scholarly journals Characteristics of hospitalizations with influenza diagnosis, France, 2012-2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Pivette ◽  
V de Lauzun ◽  
N Nicolay ◽  
A Scanff ◽  
B Hubert
Keyword(s):  
Length Of Stay ◽  
Diagnosis Related Groups ◽  
Laboratory Data ◽  
Incidence Rates ◽  
H3n2 Virus ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Age Group ◽  
Hospital System ◽  
The Impact

Abstract Background Seasonal influenza surveillance in France is based on several data sources (ambulatory data, emergency department and intensive care unit (ICU) admissions, laboratory data, mortality). However, the data do not provide a complete measure of the impact of the epidemics on the hospital system. The objective of the study was to describe the characteristics of influenza hospitalizations from the French national hospital discharge database (PMSI) between 2012 and 2017 and to precise the burden of influenza by age group and by season. Methods All hospitalizations in metropolitan France with at least one ICD-10 code related to influenza (J09, J10, J11) as a principal, related or associated diagnosis between 1 July 2012 to 30 June 2017 were extracted from the PMSI. For each season, the total number of hospitalizations, admissions to ICU, incidence and lethality rates, lengths of stay and classification in diagnosis-related groups were described by age group. Results During the 5 seasons, 91 255 hospitalizations with an influenza-diagnosis were identified. The incidence varied significantly between seasons, from 12.7/100 000 in 2013-2014 to 45.9/100 000 in 2016-2017. A high number of cases was observed in elderlies in 2014-2015 and 2016-2017, marked by the circulation of A (H3N2) virus. The proportion of hospitalizations with an admission in ICU was 10%, and was higher in the 40-79 age group (19%). Lethality increased steadily with age, from 0.5% under 20 years to 10% in 80 years and older. Length of stay also increased with age. Significant regional disparities were observed, with higher incidence rates in South-Eastern France each season. Conclusions The analysis of influenza hospitalizations from the PMSI provides important elements on influenza burden, not available in the current surveillance systems. An annual analysis, stratified by age group, would provide an indicator of the impact of the epidemics on hospital system at the end of each influenza season. Key messages Important influenza incidence variations were observed between seasons by age groups. Severity and impact of influenza (mortality, ICU, length of stay) varied significantly by age group.

scholarly journals Vaccine impact and effectiveness of meningococcal serogroup ACWY conjugate vaccine implementation in the Netherlands: a nationwide surveillance study

2021 ◽  
Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Incidence Rate ◽  
Vaccination Programme ◽  
Screening Method ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Mass Campaign ◽  
Conjugate Vaccination ◽  
The Impact

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.

scholarly journals Differences among U.S. States in Estimating the Number of People Living with HIV/AIDS: Impact on Allocation of Federal Ryan White Funding

2007 ◽  
Vol 122 (5) ◽  
pp. 644-656 ◽  
Author(s):  
Denis Nash ◽  
Evie Andreopoulos ◽  
Deborah Horowitz ◽  
Nancy Sohler ◽  
David Vlahov
Keyword(s):  
Viral Load ◽  
Laboratory Data ◽  
People Living With Hiv ◽  
Surveillance Systems ◽  
Detectable Viral Load ◽  
Hiv Positive Women ◽  
Ryan White ◽  
Immunodeficiency Syndrome ◽  
The Impact ◽  
Hiv Aids

Objective. We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds. Methods. We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios: CD4<200 cells/μL and detectable viral load (Scenario A); CD4<500 cells/μL and no viral load reporting (Scenario B); and CD4<500 cells/μL and detectable viral load (Scenario C). Results. Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1: 69.0%, Year 4: 88.1%), followed by Scenario A (Year 1: 63.3%, Year 4: 84.5%), and Scenario B (Year 1: 43.0%, Year 4: 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%). Conclusions. Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems.

scholarly journals Evaluation of Point of Need Diagnostic Tests for Use in California Influenza Outbreaks

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Ashlynn Daughton ◽  
Alina Deshpande
Keyword(s):  
Data Streams ◽  
Surveillance System ◽  
Laboratory Data ◽  
Developed Countries ◽  
The United States ◽  
Diagnostic Tools ◽  
Influenza Surveillance ◽  
Mortality Data ◽  
Surveillance Systems ◽  
Influenza Outbreaks

Because of the potential threats flu viruses pose, the United States, like many developed countries, has a very well established flu surveillance system consisting of 10 components collecting laboratory data, mortality data, hospitalization data and sentinel outpatient care data. Currently, this surveillance system is estimated to lag behind the actual seasonal outbreak by one to two weeks. As new data streams come online, it is important to understand what added benefit they bring to the flu surveillance system complex. For data streams to be effective, they should provide data in a more timely fashion or provide additional data that current surveillance systems cannot provide. Two multiplexed diagnostic tools designed to test syndromically relevant pathogens and wirelessly upload data for rapid integration and interpretation were evaluated to see how they fit into the influenza surveillance scheme in California.

scholarly journals Epidemiology of acute rubella infection in Zambia during the pre-vaccination period (2005 – 2016) as a baseline for monitoring rubella epidemiology in the post-rubella vaccine introduction era

2019 ◽  
Author(s):  
Mazyanga Lucy Mazaba ◽  
Seter Siziya ◽  
Mwaka Monze ◽  
Daniel Cohen
Keyword(s):  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Laboratory Data ◽  
Health Concern ◽  
Age Group ◽  
Childbearing Age ◽  
Rubella Vaccine ◽  
Vaccine Introduction ◽  
Hot Dry Season ◽  
The Impact

Abstract Background: Rubella is highly under reported in Zambia as in most sub-Saharan countries despite being a disease of major public health concern especially among women of childbearing age. In September 2016, Zambia introduced a combined measles-rubella vaccine in children 0-14 years. In this study, we estimated the proportion positive for acute rubella among suspected but negative measles cases between 2005 and 2016 and determined its correlates for monitoring rubella epidemiology post-rubella vaccine introduction. Methods: In a retrospective study, 4497 measles IgM negative serum samples from 5686 clinically suspected measles cases were examined for rubella IgM antibodies using the Siemens, Enzygnost® ELISA kit at the national measles laboratory. Data on demographics, year and month of onset were extracted from the surveillance data. Multivariate logistic regression analysis using backward variable selection was conducted to determine independent predictors for acute rubella. The magnitude of association was estimated using adjusted odds ratio with a 95% confidence interval. Results: Overall, a proportion of 29.2% (1313/4497) affecting mostly those between 5 and 24 years was determined. Only age, province, month and year were independently associated with acute rubella. The regional proportions varied from 21.8 – 37.3% peaking in the month of October. Persons in the age group 10-14 years (Adjusted Odds Ratio [AOR]=2.43; 95% CI [2.01 - 2.95]) were more likely while those aged <1 year less likely (AOR=0.31; 95% CI [021 - 0.48]) to have acute rubella compared to those aged 25 years or older. Persons in 2010 were less likely (AOR=0.12; CI [0.05, 0.28]) to have acute rubella compared to those in 2016. While acute rubella was more likely to occur between July and November compared to December, it was less likely to occur between February and May. Conclusions: Rubella virus was circulating in Zambia between 2005 and 2016 affecting mostly persons in the age group 5-24 years peaking in the hot dry season month of October. Although vaccination against rubella has been launched, these baseline data are important to provide a reference point when determining the impact of the vaccination program implemented. Keywords: Rubella, Acute, Proportion, Correlates, Zambia, Pre vaccination era, Immunisation

Effect of Red Blood Cell Transfusions on Clinical Outcomes in Critically Ill Children

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3851-3851
Author(s):  
Irina B. Pateva ◽  
Steven L Shein ◽  
MaryAnn O'Riordan ◽  
Sanjay P Ahuja
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Blood Cell ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Age Groups ◽  
Critically Ill Children ◽  
Age Group ◽  
Vasoactive Agents ◽  
The Impact

Abstract Introduction: The association of packed Red Blood Cell (pRBC) transfusions with worse outcomes in critically ill adults is well documented. The impact of pRBC transfusions on clinical outcomes in critically ill children, however, has not been well studied. Associations of pRBCs with outcomes such as mortality and length of stay need to be studied in large clinical databases. This will lead to improvement of our knowledge and generation of guidelines for transfusions in children hospitalized in the Pediatric Intensive Care Units (PICU). Methods: With IRB approval, the Pediatric Health Information System (PHIS) database was queried for children ≤ 18 years admitted to the PICU, receiving pRBC transfusions between January 2011 and December 2015. The PHIS is a database that captures de-identified patient information from 45 pediatric hospitals in the US. The patients of this study were stratified by age groups: less than 1 month of age; 1 month to < 3years; 3 to <10 years; 10 to < 15 years and 15 to 18 years. Patients with underlying hematological or oncological diagnoses and who had undergone HSCT were excluded from the study. Information regarding major comorbidities such as mechanical ventilation, sepsis, use of vasoactive agents, acute kidney injury (AKI) and post-operative state were extracted. Patients who received pRBCs and who did not receive pRBCs were included in the analyses. The primary outcomes were Length of Stay (LOS) and mortality. Multiple linear and logistic regression analyses were performed to define the association between pRBC transfusions and outcomes and to control for sepsis, mechanical ventilation, vasoactive medications, post-operative state and AKI. Data are shown as median (IQR). Results: Of the 393,384 patients who met the inclusion criteria, 43,569 (11%) had transfusions, with 97.2% of the patients receiving only 1 transfusion. The median (IQR) overall length of stay was 5.0 days (2, 10) and the overall mortality was 3.1%. The median (IQR) LOS for those who received pRBCs was 13 days (6, 29) compared to 4.0 days (2, 8) for those who did not. Mortality for those who received pRBCs was 10.1% compared to 2.2% for those who did not. The highest rate of pRBC transfusion was noted in the patients less than 1 month old (22%). The highest unadjusted mortality for patients who received pRBCs was also in the same age group- 7%. The associations between transfusion of pRBCs and outcomes are summarized in Table 1. Of the 393,384 patients, 19,686 (5.0 %) had sepsis; 143,085 (36.4%) were on mechanical ventilation; 141,123 (35.9%) were on vasoactive agents and 14,243 (3.6%) had AKI. After adjusting for sepsis, mechanical ventilation, use of vasoactive agents, post-op state and AKI, pRBC transfusions were associated with significantly increased LOS for all age groups. The highest increase in LOS was noted for the infants younger than 1 month of age - by 11.6 days (p<0.001). The mortality was also increased in patients who received PRBCs, when adjusted for other comorbidites, the highest risk was for patients in the age group of 15 to 18 years old: OR 2.50 (95% CI 2.14- 2.93). Conclusions: In this large, multicenter database study, we identified an association of increased mortality and LOS in critically ill children who received pRBC transfusions. More studies are needed to further investigate the impact of blood transfusions on clinical outcomes in the pediatric population. Disclosures No relevant conflicts of interest to declare.

Absenteeism in schools during the 2009 influenza A(H1N1) pandemic: a useful tool for early detection of influenza activity in the community?

2011 ◽  
Vol 140 (7) ◽  
pp. 1328-1336 ◽  
Author(s):  
E. O. KARA ◽  
A. J. ELLIOT ◽  
H. BAGNALL ◽  
D. G. F. FOORD ◽  
R. PNAISER ◽  
...  
Keyword(s):  
Syndromic Surveillance ◽  
Influenza A ◽  
Laboratory Data ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
H1n1 Pandemic ◽  
School Absenteeism ◽  
Sentinel Network ◽  
Influenza A H1n1 ◽  
Influenza Activity

SUMMARYCertain influenza outbreaks, including the 2009 influenza A(H1N1) pandemic, can predominantly affect school-age children. Therefore the use of school absenteeism data has been considered as a potential tool for providing early warning of increasing influenza activity in the community. This study retrospectively evaluates the usefulness of these data by comparing them with existing syndromic surveillance systems and laboratory data. Weekly mean percentages of absenteeism in 373 state schools (children aged 4–18 years) in Birmingham, UK, from September 2006 to September 2009, were compared with established syndromic surveillance systems including a telephone health helpline, a general practitioner sentinel network and laboratory data for influenza. Correlation coefficients were used to examine the relationship between each syndromic system. In June 2009, school absenteeism generally peaked concomitantly with the existing influenza surveillance systems in England. Weekly school absenteeism surveillance would not have detected pandemic influenza A(H1N1) earlier but daily absenteeism data and the development of baselines could improve the timeliness of the system.

scholarly journals Varicella vaccination as useful strategy for reducing the risk of varicella-related hospitalizations

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Marrella ◽  
A Casuccio ◽  
E Amodio ◽  
F Vitale
Keyword(s):  
Vaccination Coverage ◽  
Age Groups ◽  
Incidence Rates ◽  
Varicella Vaccination ◽  
Age Group ◽  
Annual Percent Change ◽  
High Coverage ◽  
Joint Point ◽  
Hospitalization Rates ◽  
The Impact

Abstract Introduction The present study summarizes evidences of the impact of varicella vaccination (VV) on hospitalization rates attributable to this infectious disease in Italy. Methods We have carried out a retrospective observational study that analysed hospital discharge records and VV coverage at 24 months collected from 2003 to 2018 by the Italian Health Ministry. All hospitalizations with the presence of an ICD-9 CM 059.X code in the principal diagnosis or in any of the five secondary diagnoses were considered as related to varicella. The hospitalization rate reduction was evaluated by calculating average annual percent change (AAPC) through joint-point analysis. Results Hospitalization rates showed a decreasing risk by age: children aged &lt;1 year were the most affected age group in each region (42.56/100,000 per year), whereas lower incidence rates were found in older age groups (23.76/100,000 in 1 to 5 years age group and &lt;4/100,000 in the following groups). Varicella hospitalization rates decreased significantly after the introduction of VV (3.42 vs. 2.67 per 100,000; P &lt; 0.001). During the first five years after vaccination introduction hospitalization rates showed a statistically significant decrease especially for infants aged &lt;1 year (AAPC -34.98%; p &lt; 0.001) and 1 to 5 years old (AAPC -35.22%; P &lt; 0.01). VV coverage was strongly correlated with hospitalization rates decrease over each paediatric age group (R-squared 0.38 in aged &lt;1 year, p &lt; 0.001; 0.71 in 1 to 5 years old, p &lt; 0.001; 0.93 in 6 to 14 years old, p &lt; 0.0001). Conclusions All the previously reported findings confirm that hospitalization rates are strictly related to both the number of years since vaccination introduction and the vaccination coverage. VV confirms to be an important step in public health strategies and the introduction of universal vaccination, with high vaccination coverage, should be considered as an extremely powerful tool for reducing the risk of complications. Key messages This study adds update findings to the literature and shows that varicella hospitalizations in Italy, from 2003 to 2018, have reduced their burden, that was high in years before varicella vaccination. Varicella vaccination introduction and high coverage are powerful tools for reducing the risk of varicella complications and related hospitalizations in the general population.

scholarly journals Media Reports as a Source for Monitoring Impact of Influenza on Hospital Care

10.2196/14627 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e14627
Author(s):  
Daphne FM Reukers ◽  
Sierk D Marbus ◽  
Hella Smit ◽  
Peter Schneeberger ◽  
Gé Donker ◽  
...  
Keyword(s):  
Content Analysis ◽  
Real Time ◽  
Hospital Admissions ◽  
Monitoring Program ◽  
Influenza Surveillance ◽  
Surveillance Systems ◽  
Suitable Alternative ◽  
Hospital Capacity ◽  
Media Reports ◽  
The Impact

Background The Netherlands, like most European countries, has a robust influenza surveillance system in primary care. However, there is a lack of real-time nationally representative data on hospital admissions for complications of influenza. Anecdotal information about hospital capacity problems during influenza epidemics can, therefore, not be substantiated. Objective The aim of this study was to assess whether media reports could provide relevant information for estimating the impact of influenza on hospital capacity, in the absence of hospital surveillance data. Methods Dutch news articles on influenza in hospitals during the influenza season (week 40 of 2017 until week 20 of 2018) were searched in a Web-based media monitoring program (Coosto). Trends in the number of weekly articles were compared with trends in 5 different influenza surveillance systems. A content analysis was performed on a selection of news articles, and information on the hospital, department, problem, and preventive or response measures was collected. Results The trend in weekly news articles correlated significantly with the trends in all 5 surveillance systems, including severe acute respiratory infections (SARI) surveillance. However, the peak in all 5 surveillance systems preceded the peak in news articles. Content analysis showed hospitals (N=69) had major capacity problems (46/69, 67%), resulting in admission stops (9/46, 20%), postponement of nonurgent surgical procedures (29/46, 63%), or both (8/46, 17%). Only few hospitals reported the use of point-of-care testing (5/69, 7%) or a separate influenza ward (3/69, 4%) to accelerate clinical management, but most resorted to ad hoc crisis management (34/69, 49%). Conclusions Media reports showed that the 2017/2018 influenza epidemic caused serious problems in hospitals throughout the country. However, because of the time lag in media reporting, it is not a suitable alternative for near real-time SARI surveillance. A robust SARI surveillance program is important to inform decision making.

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