Characterizing the epidemiology, virology, and clinical features of influenza in China’s first severe acute respiratory infection sentinel surveillance system, February 2011 – October 2013

Peng, Zhibin; Feng, Luzhao; Carolyn, Greene M; Wang, Kaili; Zhu, Guozhong; Zhang, Yequn; Hu, Jumei; Huang, Yiwei; Hui-qiong, Pan; Guo, Nongjian; Xing, Chengzhong; Chu, Yanhui; Zong-xun, Cao; Yu, Deshan; Liu, Linling; Chen, Zeling; Zeng, Fang; Xu, Wen; Xiong, Xi; Cheng, Xiuwei; Hua, Guo; Wu, Chen; Li, Ling; Jiang, Hui; Zheng, Jiandong; Xu, Zhihua; Yu, Hongjie

doi:10.1186/s12879-015-0884-1

Cited by 31 publications

(38 citation statements)

References 7 publications

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“…It was very similar to the findings in Kenya, 26.7% [25] but lower than in Rwanda, 29.2% [26]. The influenza positivity rate for SARI samples was 3.1% which was low compared to findings in South Africa and China which reported 8% and 6% respectively [27, 28]. Our data showed that relatively the influenza positivity rate (27.9%) from outbreak sites was high.…”

Section: Discussionsupporting

confidence: 86%

Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009–2015

et al. 2018

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BackgroundInfluenza is an acute viral disease of the respiratory tract which is characterized by fever, headache, myalgia, prostration, coryza, sore throat and cough. Globally, an estimated 3 to 5 million cases of severe influenza illness and 291 243–645 832 seasonal influenza-associated respiratory deaths occur annually. Although recent efforts from some African countries to describe burden of influenza disease and seasonality, these data are missing for the vast majority, including Ethiopia. Ethiopia established influenza sentinel surveillance in 2008 aiming to determine influenza strains circulating in the country and know characteristics, trend and burden of influenza viruses.MethodsWe used influenza data from sentinel surveillance sites and respiratory disease outbreak investigations from 2009 to 2015 for this analysis. We obtained the data by monitoring patients with influenza-like illness (ILI) at three health-centers, severe acute respiratory infection (SARI) at five hospitals and investigating patients during different respiratory infection outbreaks. Throat-swab specimens in viral transport media were transported to the national reference laboratory within 72 h of collection using a cold-chain system. We extracted viral RNA from throat-swabs and subjected to real-time PCR amplification. We further subtyped and characterized Influenza A-positive specimens using CDC real-time reverse transcription PCR protocol.ResultsA total of 4962 throat-swab samples were collected and 4799 (96.7%) of them were tested. Among them 988 (20.6%) were influenza-positive and of which 349 (35.3%) were seasonal influenza A(H3N2), 321 (32.5%) influenza A(H1N1)pdm2009 and 318 (32.0%) influenza B. Positivity rate was 29.5% in persons 5–14 years followed by 26.4% in 15–44 years, 21.2% in > 44 years and 6.4% in under five children. The highest positivity rate observed in November (37.5%) followed by March (27.6%), December (26.4%), October (24.4%) and January (24.3%) while the lowest positivity rate was in August (7.7%).ConclusionIn Ethiopia, seasonal Influenza A(H3N2), Influenza A(H1N1)pdm2009 and Influenza B viruses were circulating during 2009–2015. Positivity rate and number of cases peaked in November and December. Influenza is one of public health problems in Ethiopia and the need to introduce influenza vaccine and antivirus is important to prevent and treat the disease in future.

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Section: Discussionsupporting

confidence: 86%

Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009–2015

et al. 2018

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“…The independent risk factors for mortality that were identified in this analysis, age ≥ 65 years and ICU admission, are consistent with those found in a limited number of studies reporting risk factors for mortality in all SARI patients [20,24]. Of 1790 adult and adolescent SARI patients in China, age ≥ 65 years was a significant risk factor for severe SARI outcomes (ICU admission or death) [21].…”

Section: Discussionsupporting

confidence: 86%

Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010–2014

et al. 2018

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BackgroundFrom October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults ≥ 65 years old.The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality.MethodsPatients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled. Demographic data were used to link SARI patients to Arizona death certificates. Mortality within 30 days after the date of admission was calculated and risk factors were identified using logistic regression models.ResultsAmong 258 SARI patients, 47% were females, 51% were white, non-Hispanic and 39% were Hispanic. The median age was 63 years (range, 19 to 97 years) and 80% had one or more pre-existing health condition; 9% died in hospital. Mortality increased to 12% (30/258, 30% increase) when electronic vital records and a 30-day post-hospitalization time frame were used. Being age ≥ 65 years (OR = 4.0; 95% CI: 1.6–9.9) and having an intensive care unit admission (OR = 7.4; 95% CI: 3.0–17.9) were independently associated with mortality.ConclusionThe use of electronic vital records increased SARI-associated mortality estimates by 30%. These findings may help guide prevention and treatment measures, particularly in high-risk persons in this highly fluid border population.

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“…( 13 , 14 , 28 ) All three studies reported that influenza-associated hospitalization was higher among children of older age groups than among children aged < 2 years. Similar percentage of influenza-contributed respiratory hospitalizations among children < 18 years was also estimated from the global report ( 14 ) with 7.7% in developing countries and 8.5% in the WHO Western Pacific Region.…”

Section: Discussionmentioning

confidence: 99%

“…This case definition is more sensitive than the strict SARI definition used in the surveillance system during 2011–2013. ( 13 ) In most populated developing country hospitals, including hospitals that conduct surveillance associated with severe outcomes of a respiratory virus, busy clinicians examining patients describe the patient’s general condition related with ARI rather than list numerous signs and symptoms in detail. ( 30 ) For future surveillance on influenza-associated severe outcomes, if clinicians are responsible for case enrolment or if enrolment is based on patient chart review, standardization and simplification of the case definition are encouraged to improve case capture and surveillance quality.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, SARI sentinel site surveillance uses a modified version of the WHO SARI case definition which includes different criteria for patients aged > 5 years and ≤ 5 years and is also more specific. ( 13 ) Therefore, SARI surveillance likely underestimates the impact of influenza-associated hospitalizations nationwide, particularly those that do not fall within the strict SARI case definition. The contribution of influenza among respiratory hospitalizations in children aged < 18 years remains a key knowledge gap.…”

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confidence: 99%

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Influenza-associated paediatric respiratory hospitalizations in China, 1996–2012: a systematic analysis

Shang

Lafond

McFarland

et al. 2018

WPSAR

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Background: The World Health Organization recommends that children aged >= 6 months be vaccinated against influenza. Influenza vaccination policies depend on the evidence of the burden of influenza, yet few national data on influenza-associated severe outcomes among children exist in China. Methods: We conducted a systematic review of articles published from 1996 to 2012 on laboratory-confirmed, influenza-associated paediatric respiratory hospitalizations in China. We extracted data and stratified the percentage of samples testing positive for influenza by age group (< 2, < 5 and < 18 years old); case definition; test methods; and geographic location. The pooled percentage of samples testing positive for influenza was estimated with a random effects regression model. Results: Influenza was associated with 8.8% of respiratory hospitalizations among children aged < 18 years, ranging from 7.0% (95% confidence interval: 4.2–9.8%) in children aged < 2 years to 8.9% (95% confidence interval: 6.8–11%) in children aged < 5 years. The percentage of samples testing positive for influenza was consistently higher among studies with data from children aged < 5 years and < 18 years than those restricted only to children aged < 2 years; the percentages were higher in Northern China than Southern China. Discussion: Influenza is an important cause of paediatric respiratory hospitalizations in China. Influenza vaccination of school-aged children could prevent substantial influenza-associated illness, including hospitalizations, in China.

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Characterizing the epidemiology, virology, and clinical features of influenza in China’s first severe acute respiratory infection sentinel surveillance system, February 2011 – October 2013

Cited by 31 publications

References 7 publications

Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009–2015

Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009–2015

Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010–2014

Influenza-associated paediatric respiratory hospitalizations in China, 1996–2012: a systematic analysis

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