- Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux, Joint Research Unit HCL-bioMérieux, 69003, Lyon, France
| | - Robert Cohen
- AFPA (Association Française de Pédiatrie Ambulatoire), 155 Rue Edouard Branly, Zone de la Fouquetière, 44150, Ancenis, France
- Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, GRC Gemini, Université Paris XII, Association Clinique et Thérapeutique Infantile du Val de Marne, Paris, France
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Smith DRM, Jijón S, Oodally A, Shirreff G, Aït Bouziad K, Ante-Testard PA, Bastard J, Bouziri H, Daouda OS, Duchemin T, Godon-Rensonnet AS, Henriot P, Houri Y, Neynaud H, Perozziello A, Thonon F, Crépey P, Dab W, Jean K, Temime L. Sick leave due to COVID-19 during the first pandemic wave in France, 2020. Occup Environ Med 2023; 80:268-272. [PMID: 36914254 PMCID: PMC10176331 DOI: 10.1136/oemed-2022-108451] [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: 05/03/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To quantify the burden of COVID-19-related sick leave during the first pandemic wave in France, accounting for sick leaves due to symptomatic COVID-19 ('symptomatic sick leaves') and those due to close contact with COVID-19 cases ('contact sick leaves'). METHODS We combined data from a national demographic database, an occupational health survey, a social behaviour survey and a dynamic SARS-CoV-2 transmission model. Sick leave incidence from 1 March 2020 to 31 May 2020 was estimated by summing daily probabilities of symptomatic and contact sick leaves, stratified by age and administrative region. RESULTS There were an estimated 1.70M COVID-19-related sick leaves among France's 40M working-age adults during the first pandemic wave, including 0.42M due to COVID-19 symptoms and 1.28M due to COVID-19 contacts. There was great geographical variation, with peak daily sick leave incidence ranging from 230 in Corse (Corsica) to 33 000 in Île-de-France (the greater Paris region), and greatest overall burden in regions of north-eastern France. Regional sick leave burden was generally proportional to local COVID-19 prevalence, but age-adjusted employment rates and contact behaviours also contributed. For instance, 37% of symptomatic infections occurred in Île-de-France, but 45% of sick leaves. Middle-aged workers bore disproportionately high sick leave burden, owing predominantly to greater incidence of contact sick leaves. CONCLUSIONS France was heavily impacted by sick leave during the first pandemic wave, with COVID-19 contacts accounting for approximately three-quarters of COVID-19-related sick leaves. In the absence of representative sick leave registry data, local demography, employment patterns, epidemiological trends and contact behaviours can be synthesised to quantify sick leave burden and, in turn, predict economic consequences of infectious disease epidemics.
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Affiliation(s)
- David R M Smith
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France .,Epidemiology & Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris-Cité, Paris 75015, France.,Anti-Infective Evasion & Pharmacoepidemiology, Université Paris-Saclay, UVSQ, Inserm, CESP, Montigny-le-Bretonneux 78180, France
| | - Sofía Jijón
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris 75015, France
| | - Ajmal Oodally
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Epidemiology & Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris-Cité, Paris 75015, France.,Anti-Infective Evasion & Pharmacoepidemiology, Université Paris-Saclay, UVSQ, Inserm, CESP, Montigny-le-Bretonneux 78180, France
| | - George Shirreff
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Epidemiology & Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris-Cité, Paris 75015, France.,Anti-Infective Evasion & Pharmacoepidemiology, Université Paris-Saclay, UVSQ, Inserm, CESP, Montigny-le-Bretonneux 78180, France
| | - Karim Aït Bouziad
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Pearl Anne Ante-Testard
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris 75015, France
| | - Jonathan Bastard
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Epidemiology & Modelling of Antibiotic Evasion, Institut Pasteur, Université Paris-Cité, Paris 75015, France.,Anti-Infective Evasion & Pharmacoepidemiology, Université Paris-Saclay, UVSQ, Inserm, CESP, Montigny-le-Bretonneux 78180, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris 75015, France
| | - Hanifa Bouziri
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Oumou Salama Daouda
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Tom Duchemin
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | | | - Paul Henriot
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris 75015, France
| | - Yasmine Houri
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Hélène Neynaud
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Anne Perozziello
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Frédérique Thonon
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Pascal Crépey
- Arènes - UMR 6051, RSMS - U 1309, Université de Rennes, EHESP, CNRS, Inserm, Rennes 35000, France
| | - William Dab
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
| | - Kévin Jean
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris 75015, France.,MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Laura Temime
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris 75003, France
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Abstract
Several countries have implemented lockdowns to control their COVID-19 epidemic. However, questions like "where" and "when" still require answers. We assessed the impact of national and regional lockdowns considering the French first epidemic wave of COVID-19 as a case study. In a regional lockdown scenario aimed at preventing intensive care units (ICU) saturation, almost all French regions would have had to implement a lockdown within 10 days and 96% of ICU capacities would have been used. For slowly growing epidemics, with a lower reproduction number, the expected delays between regional lockdowns increase. However, the public health costs associated with these delays tend to grow with time. In a quickly growing pandemic wave, defining the timing of lockdowns at a regional rather than national level delays by a few days the implementation of a nationwide lockdown but leads to substantially higher morbidity, mortality, and stress on the healthcare system.
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Affiliation(s)
- Jonathan Roux
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France
| | - Clément R Massonnaud
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France
- Department of Biomedical Informatics, Rouen University Hospital, 76000, Rouen, France
| | - Vittoria Colizza
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Sorbonne Université, Inserm, 75012, Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR2000, Paris, France
| | - Pascal Crépey
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France.
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8
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Roux J, Massonnaud CR, Colizza V, Cauchemez S, Crépey P. Modeling the impact of national and regional lockdowns on the 2020 spring wave of COVID-19 in France. Sci Rep 2023; 13:1834. [PMID: 36725962 PMCID: PMC9890427 DOI: 10.1038/s41598-023-28687-w] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/23/2023] [Indexed: 02/03/2023] Open
Abstract
Several countries have implemented lockdowns to control their COVID-19 epidemic. However, questions like "where" and "when" still require answers. We assessed the impact of national and regional lockdowns considering the French first epidemic wave of COVID-19 as a case study. In a regional lockdown scenario aimed at preventing intensive care units (ICU) saturation, almost all French regions would have had to implement a lockdown within 10 days and 96% of ICU capacities would have been used. For slowly growing epidemics, with a lower reproduction number, the expected delays between regional lockdowns increase. However, the public health costs associated with these delays tend to grow with time. In a quickly growing pandemic wave, defining the timing of lockdowns at a regional rather than national level delays by a few days the implementation of a nationwide lockdown but leads to substantially higher morbidity, mortality, and stress on the healthcare system.
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Affiliation(s)
- Jonathan Roux
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France
| | - Clément R Massonnaud
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France.,Department of Biomedical Informatics, Rouen University Hospital, 76000, Rouen, France
| | - Vittoria Colizza
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Sorbonne Université, Inserm, 75012, Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR2000, Paris, France
| | - Pascal Crépey
- RSMS-U 1309, ARENES-UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, 15, Avenue du Professeur Léon-Bernard, CS 74312, 35043, Rennes Cedex, France.
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9
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Boudewijns B, Paget J, Del Riccio M, Coudeville L, Crépey P. Preparing for the upcoming 2022/23 influenza season: A modelling study of the susceptible population in Australia, France, Germany, Italy, Spain and the United Kingdom. Influenza Other Respir Viruses 2022; 17:e13091. [PMID: 36578202 PMCID: PMC9835402 DOI: 10.1111/irv.13091] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/30/2022] Open
Abstract
We analysed the influenza epidemic that occurred in Australia during the 2022 winter using an age-structured dynamic transmission model, which accounts for past epidemics to estimate the population susceptibility to an influenza infection. We applied the same model to five European countries. Our analysis suggests Europe might experience an early and moderately large influenza epidemic. Also, differences may arise between countries, with Germany and Spain experiencing larger epidemics, than France, Italy and the United Kingdom, especially in children.
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Affiliation(s)
- Bronke Boudewijns
- Netherlands Institute for Health Services Research (Nivel)UtrechtThe Netherlands
| | - John Paget
- Netherlands Institute for Health Services Research (Nivel)UtrechtThe Netherlands
| | - Marco Del Riccio
- Netherlands Institute for Health Services Research (Nivel)UtrechtThe Netherlands,Department of Health SciencesUniversity of FlorenceFlorenceItaly
| | | | - Pascal Crépey
- EHESP, CNRS, Inserm, Arènes ‐ UMR 6051, RSMS – U 1309Université de RennesRennesFrance
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10
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Janssen C, Mosnier A, Gavazzi G, Combadière B, Crépey P, Gaillat J, Launay O, Botelho-Nevers E. Coadministration of seasonal influenza and COVID-19 vaccines: A systematic review of clinical studies. Hum Vaccin Immunother 2022; 18:2131166. [PMID: 36256633 DOI: 10.1080/21645515.2022.2131166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 12/15/2022] Open
Abstract
The lifting of non-pharmaceutical measures preventing transmission of SARS-CoV-2 (and other viruses, including influenza viruses) raises concerns about healthcare resources and fears of an increased number of cases of influenza and COVID-19. For the 2021-2022 influenza season, the WHO and >20 European countries promoted coadministration of influenza and COVID-19 vaccines. Recently, the French Health Authority recommended coupling the COVID-19 vaccination with the 2022-2023 influenza vaccination campaign for healthcare professionals and people at risk of severe COVID-19. The present systematic review examines published data on the safety, immunogenicity, efficacy/effectiveness, and acceptability/acceptance of coadministration of influenza and COVID-19 vaccines. No safety concerns or immune interferences were found whatever the vaccines or the age of vaccinated subjects (65- or 65+). No efficacy/effectiveness data were available. The results should reassure vaccinees and vaccinators in case of coadministration and increase vaccine coverage. Healthcare systems promoting coupled campaigns must provide the necessary means for successful coadministration.
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Affiliation(s)
- Cécile Janssen
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, Annecy, France
| | | | - Gaëtan Gavazzi
- Service Universitaire de Gériatrie Clinique, CHU Grenoble Alpes, Grenoble, France.,Laboratoire T-Raig TIMC-IMAG CNRS 5525, Université Grenoble-Alpes, Grenoble, France
| | - Behazine Combadière
- Center for Immunology and Infectious Diseases, Sorbonne University, Inserm U1135, Paris, France
| | - Pascal Crépey
- Ecole des hautes études en santé publique, CNRS, Université de Rennes, ARENES - UMR 6051, Recherche sur les services et le management en santé - Inserm U 1309, Rennes, France
| | - Jacques Gaillat
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Odile Launay
- CIC 14117 Cochin-Pasteur, Université Paris Cité, Inserm, F CRIN-I REIVAC, Paris, France
| | - Elisabeth Botelho-Nevers
- Service d'Infectiologie, Hôpital Nord-CHU Saint Etienne, Saint-Etienne, France.,CIRI - Team GIMAP, Univ. Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, Saint-Etienne, France
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11
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Goupil de Bouillé J, Luong Nguyen LB, Crépey P, Garlantezec R, Doré V, Dumas A, Ben Mechlia M, Tattevin P, Gaudart J, Spire B, Lert F, Yazdanpanah Y, Delaugerre C, Noret M, Zeggagh J. Transmission of SARS-CoV-2 during indoor clubbing events: A clustered randomized, controlled, multicentre trial protocol. Front Public Health 2022; 10:981213. [PMID: 36438274 PMCID: PMC9687087 DOI: 10.3389/fpubh.2022.981213] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The SARS-CoV-2 pandemic led to the implementation of several non-pharmaceutical interventions (NPIs), from closings of bars and restaurants to curfews and lockdowns. Vaccination campaigns started hoping it could efficiently alleviate NPI. The primary objective of the "Indoor Transmission of COVID-19" (ITOC) study is to determine among a fully vaccinated population the relative risk of SARS-CoV-2 transmission during one indoor clubbing event. Secondary objectives are to assess the transmission of other respiratory viruses, risk exposure, and attitudes toward COVID-19 vaccination, health pass, and psychological impact of indoor club closing. Methods and analysis Four thousand four hundred healthy volunteers aged 18-49 years and fully vaccinated will be included in Paris region. The intervention is an 8-hour indoor clubbing event with no masks, no social distance, maximum room capacity, and ventilation. A reservation group of up to 10 people will recruit participants, who will be randomized 1:1 to either the experimental group (2,200 volunteers in two venues with capacities of 1,000 people each) or the control group (2,200 volunteers asked not to go to the club). All participants will provide a salivary sample on the day of the experiment and 7 days later. They also will answer several questionnaires. Virological analyses include polymerase chain reaction (PCR) of salivary samples and air of the venue, investigating SARS-CoV-2 and 18 respiratory viruses. Ethics and dissemination Ethical clearance was first obtained in France from the institutional review board (Comité de Protection des Personnes Ile de France VII - CPP), and the trial received clearance from the French National Agency for Medicines and Health Products (Agence National de Sécurité du Médicament - ANSM). The trial is supported and approved by The Agence Nationale Recherche sur le SIDA, les hépatites et maladies émergences (ANRS-MIE). Positive, negative, and inconclusive results will be published in peer-reviewed scientific journals. Trial registration number IDR-CB 2021-A01473-38. Clinicaltrial.gov, identifier: NCT05311865.
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Affiliation(s)
- Jeanne Goupil de Bouillé
- Service de Maladies Infectieuses et Tropicales, Hôpital Avicenne, AP-HP, Bobigny, France,LEPS Laboratoire Éducations et Pratiques de Santé, Université Paris 13, Bobigny, France,*Correspondence: Jeanne Goupil de Bouillé
| | | | - Pascal Crépey
- Univ Rennes, EHESP, CNRS, INSERM, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Ronan Garlantezec
- CHU de Rennes, University Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France
| | | | - Audrey Dumas
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Jean Gaudart
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Hop Timone, BioSTIC, Biostatistic and ICT, Marseille, France
| | - Bruno Spire
- Aix Marseille University, APHM, INSERM, IRD, SESSTIM, ISSPAM, UMR1252, Marseille, France
| | - France Lert
- ANRS, Agence Nationale Recherche Sida, Paris, France
| | - Yazdan Yazdanpanah
- ANRS, Agence Nationale Recherche Sida, Paris, France,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Constance Delaugerre
- Service de Virologie, Hôpital Saint-Louis, AP-HP, INSERM U944, Université de Paris, Paris, France
| | | | - Jeremy Zeggagh
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
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12
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Foucrier A, Perrio J, Grisel J, Crépey P, Gayat E, Vieillard-Baron A, Batteux F, Gauss T, Squara P, Lo SH, Wargon M, Hellmann R. Transition matrices model as a way to better understand and predict intra-hospital pathways of covid-19 patients. Sci Rep 2022; 12:17508. [PMID: 36266423 PMCID: PMC9584905 DOI: 10.1038/s41598-022-22227-8] [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: 02/17/2022] [Accepted: 10/11/2022] [Indexed: 01/12/2023] Open
Abstract
Since January 2020, the SARS-CoV-2 pandemic has severely affected hospital systems worldwide. In Europe, the first 3 epidemic waves (periods) have been the most severe in terms of number of infected and hospitalized patients. There are several descriptions of the demographic and clinical profiles of patients with COVID-19, but few studies of their hospital pathways. We used transition matrices, constructed from Markov chains, to illustrate the transition probabilities between different hospital wards for 90,834 patients between March 2020 and July 2021 managed in Paris area. We identified 3 epidemic periods (waves) during which the number of hospitalized patients was significantly high. Between the 3 periods, the main differences observed were: direct admission to ICU, from 14 to 18%, mortality from ICU, from 28 to 24%, length of stay (alive patients), from 9 to 7 days from CH and from 18 to 10 days from ICU. The proportion of patients transferred from CH to ICU remained stable. Understanding hospital pathways of patients is crucial to better monitor and anticipate the impact of SARS-CoV-2 pandemic on health system.
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Affiliation(s)
- Arnaud Foucrier
- Ile-de-France Regional Health Agency, Paris, France ,grid.508487.60000 0004 7885 7602Hôpital Beaujon, DMU PARABOL, University of Paris, APHP, Paris, France
| | - Jules Perrio
- Data Science and Analytics Department, SESAN, Paris, France
| | - Johann Grisel
- Data Science and Analytics Department, SESAN, Paris, France
| | - Pascal Crépey
- grid.410368.80000 0001 2191 9284Ecole des Hautes Etudes en Santé Publique, REPERES (Recherche en Pharmaco-Epidémiologie et Recours Aux Soins), University of Rennes, EA 7449, Rennes, France
| | - Etienne Gayat
- grid.508487.60000 0004 7885 7602Department of Anaesthesiology and Critical Care, Hôpital Lariboisière, DMU PARABOL, University of Paris, Paris, France ,grid.508487.60000 0004 7885 7602Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions (MASCOT), University of Paris, Paris, France
| | - Antoine Vieillard-Baron
- grid.50550.350000 0001 2175 4109University Hospital Ambroise Paré, APHP, Boulogne-Billancourt, and Université de Versailles Saint Quentin en Yvelines UMR 1018, Boulogne-Billancourt, France
| | - Frédéric Batteux
- grid.508487.60000 0004 7885 7602Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Tobias Gauss
- grid.410529.b0000 0001 0792 4829Grenoble Alpes Trauma Centre, Pôle Anesthésie-Réanimation, CHU de Grenoble, La Tronche, France
| | - Pierre Squara
- grid.477172.0Department of Intensive Care and Cardiology, Clinique Ambroise Paré, Neuilly-Sur-Seine, France
| | - Seak-Hy Lo
- Ile-de-France Regional Health Agency, Paris, France
| | - Matthias Wargon
- grid.413961.80000 0004 0443 544XEmergency Department, Hôpital Delafontaine, Saint-Denis, France ,Observatoire Regional Des Soins Non Programmés-Ile-de-France, Saint-Denis, France
| | - Romain Hellmann
- Ile-de-France Regional Health Agency, Paris, France ,grid.50550.350000 0001 2175 4109Emergency Department, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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13
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de Fougerolles TR, Damm O, Ansaldi F, Chironna M, Crépey P, de Lusignan S, Gray I, Guillen JM, Kassianos G, Mosnier A, de Lejarazu RO, Pariani E, Puig-Barbera J, Schelling J, Trippi F, Vanhems P, Wahle K, Watkins J, Rasuli A, Vitoux O, Bricout H. National influenza surveillance systems in five European countries: a qualitative comparative framework based on WHO guidance. BMC Public Health 2022; 22:1151. [PMID: 35681199 PMCID: PMC9178537 DOI: 10.1186/s12889-022-13433-0] [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: 12/10/2020] [Accepted: 05/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background Influenza surveillance systems vary widely between countries and there is no framework to evaluate national surveillance systems in terms of data generation and dissemination. This study aimed to develop and test a comparative framework for European influenza surveillance. Methods Surveillance systems were evaluated qualitatively in five European countries (France, Germany, Italy, Spain, and the United Kingdom) by a panel of influenza experts and researchers from each country. Seven surveillance sub-systems were defined: non-medically attended community surveillance, virological surveillance, community surveillance, outbreak surveillance, primary care surveillance, hospital surveillance, mortality surveillance). These covered a total of 19 comparable outcomes of increasing severity, ranging from non-medically attended cases to deaths, which were evaluated using 5 comparison criteria based on WHO guidance (granularity, timing, representativeness, sampling strategy, communication) to produce a framework to compare the five countries. Results France and the United Kingdom showed the widest range of surveillance sub-systems, particularly for hospital surveillance, followed by Germany, Spain, and Italy. In all countries, virological, primary care and hospital surveillance were well developed, but non-medically attended events, influenza cases in the community, outbreaks in closed settings and mortality estimates were not consistently reported or published. The framework also allowed the comparison of variations in data granularity, timing, representativeness, sampling strategy, and communication between countries. For data granularity, breakdown per risk condition were available in France and Spain, but not in the United Kingdom, Germany and Italy. For data communication, there were disparities in the timeliness and accessibility of surveillance data. Conclusions This new framework can be used to compare influenza surveillance systems qualitatively between countries to allow the identification of structural differences as well as to evaluate adherence to WHO guidance. The framework may be adapted for other infectious respiratory diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13433-0.
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Affiliation(s)
| | - Oliver Damm
- Sanofi-Aventis Deutschland GmbH, Berlin, Germany
| | | | - Maria Chironna
- Department of Interdisciplinary Medicine - Hygiene Section, University of Bari, Bari, Italy
| | - Pascal Crépey
- Université de Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, Rennes, France
| | - Simon de Lusignan
- University of Oxford, Oxford, UK.,Royal College of General Practitioners, London, UK
| | | | | | | | | | | | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | | | | | - Philippe Vanhems
- CIRI, Centre International de Recherche en Infectiologie, (Team (PHE3ID), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France.,Hospices Civils de Lyon and Hospices Civils de Lyon (HCL), Lyon, France
| | - Klaus Wahle
- Westfälische Wilhelms-Universität, Munich, Germany
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14
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Paireau J, Andronico A, Hozé N, Layan M, Crépey P, Roumagnac A, Lavielle M, Boëlle PY, Cauchemez S. An ensemble model based on early predictors to forecast COVID-19 health care demand in France. Proc Natl Acad Sci U S A 2022; 119:e2103302119. [PMID: 35476520 PMCID: PMC9170016 DOI: 10.1073/pnas.2103302119] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/23/2022] [Indexed: 12/24/2022] Open
Abstract
Short-term forecasting of the COVID-19 pandemic is required to facilitate the planning of COVID-19 health care demand in hospitals. Here, we evaluate the performance of 12 individual models and 19 predictors to anticipate French COVID-19-related health care needs from September 7, 2020, to March 6, 2021. We then build an ensemble model by combining the individual forecasts and retrospectively test this model from March 7, 2021, to July 6, 2021. We find that the inclusion of early predictors (epidemiological, mobility, and meteorological predictors) can halve the rms error for 14-d–ahead forecasts, with epidemiological and mobility predictors contributing the most to the improvement. On average, the ensemble model is the best or second-best model, depending on the evaluation metric. Our approach facilitates the comparison and benchmarking of competing models through their integration in a coherent analytical framework, ensuring that avenues for future improvements can be identified.
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Affiliation(s)
- Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
- Direction des Maladies Infectieuses, Santé publique France, 94415 Saint Maurice, France
| | - Alessio Andronico
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
| | - Nathanaël Hozé
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
| | - Maylis Layan
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
| | - Pascal Crépey
- Arènes–UMR 6051, RSMS–U 1309, Ecole des Hautes Etudes en Santé Publique, INSERM, CNRS, Université de Rennes, 35043 Rennes, France
| | | | - Marc Lavielle
- INRIA, 91120 Palaiseau, France
- Centre de Mathématiques Appliquées, Ecole Polytechnique, CNRS, Institut Polytechnique de Paris, 91128 Palaiseau, France
| | - Pierre-Yves Boëlle
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, 75012 Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, 75015 Paris, France
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15
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Crépey P, Massonnaud C. [Covid-19 : un pari épidémiologique perdu ?]. Rev Prat 2022; 72:523-525. [PMID: 35899639] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
COVID-19: A LOST EPIDEMIOLOGICAL BET? For the last two years, the world has been sailing from one epidemic wave to another. From lockdowns to curfews, strategies have changed over time, whether on travel restrictions, mask requirements, or vaccination. The health crisis has never ceased to toss us from one extreme to the other; each step further testing the resilience of our health system and the population's trust in its leaders. By reviewing some key stages of this pandemic crisis, we highlight why the fight against an emerging virus forces us to trials and errors, which must nevertheless be corrected in the light of the knowledge acquired. Therefore, changes in strategy become necessary even if they undermine the confidence of the population; confidence that cannot be maintained without a perfect understanding of this specific context.
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Affiliation(s)
- Pascal Crépey
- EHESP, université de Rennes, CNRS, Inserm, Arènes - UMR 6051, RSMS - U1309, Rennes, France
| | - Clément Massonnaud
- Groupe hospitalier universitaire, AP-HP Nord-Université de Paris, hôpital Bichat-Claude-Bernard, département d'épidémiologie, biostatistiques et recherche clinique, Paris, France - INSERM, UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), Paris, France
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16
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Affiliation(s)
- Pascal Crépey
- RSMS - U 1309, ARENES - UMR 6051, EHESP, CNRS, Inserm, Université de Rennes, Rennes, France
| | - Harold Noël
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | - Samuel Alizon
- MIVEGEC, CNRS, IRD, Université de Montpellier, Montpellier, France; Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France.
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17
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Velardo F, Bouziri H, Adélaïde L, Oliosi E, Layan M, Descamps A, Berthod D, Patlán-Hernández AR, Ledrans M, Pivette M, Lefort M, Roux J, Crépey P. A cross-sectional study on infectious health risks regarding freshwater sports practice in Brittany, France. J Water Health 2022; 20:356-368. [PMID: 36366992 DOI: 10.2166/wh.2022.232] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Freshwater sports expose practitioners to pathogens in the water environment and may result in infection. In French Brittany, these infections are particularly worrying, especially since 2016 with an increase in the incidence of leptospirosis reaching 1 case per 100,000 inhabitants, which represents the highest incidence observed since 1920. We aimed to estimate the prevalence of infectious diseases related to freshwater sports practice and to identify the factors associated with these infections among freshwater sports licensees in Brittany, France. From March 18, 2019, to May 8, 2019, we interviewed freshwater sports licensees (online study) and club presidents and instructors (phone study) in Brittany. Licensee participants were 18 years old or more and practiced at least one freshwater sport in one of the 79 Brittany clubs. We used logistic regression models to study the association between our variables of interest and potential risk factors. In total, 551 licensees (20.3% of the total number of licensees) and 38 clubs (48.1%) were surveyed. Among the licensees, 29 (5.3%) reported being diagnosed with leptospirosis, of which 12 (41.3%) occurred in the last 5 years. The most reported symptoms were skin irritation/itchy skin (24.3%) and 39 individuals (7.1%) reported at least one hospitalization in their lifetime for a disease related to freshwater sports. The occurrence of leptospirosis was negatively associated with boarding from a pontoon (odds ratio (OR)=0.20, 95% confidence interval (95% CI) 0.06-0.56), practicing for less than 4 years (OR=0.17, 95% CI 0.04-0.56) compared to more than 10 years, and the occurrence of leptospirosis was positively associated with taking a soapy shower after practice (OR=4.38, 95% CI 1.90-10.51). Eskimo roll was positively associated with the occurrence of otitis and conjunctivitis (OR=3.22, 95% CI 1.82-6.03), and skin irritation/itchy skin (OR=1.66, 95% CI 0.99-2.84). Otitis, conjunctivitis, and skin irritation/itchy skin are the most commonly reported freshwater sport-related diseases in French Brittany. Despite a good level of knowledge of prevention measures, their implementation by licensees and clubs remains low. Further studies are needed to identify practices associated with infectious risk in freshwater sports.
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Affiliation(s)
- Fanny Velardo
- École Pasteur-Cnam de Santé Publique, Paris, France; These authors contributed equally
| | - Hanifa Bouziri
- Conservatoire National des Arts et Métiers, Paris, France E-mail: ; These authors contributed equally
| | - Lucie Adélaïde
- Université Paris-Saclay, UFR de Pharmacie, Châtenay-Malabry, France; These authors contributed equally
| | - Emma Oliosi
- École Pasteur-Cnam de Santé Publique, Paris, France; These authors contributed equally
| | - Maylis Layan
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France; Sorbonne Université, Paris, France; These authors contributed equally
| | - Alexandre Descamps
- Université de Paris, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France; These authors contributed equally
| | - Delphine Berthod
- Service des maladies infectieuses, Institut central des hôpitaux, Hôpital du Valais, Sion, Suisse
| | | | | | - Mathilde Pivette
- Santé Publique France, Cellule régionale Bretagne, Rennes, France
| | - Mathilde Lefort
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France
| | - Jonathan Roux
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France
| | - Pascal Crépey
- Université Rennes, EHESP, REPERES (Recherche en Pharmaco-Épidémiologie et Recours aux Soins)-EA 7449, Rennes, France; See the 34th IDEA Field Epidemiology training group in the Acknowledgements section
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18
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Lemaitre M, Fouad F, Carrat F, Crépey P, Gaillat J, Gavazzi G, Launay O, Mosnier A, Levant MC, Uhart M. Estimating the burden of influenza-related and associated hospitalizations and deaths in France: An eight-season data study, 2010-2018. Influenza Other Respir Viruses 2022; 16:717-725. [PMID: 35014194 PMCID: PMC9178052 DOI: 10.1111/irv.12962] [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: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background In France, each year, influenza viruses are responsible for seasonal epidemics leading to 2–6 million cases. Influenza can cause severe disease that may lead to hospitalization or death. As severe disease may be due to the virus itself or to disease complications, estimating the burden of severe influenza is complex. The present study aimed at estimating the epidemiological and economic burden of severe influenza in France during eight consecutive influenza seasons (2010–2018). Methods Influenza‐related hospitalization and mortality data and patient characteristics were taken from the French hospital information database, PMSI. An ecological approach using cyclic regression models integrating the incidence of influenza syndrome from the Sentinelles network supplemented the PMSI data analysis in estimating excess hospitalization and mortality (CépiDc—2010–2015) and medical costs. Results Each season, the average number of influenza‐related hospitalizations was 18,979 (range: 8627–44,024), with an average length of stay of 8 days. The average number of respiratory hospitalizations indirectly related with influenza (i.e., influenza associated) was 31,490 (95% confidence interval [CI]: 24,542–39,012), with an average cost of €141 million (range: 54–217); 70% of these hospitalizations and 77% of their costs concerned individuals ≥65 years of age (65+). More than 90% of excess mortality was in 65+ subjects. Conclusions The combination of two complementary approaches allowed estimation of both influenza‐related and associated hospitalizations and deaths and their burden in France, showing the substantial impact of complications. The present study highlighted the major public health burden of influenza and its severe complications, especially in 65+ subjects.
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Affiliation(s)
| | | | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (Inserm), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Unité de Santé Publique, Paris, France
| | - Pascal Crépey
- Université de Rennes, EHESP, REPERES-EA 7449, Rennes, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble Alpes, Clinique Universitaire de Gériatrie, Pavillon Elisée-Chatin, and GREPI EA 7408, Université Grenoble Alpes, Grenoble, France
| | - Odile Launay
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,Inserm, CIC 1417, F-CRIN I-REIVAC, Assistance Publique-Hôpitaux de Paris, CIC Cochin-Pasteur, Paris, France
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19
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Di Domenico L, Sabbatini CE, Boëlle PY, Poletto C, Crépey P, Paireau J, Cauchemez S, Beck F, Noel H, Lévy-Bruhl D, Colizza V. Adherence and sustainability of interventions informing optimal control against the COVID-19 pandemic. Commun Med (Lond) 2021; 1:57. [PMID: 35602184 PMCID: PMC9053235 DOI: 10.1038/s43856-021-00057-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/10/2021] [Indexed: 11/08/2022] Open
Abstract
Background After one year of stop-and-go COVID-19 mitigation, in the spring of 2021 European countries still experienced sustained viral circulation due to the Alpha variant. As the prospect of entering a new pandemic phase through vaccination was drawing closer, a key challenge remained on how to balance the efficacy of long-lasting interventions and their impact on the quality of life. Methods Focusing on the third wave in France during spring 2021, we simulate intervention scenarios of varying intensity and duration, with potential waning of adherence over time, based on past mobility data and modeling estimates. We identify optimal strategies by balancing efficacy of interventions with a data-driven "distress" index, integrating intensity and duration of social distancing. Results We show that moderate interventions would require a much longer time to achieve the same result as high intensity lockdowns, with the additional risk of deteriorating control as adherence wanes. Shorter strict lockdowns are largely more effective than longer moderate lockdowns, for similar intermediate distress and infringement on individual freedom. Conclusions Our study shows that favoring milder interventions over more stringent short approaches on the basis of perceived acceptability could be detrimental in the long term, especially with waning adherence.
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Affiliation(s)
- Laura Di Domenico
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Chiara E. Sabbatini
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Chiara Poletto
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins »—EA 7449, 35043 Rennes, France
| | - Juliette Paireau
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - François Beck
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Harold Noel
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Daniel Lévy-Bruhl
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Tokyo Tech World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
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20
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Tran Kiem C, Bosetti P, Paireau J, Crépey P, Salje H, Lefrancq N, Fontanet A, Benamouzig D, Boëlle PY, Desenclos JC, Opatowski L, Cauchemez S. SARS-CoV-2 transmission across age groups in France and implications for control. Nat Commun 2021; 12:6895. [PMID: 34824245 PMCID: PMC8617041 DOI: 10.1038/s41467-021-27163-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022] Open
Abstract
The shielding of older individuals has been proposed to limit COVID-19 hospitalizations while relaxing general social distancing in the absence of vaccines. Evaluating such approaches requires a deep understanding of transmission dynamics across ages. Here, we use detailed age-specific case and hospitalization data to model the rebound in the French epidemic in summer 2020, characterize age-specific transmission dynamics and critically evaluate different age-targeted intervention measures in the absence of vaccines. We find that while the rebound started in young adults, it reached individuals aged ≥80 y.o. after 4 weeks, despite substantial contact reductions, indicating substantial transmission flows across ages. We derive the contribution of each age group to transmission. While shielding older individuals reduces mortality, it is insufficient to allow major relaxations of social distancing. When the epidemic remains manageable (R close to 1), targeting those most contributing to transmission is better than shielding at-risk individuals. Pandemic control requires an effort from all age groups.
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Affiliation(s)
- Cécile Tran Kiem
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France
- Collège Doctoral, Sorbonne Université, Paris, France
| | - Paolo Bosetti
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France
| | - Juliette Paireau
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France
- Santé publique France, French National Public Health Agency, Saint-Maurice, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES (Recherche en Pharmaco-Epidémiologie et Recours aux Soins), EA 7449, Rennes, France
| | - Henrik Salje
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Noémie Lefrancq
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Arnaud Fontanet
- Institut Pasteur, Université de Paris, Emerging Diseases Epidemiology Unit, Paris, France
- Conservatoire National des Arts et Métiers, PACRI Unit, Paris, France
| | - Daniel Benamouzig
- Sciences Po - Centre de sociologie des organisations and Chaire santé - CNRS, Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, Gif-sur-Yvette, France
- Institut Pasteur, Université de Paris, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France
| | - Simon Cauchemez
- Institut Pasteur, Université de Paris, Mathematical Modelling of Infectious Diseases Unit, CNRS UMR 2000, Paris, France.
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21
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Tran Kiem C, Massonnaud CR, Levy-Bruhl D, Poletto C, Colizza V, Bosetti P, Fontanet A, Gabet A, Olié V, Zanetti L, Boëlle PY, Crépey P, Cauchemez S. A modelling study investigating short and medium-term challenges for COVID-19 vaccination: From prioritisation to the relaxation of measures. EClinicalMedicine 2021; 38:101001. [PMID: 34278284 PMCID: PMC8278244 DOI: 10.1016/j.eclinm.2021.101001] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The roll-out of COVID-19 vaccines is a multi-faceted challenge whose performance depends on pace of vaccination, vaccine characteristics and heterogeneities in individual risks. METHODS We developed a mathematical model accounting for the risk of severe disease by age and comorbidity, and transmission dynamics. We compared vaccine prioritisation strategies in the early roll-out stage and quantified the extent to which measures could be relaxed as a function of the vaccine coverage achieved in France. FINDINGS Prioritizing at-risk individuals reduces morbi-mortality the most if vaccines only reduce severity, but is of less importance if vaccines also substantially reduce infectivity or susceptibility. Age is the most important factor to consider for prioritization; additionally accounting for comorbidities increases the performance of the campaign in a context of scarce resources. Vaccinating 90% of ≥65 y.o. and 70% of 18-64 y.o. before autumn 2021 with a vaccine that reduces severity by 90% and susceptibility by 80%, we find that control measures reducing transmission rates by 15-27% should be maintained to remain below 1000 daily hospital admissions in France with a highly transmissible variant (basic reproduction number R0 = 4). Assuming 90% of ≥65 y.o. are vaccinated, full relaxation of control measures might be achieved with a vaccine coverage of 89-100% in 18-64 y.o or 60-69% of 0-64 y.o. INTERPRETATION Age and comorbidity-based vaccine prioritization strategies could reduce the burden of the disease. Very high vaccination coverage may be required to completely relax control measures. Vaccination of children, if possible, could lower coverage targets necessary to achieve this objective.
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Affiliation(s)
- Cécile Tran Kiem
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 25-28 rue du Dr Roux, 75015 Paris, France
- Sorbonne Université, Paris, France
| | - Clément R. Massonnaud
- Univ Rennes, EHESP, REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins », EA 7449 Rennes, France
- Centre Hospitalier Universitaire de Rouen, Département d'Informatique Médicale, D2IM, Rouen, France
| | | | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Paolo Bosetti
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 25-28 rue du Dr Roux, 75015 Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | | | - Laura Zanetti
- Haute Autorité de Santé, Saint-Denis La plaine Stade de France, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins », EA 7449 Rennes, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 25-28 rue du Dr Roux, 75015 Paris, France
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22
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Roux J, Nekkab N, Colomb-Cotinat M, Astagneau P, Crépey P. Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010-20. J Antimicrob Chemother 2021; 76:226-232. [PMID: 32929455 DOI: 10.1093/jac/dkaa388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/17/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Carbapenemase-producing Enterobacteriaceae (CPE) cause resistant healthcare-associated infections that jeopardize healthcare systems and patient safety worldwide. The number of CPE episodes has been increasing in France since 2009, but the dynamics are still poorly understood. OBJECTIVES To use time-series modelling to describe the dynamics of CPE episodes from August 2010 to December 2016 and to forecast the evolution of CPE episodes for the 2017-20 period. METHODS We used time series to analyse CPE episodes from August 2010 to November 2016 reported to the French national surveillance system. The impact of seasonality was quantified using seasonal-to-irregular ratios. Seven time-series models and three ensemble stacking models (average, convex and linear stacking) were assessed and compared with forecast CPE episodes during 2017-20. RESULTS During 2010-16, 3559 CPE episodes were observed in France. Compared with the average yearly trend, we observed a 30% increase in the number of CPE episodes in the autumn. We noticed a 1 month lagged seasonality of non-imported episodes compared with imported episodes. Average stacking gave the best forecasts and predicted an increase during 2017-20 with a peak up to 345 CPE episodes (95% prediction interval = 124-1158, 80% prediction interval = 171-742) in September 2020. CONCLUSIONS The observed seasonality of CPE episodes sheds light on potential factors associated with the increased frequency of episodes, which need further investigation. Our model predicts that the number of CPE episodes will continue to rise in the coming years in France, mainly due to local dissemination, associated with bacterial carriage by patients in the community, which is becoming an immediate challenge with regard to outbreak control.
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Affiliation(s)
- Jonathan Roux
- Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and health services research) - EA 7449, Rennes, France
| | - Narimane Nekkab
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, Paris, France.,Institut Pasteur, Cnam, Unité PACRI, Paris, France
| | | | - Pascal Astagneau
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Centre de prévention des infections associées aux soins, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES (Pharmacoepidemiology and health services research) - EA 7449, Rennes, France
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23
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Moutchia J, Njouom R, Rumpler E, Besombes C, Texier G, Tejiokem M, Crépey P, Fontanet A, Shimakawa Y. Maternal age at first childbirth and geographical variation in HBV prevalence in Cameroon: Important role of mother-to-child transmission. Clin Infect Dis 2021; 74:836-845. [PMID: 34125878 DOI: 10.1093/cid/ciab548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/13/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The prevalence of hepatitis B virus (HBV) infection varies geographically around the world. However, the underlying reasons for this variation are unknown. Using a nationally representative population-based sample from all 58 administrative divisions in Cameroon, we examined the association between median maternal age at first childbirth in a preceding generation, a proxy for the frequency of mother-to-child transmission (MTCT) of HBV in a region, and the risk of chronic HBV infection, defined as positive surface antigen (HBsAg), in the index generation. METHODS We estimated a division-specific median maternal age at first childbirth using historical data from Demographic Health Surveys (DHS) in 1991/1998/2004/2011. We tested HBsAg in 2011 DHS participants. We used maps to display spatial variation and spatial models for the analysis. RESULTS In 14,150 participants (median 27 years old, 51% females), the overall weighted prevalence of HBsAg was 11.9% (95%CI: 11.0-12.8), with a wide geographical variation across the divisions (range: 6.3-23.7%). After adjusting for confounding factors and spatial dependency, lower maternal age at first childbirth was significantly associated with positive HBsAg at the division level (β: 1.89 [95%CI: 1.26-2.52], p<0.001), and at the individual level (OR: 1.20 [95%CI: 1.04-1.39], p=0.016). A similar ecological correlation was observed across other African countries. CONCLUSIONS The significant association between the maternal age at first childbirth and HBsAg-positivity suggests a crucial role of MTCT in maintaining high HBV endemicity in some areas in Cameroon. This underlines an urgent need to effectively prevent MTCT in order to achieve WHO's global hepatitis elimination goals.
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Affiliation(s)
- Jude Moutchia
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.,REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Université Rennes, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Eva Rumpler
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Camille Besombes
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Gaëtan Texier
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaoundé, Cameroon.,Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, Marseille, France
| | - Mathurin Tejiokem
- Department of Epidemiology and Public Health, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Pascal Crépey
- REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Université Rennes, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Arnaud Fontanet
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.,PACRI unit, Conservatoire National des Arts et Métiers, Paris, France
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
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24
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Tran Kiem C, Crépey P, Bosetti P, Levy Bruhl D, Yazdanpanah Y, Salje H, Boëlle PY, Cauchemez S. Lockdown as a last resort option in case of COVID-19 epidemic rebound: a modelling study. ACTA ACUST UNITED AC 2021; 26. [PMID: 34085634 PMCID: PMC8176673 DOI: 10.2807/1560-7917.es.2021.26.22.2001536] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Given its high economic and societal cost, policymakers might be reluctant to implement a large-scale lockdown in case of coronavirus disease (COVID-19) epidemic rebound. They may consider it as a last resort option if alternative control measures fail to reduce transmission. Aim We developed a modelling framework to ascertain the use of lockdown to ensure intensive care unit (ICU) capacity does not exceed a peak target defined by policymakers. Methods We used a deterministic compartmental model describing transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the trajectories of COVID-19 patients in healthcare settings, accounting for age-specific mixing patterns and an increasing probability of severe outcomes with age. The framework is illustrated in the context of metropolitan France. Results The daily incidence of ICU admissions and the number of occupied ICU beds are the most robust indicators to decide when a lockdown should be triggered. When the doubling time of hospitalisations estimated before lockdown is between 8 and 20 days, lockdown should be enforced when ICU admissions reach 3.0–3.7 and 7.8–9.5 per million for peak targets of 62 and 154 ICU beds per million (4,000 and 10,000 beds for metropolitan France), respectively. When implemented earlier, the lockdown duration required to get back below a desired level is also shorter. Conclusions We provide simple indicators and triggers to decide if and when a last-resort lockdown should be implemented to avoid saturation of ICU. These metrics can support the planning and real-time management of successive COVID-19 pandemic waves.
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Affiliation(s)
- Cécile Tran Kiem
- Collège Doctoral, Sorbonne Université, Paris, France.,Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Pascal Crépey
- Univ Rennes, EHESP, REPERES « Recherche en Pharmaco-Epidémiologie et Recours aux Soins » - EA 7449, Rennes, France
| | - Paolo Bosetti
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Daniel Levy Bruhl
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Yazdan Yazdanpanah
- Infections Antimicrobials Modelling Evolution (IAME), UMR1137, INSERM, University of Paris, Paris, France
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom.,Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Pierre-Yves Boëlle
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
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25
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Temime L, Gustin MP, Duval A, Buetti N, Crépey P, Guillemot D, Thiébaut R, Vanhems P, Zahar JR, Smith DRM, Opatowski L. A Conceptual Discussion About the Basic Reproduction Number of Severe Acute Respiratory Syndrome Coronavirus 2 in Healthcare Settings. Clin Infect Dis 2021; 72:141-143. [PMID: 32473007 PMCID: PMC7314155 DOI: 10.1093/cid/ciaa682] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Received: 04/20/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022] Open
Abstract
To date, no specific estimate of R0 for SARS-CoV-2 is available for healthcare settings. Using interindividual contact data, we highlight that R0 estimates from the community cannot translate directly to healthcare settings, with pre-pandemic R0 values ranging 1.3-7.7 in 3 illustrative healthcare institutions. This has implications for nosocomial COVID-19 control.
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Affiliation(s)
- Laura Temime
- MESuRS laboratory, Conservatoire national des arts et métiers, Paris, France
- PACRI Unit, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France
| | - Marie-Paule Gustin
- Institute of Pharmaceutic and Biological Sciences, University Claude Bernard Lyon 1, Villeurbanne, France
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Audrey Duval
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
| | - Niccolò Buetti
- UPRES-EA 7449 REPERES “Recherche en Pharmaco-Epidémiologie et Recours aux Soins” – EHESP – Université de Rennes, Rennes, France
| | - Pascal Crépey
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
| | - Didier Guillemot
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
- AP-HP Paris Saclay, Public Health, Medical Information, Clinical research, Le Kremlin-Bicêtre, France
| | - Rodolphe Thiébaut
- INSERM U1219 Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
- INRIA SISTM team, Talence, France
- Vaccine Research Institute, Créteil, France
| | - Philippe Vanhems
- Emerging Pathogens Laboratory-Fondation Mérieux, International Center for Infectiology Research (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
- Service d’Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437, Lyon, France
- Inserm, F CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - Jean-Ralph Zahar
- IAME, UMR1137, Inserm, Univ. Paris 13, Sorbonne Paris Cité, Paris, France
- Service de Microbiologie Clinique et Unité de Contrôle et de Prévention du Risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - David R M Smith
- MESuRS laboratory, Conservatoire national des arts et métiers, Paris, France
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
| | - Lulla Opatowski
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion unit, Paris, France
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Zeevat F, Crépey P, Dolk FCK, Postma AJ, Breeveld-Dwarkasing VNA, Postma MJ. Cost-Effectiveness of Quadrivalent Versus Trivalent Influenza Vaccination in the Dutch National Influenza Prevention Program. Value Health 2021; 24:3-10. [PMID: 33431150 DOI: 10.1016/j.jval.2020.11.002] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 10/16/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES As of 2019, quadrivalent influenza vaccine (QIV) has replaced trivalent influenza vaccine (TIV) in the national immunization program in The Netherlands. Target groups are individuals of 60+ years of age and those with chronic diseases. The objective was to estimate the incremental break-even price of QIV over TIV at a threshold of €20 000 per quality-adjusted life-year (QALY). METHODS An age-structured compartmental dynamic model was adapted for The Netherlands to assess health outcomes and associated costs of vaccinating all individuals at higher risk for influenza with QIV instead of TIV over the seasons 2010 to 2018. Influenza incidence rates were derived from a global database. Other parameters (probabilities, QALYs and costs) were extracted from the literature and applied according to Dutch guidelines. A threshold of €20 000 per QALY was applied to estimate the incremental break-even prices of QIV versus TIV. Sensitivity analyses were performed to test the robustness of the model outcomes. RESULTS Retrospectively, vaccination with QIV instead of TIV could have prevented on average 9500 symptomatic influenza cases, 2130 outpatient visits, 84 hospitalizations, and 38 deaths per year over the seasons 2010 to 2018. This translates into 385 QALYs and 398 life-years potentially gained. On average, totals of €431 527 direct and €2 388 810 indirect costs could have been saved each year. CONCLUSION Using QIV over TIV during the influenza seasons 2010 to 2018 would have been cost-effective at an incremental price of maximally €3.81 (95% confidence interval, €3.26-4.31). Sensitivity analysis showed consistent findings on the incremental break-even price in the same range.
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Affiliation(s)
- Florian Zeevat
- Department of Health Sciences, University of Groningen, University Medical Centre, Groningen, The Netherlands.
| | - Pascal Crépey
- Department of Quantitative Methods in Public Health, University of Rennes, Rennes, France
| | - F Christiaan K Dolk
- Unit of PharmacoTherapy, Epidemiology, and Economics, University of Groningen, Department of Pharmacy, Groningen, The Netherlands
| | | | | | - Maarten J Postma
- Department of Health Sciences, University of Groningen, University Medical Centre, Groningen, The Netherlands; Unit of PharmacoTherapy, Epidemiology, and Economics, University of Groningen, Department of Pharmacy, Groningen, The Netherlands; Department of Economics, Econometrics, and Finance, University of Groningen, Faculty of Economics and Business, Groningen, The Netherlands
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Nekkab N, Crépey P, Astagneau P, Opatowski L, Temime L. Assessing the role of inter-facility patient transfer in the spread of carbapenemase-producing Enterobacteriaceae: the case of France between 2012 and 2015. Sci Rep 2020; 10:14910. [PMID: 32913244 PMCID: PMC7483561 DOI: 10.1038/s41598-020-71212-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/31/2020] [Indexed: 11/09/2022] Open
Abstract
The spread of carbapenemase-producing Enterobacteriaceae (CPE) in healthcare settings is a major public health threat that has been associated with cross-border and local patient transfers between healthcare facilities. Since the impact of transfers on spread may vary, our study aimed to assess the contribution of a patient transfer network on CPE incidence and spread at a countrywide level, with a case study of France from 2012 to 2015. Our results suggest a transition in 2013 from a CPE epidemic sustained by internationally imported episodes to an epidemic sustained by local transmission events through patient transfers. Incident episodes tend to occur within close spatial distance of their potential infector. We also observe an increasing frequency of multiple spreading events, originating from a limited number of regional hubs. Consequently, coordinated prevention and infection control strategies should focus on transfers of carriers of CPE to reduce regional and inter-regional transmission.
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Affiliation(s)
- Narimane Nekkab
- Laboratoire MESuRS, Conservatoire National Des Arts Et Métiers, Paris, France. .,Unité PACRI, Institut Pasteur, Conservatoire National Des Arts Et Métiers, Paris, France. .,EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, University Rennes, Rennes, France.
| | - Pascal Crépey
- EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, University Rennes, Rennes, France
| | - Pascal Astagneau
- Centre régional de prévention Des Infections associées Aux Soins (CPias), Paris, France.,INSERM, Institut Pierre Louis D'Epidémiologie Et de Santé Publique, Sorbonne Université, 75013, Paris, France
| | - Lulla Opatowski
- UMR 1181, «Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases» (B2PHI), University Versailles Saint Quentin en Yvelines, Saint Quentin en Yvelines, France.,Pharmacoepidemiology and Infectious Diseases Unit, Institut Pasteur, Paris, France.,Inserm UMR 1181 (B2PHI), Paris, France
| | - Laura Temime
- Laboratoire MESuRS, Conservatoire National Des Arts Et Métiers, Paris, France.,Unité PACRI, Institut Pasteur, Conservatoire National Des Arts Et Métiers, Paris, France
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Fouad F, Lemaitre M, Carrat F, Crépey P, Gaillat J, Launay O, Mosnier A, Gavazzi G, Levant M, Uhart M. Estimation du fardeau hospitalier direct et attribuable à la grippe en France à partir de la base PMSI. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.351] [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: 11/30/2022]
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Crépey P, Redondo E, Díez-Domingo J, Ortiz de Lejarazu R, Martinón-Torres F, Gil de Miguel Á, López-Belmonte JL, Alvarez FP, Bricout H, Solozabal M. From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain. PLoS One 2020; 15:e0233526. [PMID: 32437476 PMCID: PMC7241783 DOI: 10.1371/journal.pone.0233526] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/06/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Quadrivalent influenza vaccine (QIV) includes the same strains as trivalent influenza vaccine (TIV) plus an additional B strain of the other B lineage. The aim of the study was to analyse the public health and economic impact of replacing TIV with QIV in different scenarios in Spain. METHODS A dynamic transmission model was developed to estimate the number of influenza B cases prevented under TIV and QIV strategies (<65 years (high risk) and ≥65 years). This model considers cross-protective immunity induced by different lineages of influenza B. The output of the transmission model was used as input for a decision tree model that estimated the economic impact of switching TIV to QIV. The models were populated with Spanish data whenever possible. Deterministic univariate and probabilistic multivariate sensitivity analyses were performed. RESULTS Replacing TIV with QIV in all eligible patients with current vaccine coverage in Spain may have prevented 138,707 influenza B cases per season and, therefore avoided 10,748 outpatient visits, 3,179 hospitalizations and 192 deaths. The replacement could save €532,768 in outpatient visit costs, €13 million in hospitalization costs, and €3 million in costs of influenza-related deaths per year. An additional €5 million costs associated with productivity loss could be saved per year, from the societal perspective. The budget impact from societal perspective would be €6.5 million, and the incremental cost-effectiveness ratio (ICER) €1,527 per quality-adjusted life year (QALY). Sensitivity analyses showed robust results. In additional scenarios, QIV also showed an impact at public health level reducing influenza B related cases, outpatient visits, hospitalizations and deaths. CONCLUSIONS Our results show public health and economic benefits for influenza prevention with QIV. It would be an efficient intervention for the Spanish National Health Service with major health benefits especially in the population ≥65-year.
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Affiliation(s)
- Pascal Crépey
- Department of Quantitative Methods in Public Health, UPRES-EA-7449 Reperes, EHESP, University of Rennes, Rennes, France
| | - Esther Redondo
- Centro de Salud Internacional Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Javier Díez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Raúl Ortiz de Lejarazu
- Centro Nacional de Gripe de Valladolid, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Federico Martinón-Torres
- Servicio Pediatría, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Grupo de Genética, Infecciones y Vacunas en Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Gil de Miguel
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
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Roux J, Massonnaud C, Crépey P. A model of Carbapenemase-Producing Enterobacteriaceae spreading in the French hospitals network. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.531] [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: 11/13/2022] Open
Abstract
Abstract
Background
Carbapenemase-Producing Enterobacteriaceae (CPE) are spreading at an alarming rate and threaten health systems and patient safety worldwide. In France, their transmission is driven by importation of international cases and inter-regional dissemination due to patients’ transfers between hospitals. This study aims at defining a mathematical model reproducing CPE transmission on the French network of hospitals.
Methods
CPE spreading is modeled using a stochastic susceptible-colonized-infected (SCI) hospital-based model. It takes into account both CPE dissemination through patient transfers, and importations either from foreign countries or in-town transmission. The patient transfer network was reconstructed using data from the French hospital discharge database (PMSI) over the years 2014-2017. Epidemiological parameters were estimated from surveillance data of CPE episodes from August 2010 to November 2016 from the French national Healthcare-Associated Infections Early Warning and Response System.
Results
Our epidemiological model replicates the number of CPE hospital outbreaks occurring in France on a network of 2,433 hospitals. It allows to estimate the number of unobserved hospitals’ colonization and differentiate outbreaks due to foreign importation from outbreaks due to patient transfers. Finally, the model can be used to benchmark control strategies based on patient redirections, or targeted screening.
Conclusions
This study is the first to simulate CPE spread in France using real-life patient transfers data. Our mathematical model may further help public health authorities in the definition and evaluation of new control strategies of CPE transmission based on patient flows between hospitals.
Key messages
The mathematical model take into account CPE spreading through hospital transfers and importations from origins using real-life data. Our stochastic susceptible-colonized-infected (SCI) hospital-based model reproduces CPE spread in France and further help in evaluating control strategies of CPE transmission.
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Affiliation(s)
- J Roux
- Reperes – EA 7449, Univ Rennes, EHESP, Rennes, France
| | - C Massonnaud
- Reperes – EA 7449, Univ Rennes, EHESP, Rennes, France
| | - P Crépey
- Reperes – EA 7449, Univ Rennes, EHESP, Rennes, France
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Roux J, Nekkab N, Astagneau P, Crépey P. Modeling Carbapenemase-producing Enterobacteriaceae episodes’ evolution in France over 2010-2020. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.289] [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: 11/13/2022] Open
Abstract
Abstract
Background
Incidence of Carbapenemase-Producing Enterobacteriaceae (CPE) episodes within hospitals is rising at an alarming rate and threaten health systems and patient safety worldwide. Their number is growing in France since 2009 associated with inter-regional dissemination and importation of international cases. This study aimed at describing the dynamics of CPE episodes in France over 2010-2016 and forecasting their evolution for 2017-2020.
Methods
Surveillance data of CPE episodes (imported and non-imported) from August 2010 to November 2016 were issued from the French national Healthcare-Associated Infections Early Warning and Response System. Impact of seasonality on the number of CPE episodes was analyzed using seasonal-to-irregular ratios. Seven models issued from time series analysis and three ensemble stacking models (average, convex and linear stacking) were used to describe and forecast CPE episodes. The model with the best forecasting’s quality was then trained on all available data (2010-2016) and used to predict CPE episodes over 2017-2020.
Results
Over 2010-2016, 3,559 CPE episodes were observed in France. Compared to the average yearly trend, we observed a 30% increase in the number of CPE episodes in September and October. On the opposite, a decrease of 20% was noticed in February compared to other months. We also noticed a 1-month lagged seasonality of non-imported episodes compared to imported ones. The number of non-imported episodes appeared to grow faster than imported ones starting from 2014. Average stacking gave the best forecasts and predicted an increase over 2017-2020 with a peak up to 345 CPE episodes (95% PI [124-1,158], 80% PI [171-742]) in September 2020.
Conclusions
The number of CPE episodes is predicted to rise in the next years in France because of non-imported episodes. These results could help public health authorities in the definition and evaluation of new containment strategies.
Key messages
Time series modeling predicts an increase in the number of CPE episodes in France in the next few years with a quicker rise of non-imported episodes. An increase of 30% in the number of CPE episodes was observed in September and October with a 1-month lagged seasonality impact of non-imported episodes compared to imported one.
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Affiliation(s)
- J Roux
- REPERES - EA 7449, University of Rennes, EHESP, Rennes, France
| | - N Nekkab
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers (CNAM), Paris, France
- Unité PACRI, Institut Pasteur, CNAM, Paris, France
| | - P Astagneau
- CPias Ile-de-France, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre & Marie Curie, Sorbonne Université, Paris, France
| | - P Crépey
- REPERES - EA 7449, University of Rennes, EHESP, Rennes, France
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Koutangni T, Crépey P, Woringer M, Porgho S, Bicaba BW, Tall H, Mueller JE. Compartmental models for seasonal hyperendemic bacterial meningitis in the African meningitis belt. Epidemiol Infect 2018; 147:e14. [PMID: 30264686 PMCID: PMC6520558 DOI: 10.1017/s0950268818002625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Received: 10/06/2017] [Revised: 07/03/2018] [Accepted: 08/22/2018] [Indexed: 11/29/2022] Open
Abstract
The pathophysiological mechanisms underlying the seasonal dynamic and epidemic occurrence of bacterial meningitis in the African meningitis belt remain unknown. Regular seasonality (seasonal hyperendemicity) is observed for both meningococcal and pneumococcal meningitis and understanding this is critical for better prevention and modelling. The two principal hypotheses for hyperendemicity during the dry season imply (1) an increased risk of invasive disease given asymptomatic carriage of meningococci and pneumococci; or (2) an increased transmission of these bacteria from carriers and ill individuals. In this study, we formulated three compartmental deterministic models of seasonal hyperendemicity, featuring one (model1-'inv' or model2-'transm'), or a combination (model3-'inv-transm') of the two hypotheses. We parameterised the models based on current knowledge on meningococcal and pneumococcal biology and pathophysiology. We compared the three models' performance in reproducing weekly incidences of suspected cases of acute bacterial meningitis reported by health centres in Burkina Faso during 2004-2010, through the meningitis surveillance system. The three models performed well (coefficient of determination R2, 0.72, 0.86 and 0.87, respectively). Model2-'transm' and model3-'inv-transm' better captured the amplitude of the seasonal incidence. However, model2-'transm' required a higher constant invasion rate for a similar average baseline transmission rate. The results suggest that a combination of seasonal changes of the risk of invasive disease and carriage transmission is involved in the hyperendemic seasonality of bacterial meningitis in the African meningitis belt. Consequently, both interventions reducing the risk of nasopharyngeal invasion and the bacteria transmission, especially during the dry season are believed to be needed to limit the recurrent seasonality of bacterial meningitis in the meningitis belt.
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Affiliation(s)
- T. Koutangni
- Université Pierre et Marie Curie, 4 Place Jussieu, 75005 Paris, France
- Unité de l'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
- EHESP French School of Public Health, Sorbonne Paris Cité, 20 avenue George Sand, 93210 La Plaine St Denis, France
| | - P. Crépey
- UMR Emergence des Pathologies Virales, Université Aix-Marseille – IRD 190 – Inserm 1207 – EHESP, 27 Boulevard Jean-Moulin 13385 Marseille Cedex 5, France
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) – EA 7449, F-35000 Rennes, France
| | - M. Woringer
- Institut de Biologie de l'Ecole Normale Supérieure (IBENS), PSL Research University, 45 Rue dʼUlm, 75005 Paris, France
| | - S. Porgho
- Direction de la Lutte contre la Maladie, Ministère de la Santé, 03 BP 7035 Ouagadougou 03, Burkina Faso
| | - B. W. Bicaba
- Direction de la Lutte contre la Maladie, Ministère de la Santé, 03 BP 7035 Ouagadougou 03, Burkina Faso
| | - H. Tall
- Agence de Médecine Préventive, 10 BP 638. Ouagadougou, Burkina Faso
| | - J. E. Mueller
- Unité de l'Epidémiologie des Maladies Emergentes, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
- EHESP French School of Public Health, Sorbonne Paris Cité, 20 avenue George Sand, 93210 La Plaine St Denis, France
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Nekkab N, Crépey P, Temime L. Assessing the role of a patient transfer network in the spread of carbapenemase-producing Enterobacteriaceae: The case of France between 2012 and 2015. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.080] [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: 10/28/2022] Open
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Crépey P, Barthélemy M, Valleron AJ, Alvarez F. sispread: A Software to Simulate Infectious Diseases Spreading on Contact Networks. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1627827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives: We present a simulation software which allows studying the dynamics of a hypothetic infectious disease within a network of connected people. The software is aimed to facilitate the discrimination of stochastic factors governing the evolution of an infection in a network. In order to do this it provides simple tools to create networks of individuals and to set the epidemiological parameters of the outbreaks.
Methods: Three popular models of infectious disease can be used (SI, SIS, SIR). The simulated networks are either the algorithm-based included ones (scale free, small-world, and random homogeneous networks), or provided by third party software.
Results: It allows the simulation of a single or many outbreaks over a network, or outbreaks over multiple networks (with identical properties). Standard outputs are the evolution of the prevalence of the disease, on a single outbreak basis or by averaging many outbreaks. The user can also obtain customized outputs which address in detail different possible epidemiological questions about the spread of an infectious agent in a community.
Conclusions: The presented software introduces sources of stochasticity present in real epidemics by simulating outbreaks on contact networks of individuals. This approach may help to understand the paths followed by outbreaks in a given community and to design new strategies for preventing and controlling them.
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Nekkab N, Astagneau P, Temime L, Crépey P. Spread of hospital-acquired infections: A comparison of healthcare networks. PLoS Comput Biol 2017; 13:e1005666. [PMID: 28837555 PMCID: PMC5570216 DOI: 10.1371/journal.pcbi.1005666] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 01/06/2017] [Accepted: 07/03/2017] [Indexed: 11/20/2022] Open
Abstract
Hospital-acquired infections (HAIs), including emerging multi-drug resistant organisms, threaten healthcare systems worldwide. Efficient containment measures of HAIs must mobilize the entire healthcare network. Thus, to best understand how to reduce the potential scale of HAI epidemic spread, we explore patient transfer patterns in the French healthcare system. Using an exhaustive database of all hospital discharge summaries in France in 2014, we construct and analyze three patient networks based on the following: transfers of patients with HAI (HAI-specific network); patients with suspected HAI (suspected-HAI network); and all patients (general network). All three networks have heterogeneous patient flow and demonstrate small-world and scale-free characteristics. Patient populations that comprise these networks are also heterogeneous in their movement patterns. Ranking of hospitals by centrality measures and comparing community clustering using community detection algorithms shows that despite the differences in patient population, the HAI-specific and suspected-HAI networks rely on the same underlying structure as that of the general network. As a result, the general network may be more reliable in studying potential spread of HAIs. Finally, we identify transfer patterns at both the French regional and departmental (county) levels that are important in the identification of key hospital centers, patient flow trajectories, and regional clusters that may serve as a basis for novel wide-scale infection control strategies. Hospital-acquired infections (HAIs), including emerging multi-drug resistant organisms, threaten healthcare systems worldwide. Efficient containment measures of HAIs must mobilize the entire healthcare network. Thus, to best understand how to reduce the scale of potential HAI epidemic spread, we explore patient transfer patterns in the French healthcare system. We construct and compare the characteristics of three different patient transfer networks based on data on transfers of patients with diagnosed HAIs, suspected HAIs, or of all patients. Our analyses show that these healthcare networks, the patient populations that comprise them and the patient movement patterns are heterogeneous and centralized. Despite the differences in patient populations, the HAI-specific and suspected-HAI healthcare networks have the same underlying structure as that of the general healthcare network. We identify key hospital centers, patient flow trajectories, at both the regional and department (county) level that may serve as a basis for proposing novel wide-scale infection control strategies.
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Affiliation(s)
- Narimane Nekkab
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, 292 Rue Saint-Martin, Paris, France
- Institut Pasteur, Cnam, Unité PACRI, 25–28, rue du Docteur Roux, Paris, France
- Ecole des Hautes Etudes en Santé Publique, Département d'Epidémiologie et de Biostatistiques, 15 Avenue du Professeur-Léon-Bernard, Rennes, France
- * E-mail:
| | - Pascal Astagneau
- Ecole des Hautes Etudes en Santé Publique, Département d'Epidémiologie et de Biostatistiques, 15 Avenue du Professeur-Léon-Bernard, Rennes, France
- Centre de prévention des infections associées aux soins (C-CLIN), APHP, Paris, France
- Faculté de médecine Pierre et Marie Curie, Sorbonne Universités, Paris, France
| | - Laura Temime
- Laboratoire MESuRS, Conservatoire National des Arts et Métiers, 292 Rue Saint-Martin, Paris, France
- Institut Pasteur, Cnam, Unité PACRI, 25–28, rue du Docteur Roux, Paris, France
| | - Pascal Crépey
- Ecole des Hautes Etudes en Santé Publique, Département d'Epidémiologie et de Biostatistiques, 15 Avenue du Professeur-Léon-Bernard, Rennes, France
- UMR190, Emergence des Pathologies Virales, Marseille, France
- UPRES EA 7449 Reperes, Rennes, France
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Elias C, Fournier A, Vasiliu A, Beix N, Demillac R, Tillaut H, Guillois Y, Eyebe S, Mollo B, Crépey P. Seasonal influenza vaccination coverage and its determinants among nursing homes personnel in western France. BMC Public Health 2017; 17:634. [PMID: 28687075 PMCID: PMC5501011 DOI: 10.1186/s12889-017-4556-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 06/29/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Influenza-associated deaths is an important risk for the elderly in nursing homes (NHs) worldwide. Vaccination coverage among residents is high but poorly effective due to immunosenescence. Hence, vaccination of personnel is an efficient way to protect residents. Our objective was to quantify the seasonal influenza vaccination (IV) coverage among NH for elderly workers and identify its determinants in France. METHODS We conducted a cross-sectional study in March 2016 in a randomized sample of NHs of the Ille-et-Vilaine department of Brittany, in western France. A standardized questionnaire was administered to a randomized sample of NH workers for face-to-face interviews. General data about the establishment was also collected. RESULTS Among the 33 NHs surveyed, IV coverage for the 2015-2016 season among permanent workers was estimated at 20% (95% Confidence Interval (CI) 15.3%-26.4%) ranging from 0% to 69% depending on the establishments surveyed. Moreover, IV was associated with having previously experienced a "severe" influenza episode in the past (Prevalence Ratio 1.48, 95% CI 1.01-2.17), and varied by professional categories (p < 0.004) with better coverage among administrative staff. Better knowledge about influenza prevention tools was also correlated (p < 0.001) with a higher IV coverage. Individual perceptions of vaccination benefits had a significant influence on the IV coverage (p < 0.001). Although IV coverage did not reach a high rate, our study showed that personnel considered themselves sufficiently informed about IV. CONCLUSIONS IV coverage remains low in the NH worker population in Ille-et-Vilaine and also possibly in France. Strong variations of IV coverage among NHs suggest that management and working environment play an important role. To overcome vaccine "hesitancy", specific communication tools may be required to be adapted to the various NH professionals to improve influenza prevention.
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Affiliation(s)
- Christelle Elias
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Anna Fournier
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Anca Vasiliu
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Nicolas Beix
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Rémi Demillac
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Epiter, F-94415 Saint-Maurice, France
| | - Hélène Tillaut
- Santé publique France, Cellule d’intervention en région Bretagne, F-94415 Saint-Maurice, France
| | - Yvonnick Guillois
- Santé publique France, Cellule d’intervention en région Bretagne, F-94415 Saint-Maurice, France
| | - Serge Eyebe
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Bastien Mollo
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- Ecole Pasteur-CNAM de Santé Publique, Paris, France
| | - Pascal Crépey
- Ecole des Hautes Etudes en Santé Publique, Université Sorbonne Paris Cité, Rennes, France
- UMR “Emergence des Pathologies Virales”, Aix-Marseille University - IRD 190 - Inserm 1207 - EHESP, Marseille, France
- EA 7449 Reperes, EHESP - Université de Rennes 1, Rennes, France
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de Boer PT, van Maanen BM, Damm O, Ultsch B, Dolk FCK, Crépey P, Pitman R, Wilschut JC, Postma MJ. A systematic review of the health economic consequences of quadrivalent influenza vaccination. Expert Rev Pharmacoecon Outcomes Res 2017; 17:249-265. [PMID: 28613092 DOI: 10.1080/14737167.2017.1343145] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 10/19/2022]
Abstract
BACKGROUND Quadrivalent influenza vaccines (QIVs) contain antigens derived from an additional influenza type B virus as compared with currently used trivalent influenza vaccines (TIVs). This should overcome a potential reduced vaccine protection due to mismatches between TIV and circulating B viruses. In this study, we systematically reviewed the available literature on health economic evaluations of switching from TIV to QIV. Areas covered: The databases of Medline and Embase were searched systematically to identify health economic evaluations of QIV versus TIV published before September 2016.A total of sixteen studies were included, thirteen cost-effectiveness analyses and three cost-comparisons. Expert commentary: Published evidence on the cost-effectiveness of QIV suggests that switching from TIV to QIV would be a valuable intervention from both the public health and economic viewpoint. However, more research seems mandatory. Our main recommendations for future research include: 1) more extensive use of dynamic models in order to estimate the full impact of QIV on influenza transmission including indirect effects, 2) improved availability of data on disease outcomes and costs related to influenza type B viruses, and 3) more research on immunogenicity of natural influenza infection and vaccination, with emphasis on cross-reactivity between different influenza B viruses and duration of protection.
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Affiliation(s)
- Pieter T de Boer
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Britt M van Maanen
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Oliver Damm
- b Department of Health Economics and Health Care Management, School of Public Health , Bielefeld University , Bielefeld , Germany
| | - Bernhard Ultsch
- c Immunisation Unit , Robert Koch Institute , Berlin , Germany
| | - Franklin C K Dolk
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Pascal Crépey
- d Department of Quantitative Methods in Public Health , EHESP Rennes , Sorbonne Paris Cité, Rennes , France.,e UPRES-EA-7449 Reperes, University of Rennes 1 , Rennes , France
| | | | - Jan C Wilschut
- g Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Maarten J Postma
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands.,h Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,i Institute of Science in Healthy Aging & healthcaRE (SHARE) , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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de Boer PT, Crépey P, Pitman RJ, Macabeo B, Chit A, Postma MJ. Cost-Effectiveness of Quadrivalent versus Trivalent Influenza Vaccine in the United States. Value Health 2016; 19:964-975. [PMID: 27987647 DOI: 10.1016/j.jval.2016.05.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 05/17/2016] [Accepted: 05/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Designed to overcome influenza B mismatch, new quadrivalent influenza vaccines (QIVs) contain one additional B strain compared with trivalent influenza vaccines (TIVs). OBJECTIVE To examine the expected public health impact, budget impact, and incremental cost-effectiveness of QIV versus TIV in the United States. METHODS A dynamic transmission model was used to predict the annual incidence of influenza over the 20-year-period of 2014 to 2034 under either a TIV program or a QIV program. A decision tree model was interfaced with the transmission model to estimate the public health impact and the cost-effectiveness of replacing TIV with QIV from a societal perspective. Our models were informed by published data from the United States on influenza complication probabilities and relevant costs. The incremental vaccine price of QIV as compared with that of TIV was set at US $5.40 per dose. RESULTS Over the next 20 years, replacing TIV with QIV may reduce the number of influenza B cases by 27.2% (16.0 million cases), resulting in the prevention of 137,600 hospitalizations and 16,100 deaths and a gain of 212,000 quality-adjusted life-years (QALYs). The net societal budget impact would be US $5.8 billion and the incremental cost-effectiveness ratio US $27,411/QALY gained. In the probabilistic sensitivity analysis, 100% and 96.5% of the simulations fell below US $100,000/QALY and US $50,000/QALY, respectively. CONCLUSIONS Introducing QIV into the US immunization program may prevent a substantial number of hospitalizations and deaths. QIV is also expected to be a cost-effective alternative option to TIV.
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Affiliation(s)
- Pieter T de Boer
- Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
| | - Pascal Crépey
- EHESP Rennes, Sorbonne Paris-Cité, Paris, France; Aix-Marseille Univ, UMR EPV 190, Marseille, France
| | | | | | - Ayman Chit
- Sanofi Pasteur, Swiftwater, PA, USA; Lesli Dan Faculty of Pharmacy, Toronto, Ontario, Canada
| | - Maarten J Postma
- Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Institute of Science in Healthy Aging & healthcaRE (SHARE), University Medical Center Groningen (UMCG), Groningen, The Netherlands; Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
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Crépey P, de Boer PT, Postma MJ, Pitman R. Retrospective public health impact of a quadrivalent influenza vaccine in the United States. Influenza Other Respir Viruses 2016; 9 Suppl 1:39-46. [PMID: 26256294 PMCID: PMC4549101 DOI: 10.1111/irv.12318] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 04/20/2015] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Vaccination is an effective preventive strategy against influenza. However, current trivalent influenza vaccines (TIVs) contain only one of the two influenza B lineages that circulate each year. Vaccine mismatches are frequent because predicting which one will predominate is difficult. Recently licensed quadrivalent influenza vaccines (QIVs) containing the two B lineages should address this issue. Our study estimates their impact by assessing what would have been the US public health benefit of routinely vaccinating with QIV in 2000-2013. METHODS We developed a dynamic compartmental model that accounts for interactions between influenza B lineages (natural or vaccine-induced) and simulates the multiyear influenza dynamics for 2000-2013. Age-structured population dynamics, vaccine efficacy (VE) per strain, and weekly ramp-up of vaccination coverage are modeled. Sensitivity analyses were performed on VE, duration of immunity, and levels of vaccine-induced cross-protection between B lineages. RESULTS Assuming a cross-protection of 70% of the VE of the matched vaccine, the model predicts 16% more B lineage cases prevented by QIV. Elderly (≥65 years) and young seniors (50-64 years) benefit most from QIV, with 21% and 18% reductions in B lineage cases. Reducing cross-protection to 50%, 30%, and 0% of the VE of the matched vaccine improves the relative benefit of QIV to 25%, 30%, and 34% less B lineage cases. CONCLUSION Using a dynamic retrospective framework with real-life vaccine mismatch, our analysis shows that QIV routine vaccination in the United States has the potential to substantially reduce the number of influenza infections, even with relatively high estimates of TIV-induced cross-protection.
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Affiliation(s)
- Pascal Crépey
- EHESP Rennes, Sorbonne Paris-cité, Paris, France.,Aix-Marseille Univ, UMR EPV Emergence des Pathologies Virales-190, Marseille, France
| | - Pieter T de Boer
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Maarten J Postma
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.,Institute of Science in Healthy Aging & health caRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
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Pivette M, Mueller JE, Crépey P, Bar-Hen A. Drug sales data analysis for outbreak detection of infectious diseases: a systematic literature review. BMC Infect Dis 2014; 14:604. [PMID: 25403237 PMCID: PMC4240820 DOI: 10.1186/s12879-014-0604-2] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 10/31/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This systematic literature review aimed to summarize evidence for the added value of drug sales data analysis for the surveillance of infectious diseases. METHODS A search for relevant publications was conducted in Pubmed, Embase, Scopus, Cochrane Library, African Index Medicus and Lilacs databases. Retrieved studies were evaluated in terms of objectives, diseases studied, data sources, methodologies and performance for real-time surveillance. Most studies compared drug sales data to reference surveillance data using correlation measurements or indicators of outbreak detection performance (sensitivity, specificity, timeliness of the detection). RESULTS We screened 3266 articles and included 27 in the review. Most studies focused on acute respiratory and gastroenteritis infections. Nineteen studies retrospectively compared drug sales data to reference clinical data, and significant correlations were observed in 17 of them. Four studies found that over-the-counter drug sales preceded clinical data in terms of incidence increase. Five studies developed and evaluated statistical algorithms for selecting drug groups to monitor specific diseases. Another three studies developed models to predict incidence increase from drug sales. CONCLUSIONS Drug sales data analyses appear to be a useful tool for surveillance of gastrointestinal and respiratory disease, and OTC drugs have the potential for early outbreak detection. Their utility remains to be investigated for other diseases, in particular those poorly surveyed.
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Affiliation(s)
- Mathilde Pivette
- EHESP French School of Public Health, Sorbonne Paris Cité, Rennes, France.
- Université Paris Descartes, MAP5, Paris, France.
- Celtipharm, Vannes, France.
| | - Judith E Mueller
- EHESP French School of Public Health, Sorbonne Paris Cité, Rennes, France.
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France.
| | - Pascal Crépey
- EHESP French School of Public Health, Sorbonne Paris Cité, Rennes, France.
- Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, UMR_D 190 "Emergence des Pathologies Virales", Marseille, France.
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De Boer PT, Pitman RJ, Macabeo B, Chit A, Postma MJ, Crépey P. Cost-Effectiveness of Quadrivalent Versus Trivalent Influenza Vaccine in the United States. Value Health 2014; 17:A679. [PMID: 27202508 DOI: 10.1016/j.jval.2014.08.2528] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- P T De Boer
- University of Groningen, Groningen, The Netherlands
| | | | | | - A Chit
- Sanofi Pasteur, Toronto, ON, Canada
| | - M J Postma
- University of Groningen, Groningen, The Netherlands
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Crépey P, de Boer P, Postma MJ, Pitman RJ. Retrospective Public Health Impact of a Quadrivalent Influenza Vaccine in the United States Over the Period 2000-2014. Value Health 2014; 17:A664-A665. [PMID: 27202425 DOI: 10.1016/j.jval.2014.08.2446] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- P Crépey
- EHESP; UMR190-EPV, Rennes, France
| | - P de Boer
- University of Groningen, Groningen, The Netherlands
| | - M J Postma
- University of Groningen, Groningen, The Netherlands
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Pivette M, Mueller JE, Crépey P, Bar-Hen A. Surveillance of gastrointestinal disease in France using drug sales data. Epidemics 2014; 8:1-8. [DOI: 10.1016/j.epidem.2014.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 05/02/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022] Open
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Isnard H, Helynck B, Crépey P. Perception et usage de la cigarette électronique et du tabac dans une population étudiante, enquête IDEA 2014. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.034] [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: 10/24/2022] Open
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Genow J, Boyd A, Tillaut H, Demillac R, Crépey P. Étude transversale des pratiques de diagnostics et de traitement de la gale par les médecins : un faible suivi des recommandations pourrait expliquer l’épidémie. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Crépey P, Pivette M, Desvarieux M. Potential impact of influenza A/H1N1 pandemic and hand-gels on acute diarrhea epidemic in France. PLoS One 2013; 8:e75226. [PMID: 24124479 PMCID: PMC3790785 DOI: 10.1371/journal.pone.0075226] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 09/20/2012] [Accepted: 08/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The 2009 A/H1N1 influenza pandemic has received a great deal of attention from public health authorities. Our study examines whether this pandemic and the resulting public health measures could have impacted acute diarrhea, a prevalent, highly transmissible and historically monitored disease. METHODS Using augmentation procedures of national data for the previous five years (2004-2009), we estimated the expected timing and incidence of acute diarrhea in France in 2009-2010 and evaluated differences with the observed. We also reviewed national hand gels for the same period. FINDINGS Number of episodes of acute diarrhea in France in 2009-2010 was significantly lower than expected until the third week of December (-24%, 95% CI [-36%; -9%]), then significantly higher (+40%, 95% CI [22%; 62%]), leading to a surplus of 574,440 episodes. The epidemic was delayed by 5 weeks with a peak 1.3 times higher than expected. Hand-gels sales inversely correlated with incidence of both influenza-like illness and acute diarrheal disease. Among individuals >65 yo, no excess cases of influenza and no excess rebound in acute diarrhea were observed, despite similar delay in the onset of the seasonal diarrheal epidemic. INTERPRETATION Our results suggest that at least one endemic disease had an unexpected behavior in 2009-2010. Acute diarrhea seems to have been controlled during the beginning of the pandemic in all age groups, but later peaked higher than expected in the younger population. The all-age delay in seasonal onset seems partly attributable to hand-gels use, while the differential magnitude of the seasonal epidemic between young and old, concurrent for both influenza and acute diarrhea, is compatible with disease interaction.
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Affiliation(s)
- Pascal Crépey
- École des hautes études en santé publique Rennes, Sorbonne Paris Cité, Paris, France
- UMR EPV Emergence des Pathologies Virales –190, Aix-Marseille University, Marseille, France
| | - Mathilde Pivette
- École des hautes études en santé publique Rennes, Sorbonne Paris Cité, Paris, France
- MAP5, Université René Descartes-Paris5, Paris, France
| | - Moïse Desvarieux
- École des hautes études en santé publique Rennes, Sorbonne Paris Cité, Paris, France
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, United States of America
- U 738, Institut National de la Santé et de la Recherche Médicale, Paris, France
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Kieffer A, Paboriboune P, Crépey P, Flaissier B, Souvong V, Steenkeste N, Salez N, Babin FX, Longuet C, Carrat F, Flahault A, de Lamballerie X. 2009 A(H1N1) seroconversion rates and risk factors among the general population in Vientiane Capital, Laos. PLoS One 2013; 8:e61909. [PMID: 23637928 PMCID: PMC3630132 DOI: 10.1371/journal.pone.0061909] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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: 11/10/2012] [Accepted: 03/14/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess 2009 A(H1N1) seroconversion rates and their determinants within an unvaccinated population in Vientiane Capital, Laos. METHODS CoPanFlu Laos, a general population cohort of 807 households and 4,072 participants was established in March 2010. Sociodemographic data, epidemiological data, and capillary blood samples were collected from all the household members in March, and again in October 2010, in order to assess the level of antibodies to 2009 A(H1N1) with the haemagglutination inhibition assay. 2009 A(H1N1) seroconversion was defined as a fourfold or greater increase in titre between inclusion and follow-up. Determinants for pandemic influenza infection were studied using the generalized estimating equations model, taking household clustering into account. RESULTS Between March and November 2010, 3,524 paired sera were tested. Prior to the pandemic, our cohort was almost completely vaccine-naive for seasonal influenza. The overall seroconversion rate among nonvaccinated individuals (n = 2,810) was 14.3% (95%CI [13.0, 15.6]), with the highest rate for participants under 20 yo (19.8%, 95%CI [17.4, 22.4]) and the lowest rate for participants over 60 yo (6.5%, 95%CI [3.7, 10.4]). Participants with lower baseline titres had significantly higher infection rates, with a dose-effect relationship. Odds ratios (ORs) ranged from 76.5 (95%CI [27.1, 215.8]), for those with a titre at inclusion of 1∶10, to 8.1 (95%CI [3.3, 20.4]), for those with a titre of 1∶40. Having another household member with a titre ≥1∶80 was associated with a higher likelihood of immunity (OR = 3.3, 95%CI [2.8, 3.9]). CONCLUSION The determinants and age distribution for seroconversion within a vaccine-naive population were similar to those found in developed countries. This pandemic was characterized by strong epidemiological determinants, regardless of geographical zone and level of development. Moreover, we detected pre-existing cross-reacting antibodies in participants over 60 yo, which could not have originated from former multiple vaccination as has been suggested elsewhere.
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Affiliation(s)
- Alexia Kieffer
- UMR 190, Aix-Marseille Université - IRD - EHESP, Marseille, France.
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Crépey P, Pivette M, Bar-Hen A. Quantitative assessment of preventive behaviors in France during the Fukushima nuclear crisis. PLoS One 2013; 8:e58385. [PMID: 23505499 PMCID: PMC3591339 DOI: 10.1371/journal.pone.0058385] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 09/20/2012] [Accepted: 02/04/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The Fukushima nuclear disaster has generated worldwide concern on the risk of exposure to nuclear radiations. In Europe, health authorities had to issue statements about the lack of usefulness of iodine based preventive treatments within their borders. However a lack of confidence in official messages has developed in various European countries due to recent perceived failures in managing public health crises. The lay population preventive behaviors in this context are largely unknown. Consequently, to examine the effects of public health crisis on lay behaviors leading to pharmaceuticals purchases, we studied the sales of iodine-based products in France before, during and after the crisis. METHODS We focused our study on 58 iodine-based drugs available with and without a physician prescription. Our data came from a stratified sample of 3004 pharmacies in metropolitan France. Our study period was from January 2010 to April 2012, with a focus on March-April 2011. We differentiated sales of drugs prescribed by physicians from sales of drugs obtained without a prescription. We used a CUSUM method to detect abnormal increases in sales activity and cross-correlations to assess shifts in sales timing. RESULTS Sales of iodine-based nutritional complements, and later sales of iodine-based homeopathic remedies, substantially increased (up to 3-fold) during a period of 20 days. Their temporal patterns were correlated to specific events during the crisis. Prescriptions for iodine-based homeopathy increased (up to 35% of all sales). Iodine pills, strictly regulated by health authorities, have also been sold but on a very small scale. CONCLUSION These results indicate uncontrolled preventive behaviors resulting in the potentially unjustifiable consumption of available drugs. They have implications in public policy, and demonstrate the usefulness of drug sales surveillance for instantaneous evaluation of population behavior during a global crisis.
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Giglio N, Gentile A, Lees L, Micone P, Armoni J, Reygrobellet C, Crépey P. Public health and economic benefits of new pediatric influenza vaccination programs in Argentina. Hum Vaccin Immunother 2012; 8:312-22. [PMID: 22330959 PMCID: PMC3426079 DOI: 10.4161/hv.18569] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Argentina’s population was heavily affected by the 2009 influenza pandemic, particularly children, in whom incidence of seasonal influenza is consistently high. Following the pandemic, Argentinean national recommendations for pediatric vaccination against A/H1N1 influenza were defined for all children aged up to five years, in line with programs implemented by national authorities elsewhere. Economic evaluations have found that vaccination programs for this population against seasonal influenza are cost-effective, if not cost-saving in many countries. Recently, Argentina decided to routinely vaccinate against influenza children aged 6–23 mo-old. But, the economic value of such strategies for the country has never been assessed.
Methods: A model was developed to assess the value of four different vaccination strategies: (1) no pediatric vaccination; (2) vaccination of 6–23 mo-old children; (3) vaccination of 6–36 mo-old children; (4) vaccination of 6 mo−5 y-old children. We first estimated community health benefits of vaccination then we evaluated the economic and quality-of-life impact of these strategies on the population. Data used in the model come from surveillance networks, published literature, national databases and retrospective hospital-based data. Results: Pediatric influenza vaccination benefited not only children but also the overall community, due to decreased disease transmission. Our results showed that the recent decision by Argentina to vaccinate 6–23 mo-old children is cost-effective as would be the incremental vaccination of broader age groups. Conclusions: Results from this study are consistent with previous analyses in other countries confirming that implementing influenza pediatric vaccination programs can be highly cost-effective through individual- and community protection against the disease.
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Affiliation(s)
- Norberto Giglio
- Epidemiología Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
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Crépey P, Getsios D. Underestimation of Invasive Meningococcal Disease Case Fatality Rates. Clin Infect Dis 2009; 49:1136-7; author reply 1137. [DOI: 10.1086/605599] [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: 11/04/2022] Open
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